intertrigo

Intertrigo is an inflammatory condition of skin folds characterized by irritation, maceration, and friction-driven damage of areas where skin surfaces rub together. It commonly occurs in warm, moist environments and is frequently complicated by secondary infections with yeasts such as Candida species, bacteria, or Malassezia.

Risk factors include obesity, diabetes, pregnancy, immobility, excessive sweating, and occlusive clothing. It most often affects intertriginous areas such as the axillae, inguinal folds, under the breasts, and the neck, abdomen, groin, or buttock folds.

Symptoms typically include red, irritated patches that are moist or macerated, with itching, burning, and sometimes painful fissures. Satellite vesicles or pustules may be present, and there may be odor or discomfort in the affected areas.

Diagnosis is usually clinical. If infection is suspected or the course is atypical, diagnostic tests such as microscopy or culture can identify Candida, bacteria, or other organisms. Differential diagnoses include candidal dermatitis, irritant or allergic contact dermatitis, inverse psoriasis, tinea cruris, and erythrasma.

Treatment emphasizes reducing moisture and friction, protecting the skin, and treating any infection. Approaches include gentle cleansing, thorough drying, and use of skin-barrier protectants (such as petrolatum or zinc oxide). Topical antifungals are used for suspected fungal involvement; topical antibiotics for secondary bacterial infection; and short courses of low- to mid-potency corticosteroids may be used to control inflammation. In severe cases, or when topical therapy fails, systemic antifungal or antibiotic treatment may be required.

Prevention focuses on keeping folds dry and well-ventilated, wearing breathable clothing, and managing contributing conditions such as obesity or diabetes. Regular skin checks in high-risk individuals can help detect recurrence early.

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