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Intertrigo is the medical term given to a rash that occurs between the folds of the skin and commonly affects areas such as the armpits, genital region, under the breasts, and the abdomen.

Other areas of involvement may include:

  • The inner thighs.
  • The spaces between the fingers and toes.
  • In the crease of the neck.
  • Between the buttocks.

In infants, intertrigo often appears as a diaper rash.

Causes and Risk Factors

Intertrigo is an inflammatory process that affects the skin and it may be caused by moisture trapped between the skin folds, heat and humidity, improper air circulation, and friction between the skin fold.

Risk factors that increase the chance of developing intertrigo include:

  • Obesity.
  • Being diagnosed with diabetes.
  • Exposure to high humidity and heat.
  • Having a brace, splint, or artificial limb which can cause friction.

Other risk factors may include:

  • Excessive sweating.
  • Urinary or faecal incontinence.
  • Malnutrition.
  • Poor hygiene.
  • A suppressed immune system as a result of medications such as steroids and chemotherapy agents, infections such as HIV, and other skin conditions such as psoriasis.
Infants, due to their bent posture, shorter necks, and baby fat, have an increased risk for developing intertrigo.

Symptoms and Signs

Intertrigo may cause clinical features such as:

  • A red or red/brown discolouration of the skin.
  • Skin that appears to be crusty or cracked.
  • The affected areas can be itchy.
  • Persistent scratching that causes the skin to break and become infected. Microorganisms that can cause a secondary infection include bacteria and fungi.
  • The skin can appear raw from the scratching.
  • Fluid or pus can ooze from an infected wound and this can have a foul odour to it.

Prevention and Management

Patients diagnosed with intertrigo are suggested to keep the affected area of skin dry and exposed to air or air-dry with a hair dryer set on the cool setting. Areas that are oozing may be controlled with moist compresses with Burow's solution applied to them. A barrier cream can also be applied thereafter to help protect the skin from any other irritants which can worsen the inflammation.

If these conservative measures are ineffective, a medical doctor may prescribe medications such as:

  • Steroid creams or ointments to be applied to the affected skin.
  • An antibiotic or antifungal preparation for infected wounds.
  • Oral versions of the mentioned medications if the topical agents are not effective.

Suggestions and recommendations to help lower the risk of developing intertrigo include:

  • Keeping the skin as cool and dry as possible. After showering, one should attempt to dry off as thoroughly as possible.
  • Wearing tight clothing or shoes should be avoided to prevent moisture from building up in the high-risk areas.
  • Wearing a bra with good support and that doesn't dig into the skin.
  • Wearing open-toed shoes if the areas between the toes are affected.
  • Changing diapers more frequently in infants with a diaper rash.
  • Reducing weight as this helps to decrease the area of skin-folding.
Affected individuals with symptoms and signs of intertrigo are urged to consult with their primary care doctor to be assessed and managed appropriately in order to prevent complications such as secondary skin infections.

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