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Intertrigo
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<h2 id="cause">Cause</h2> <h3>Bacterial</h3> <p class="note">See also: <a href="/facts/Streptococcal_intertrigo/4vLQ9Fvb">Streptococcal intertrigo</a></p> <p>Bacterial intertrigo can be caused by <i><a href="/facts/Streptococci/Fx8lJ0nz">Streptococci</a></i> and <i><a href="/facts/Corynebacterium_minutissimum/XauFIFVT">Corynebacterium minutissimum</a></i>.<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a><a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> </p> <h2 id="diagnosis">Diagnosis</h2> <p>Intertrigo can be diagnosed clinically by a medical professional after taking a thorough history and performing a detailed physical examination. Many other skin conditions can mimic intertrigo's appearance including <a href="/facts/Erythrasma/IknxK9HS">erythrasma</a>, <a href="/facts/Inverse_psoriasis/zdp7RUUC">inverse psoriasis</a>, <a href="/facts/Scabies/QCPVVhQ0">scabies</a>, <a href="/facts/Pyoderma/hhH5CVzL">pyoderma</a>, <a href="/facts/Atopic_dermatitis/DvmdVwWu">atopic dermatitis</a>, <a href="/facts/Candidiasis/gklGEfuq">candidiasis</a>, <a href="/facts/Seborrheic_dermatitis/d1CfhTDG">seborrheic dermatitis</a>, and <a href="/facts/Dermatophytosis/hFyb8T6n">fungal infections of the superficial skin</a> like <i><a href="/facts/Tinea_versicolor/y4wzgMrl">Tinea versicolor</a></i> or <i><a href="/facts/Tinea_corporis/XSJeruaC">Tinea corporis</a></i>.<a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> </p> <h2 id="treatment">Treatment</h2> <p>Treatment for intertrigo focuses on managing excess moisture, friction, and addressing secondary infections.<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a> </p><p>Initial management emphasizes prevention and patient education. Patients are often advised to wear loose, breathable clothing (such as cotton) and avoid synthetic fabrics. Moisture-wicking textiles designed for skin folds are also increasingly recommended due to their ability to wick away moisture, promote evaporation, reduce friction, and often provide antimicrobial properties through embedded silver.<a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a><a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a> </p><p>Daily skin fold hygiene, including cleansing with a pH-balanced cleanser (avoiding alkaline soaps) and thorough drying, is commonly advised.<a class="footnote-ref" id="fnref:12" href="#fn:12"><sup>12</sup></a> Skin barrier products are also commonly suggested to protect against both moisture and friction.<a class="footnote-ref" id="fnref:13" href="#fn:13"><sup>13</sup></a><a class="footnote-ref" id="fnref:14" href="#fn:14"><sup>14</sup></a><a class="footnote-ref" id="fnref:15" href="#fn:15"><sup>15</sup></a><a class="footnote-ref" id="fnref:16" href="#fn:16"><sup>16</sup></a> While specific product selection guidance is limited, <a href="/facts/Barrier_cream/QTShDpot">barrier creams</a> containing <a href="/facts/Zinc_oxide/P7sTyDez">zinc oxide</a> or honey have been used.<a class="footnote-ref" id="fnref:17" href="#fn:17"><sup>17</sup></a><a class="footnote-ref" id="fnref:18" href="#fn:18"><sup>18</sup></a><a class="footnote-ref" id="fnref:19" href="#fn:19"><sup>19</sup></a> Absorptive powders like talc or cornstarch are generally no longer recommended.