Intertrigo

Intertrigo is a common condition found where two opposing skin surfaces rub together. It occurs in both normal and obesity-related skin folds. Infants, children, and the elderly are most commonly affected. Warm, humid weather and obesity are also predisposing factors. The inflammation associated with intertrigo results from friction, heat, and moisture, which also predisposes the skin to infection by bacteria, yeasts, and fungus.

Presentation:
Intertrigo presents as red, moist patches in the skin folds with possible fissuring or breakdown of the skin surface. It is most commonly found in the groin, armpits, and the folds under the breasts. Intertrigo may also affect the umbilicus (belly-button), finger and toe webs, and the creases of the arms, neck, and eyelids. Affected individuals may experience itching and burning. Other skin conditions may present similarly to intertrigo, including seborrheic dermatitis, psoriasis, and erythrasma (a superficial bacterial infection of the skin folds).

Treatment:
One of the most important therapies for intertrigo involves the reduction of friction and moisture (gauze, powders). Low-potency topical corticosteroid creams may help to reduce inflammation. Topical antifungal and antimicrobial agents are often necessary to eradicate yeasts/fungus and bacteria, respectively. Weight reduction may prove beneficial in cases of intertrigo involving obesity-related skin folds.

References:
James WD, Berger TG, and Elston DM. “Bacterial Infections.” Andrews’ Diseases of the Skin. 10th Ed. Saunders:Canada, 2006, 459-78, 251-95.
Janniger CK, Schwartz RA, Szepietowski JC et al. Intertrigo and Common
Secondary Skin Infections. Am Fam Physician 2005;72:833-8.

Matthew Smetanick, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia.