Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:40

846 Intertrigo

■Excessive moisture may predispose.

■Obesity is a predisposing factor.

■Candida is frequently involved.

■Diabetes mellitus may predispose.

Signs & Symptoms

■Inflammation characterized by erythema, maceration and pustules

in the folds, primarily the inguinal folds

tests

■Basic tests: Potassium hydroxide preparation

Specific Diagnostic Tests

■Fungal culture

■Imaging studies – none

differential diagnosis

■Inverse psoriasis

■Dermatophyte infection

■Seborrheic dermatitis

■Benign familial pemphigus (Hailey-Hailey disease)

■Necrolytic migratory erythema

■Nutritional deficiencies (e.g., zinc)

■Extramammary Paget’s disease (particularly if unilateral)

management

What to Do First

■Assess the risk factors, such as trauma, exposure to excess moisture,

diabetes.

General Measures

■Keep area dry.

■Assess the need for systemic therapy vs. local therapy.

specific therapy

■Drying techniques

■Topical antifungal cream (e.g., clotrimazole, ketoconazole) com-

bined with a low-potency corticosteroid cream (e.g., desonide,

hydorcortisone). Avoid using existing mixtures that contain