<a class="footnote-ref" id="fnref:20" href="#fn:20"><sup>20</sup></a> </p><p>Secondary infections often require targeted treatment. For fungal and candidal infections, topical <a href="/facts/Antifungal/WEk5nS2B">antifungals</a> (<a href="/facts/Clotrimazole/SRY1jAW9">clotrimazole</a>, <a href="/facts/Nystatin/povtrmq3">nystatin</a>, <a href="/facts/Miconazole/PjA5UgFB">miconazole</a>) are typical; severe cases may require systemic antifungals (<a href="/facts/Fluconazole/UYpk9mKl">fluconazole</a>, <a href="/facts/Itraconazole/x7IeB92o">itraconazole</a>). Topical miconazole is sometimes preferred for its additional antibacterial action. Treatment usually lasts at least two weeks. For significant inflammation and itching, combination antifungal/low-potency <a href="/facts/Corticosteroid/jeL2QeIL">corticosteroid</a> preparations may be used, though evidence supporting corticosteroids over antifungals alone is limited. Bacterial infections may require topical or systemic antibiotics (e.g., <a href="/facts/Erythromycin/dPt7avsU">erythromycin</a>), used judiciously due to antimicrobial resistance concerns.<a class="footnote-ref" id="fnref:21" href="#fn:21"><sup>21</sup></a><a class="footnote-ref" id="fnref:22" href="#fn:22"><sup>22</sup></a> </p><p>In severe or refractory cases where medical management fails, surgical options may be considered.<a class="footnote-ref" id="fnref:23" href="#fn:23"><sup>23</sup></a> These include procedures to remove excess skin and tissue, such as <a href="/facts/Panniculectomy/oVz370BR">panniculectomy</a> (removal of excess abdominal skin and fat)<a class="footnote-ref" id="fnref:24" href="#fn:24"><sup>24</sup></a> or other body contouring procedures. Breast reduction can be beneficial for women with <a href="/facts/Breast_hypertrophy/zwB6GnNL">macromastia</a>, and post-bariatric patients with excess skin folds may also benefit from body contouring procedures to reduce skin-on-skin contact and improve hygiene.<a class="footnote-ref" id="fnref:25" href="#fn:25"><sup>25</sup></a> </p><p>Intertrigo is also a known symptom of <a href="/facts/Vitamin_B6/9IavWjwM">vitamin B6</a> deficiency.<a class="footnote-ref" id="fnref:26" href="#fn:26"><sup>26</sup></a> </p> <h2 id="see-also">See also</h2> <ul><li><a href="/facts/Diaper_rash/pWCmNox0">Diaper rash</a></li> <li><a href="/facts/List_of_skin_diseases/U58kszg2">List of skin diseases</a></li></ul> <h2 id="external-links">External links</h2> <ul><li><a href="http://www.aocd.org/skin/dermatologic_diseases/intertrigo.html">A.O.C.D.: Intertrigo</a></li> <li><a href="http://www.emedicine.com/derm/topic198.htm">eMedicine: Intertrigo</a> (by Samuel Selden, M.D.)</li> <li><a href="https://web.archive.org/web/20050304002053/http://www.dermadoctor.com/pages/newsletter163.asp">DERMAdoctor: Intertrigo</a> (by Audrey Kunin, M.D.)</li></ul> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "14. Bacterial infections". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 266-267. ISBN 978-0-323-54753-6. <a href="978-0-323-54753-6" target="_blank">978-0-323-54753-6</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> <li id="fn:7"><p>Tüzün, Y; Wolf, R; Engin, B; Keçici, AS; Kutlubay, Z (July–August 2015). "Bacterial infections of the folds (intertriginous areas)". Clinics in Dermatology (Review). 33 (4): 420–8. doi:10.1016/j.clindermatol.2015.04.003. PMID 26051056. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li> <li id="fn:8"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></p></li> <li id="fn:9"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></p></li> <li id="fn:10"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></p></li> <li id="fn:11"><p>Enkhorn M, Ramirez I, Lee M, Barber H (10 April 2019). "Best Practice for the Treatment of Intertrigo". NWCommons. Northwestern College. Retrieved 20 January 2025. <a href="https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/" target="_blank">https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></p></li> <li id="fn:12"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></p></li> <li id="fn:13"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:13" class="footnote-back-ref">↩</a></p></li> <li id="fn:14"><p>Enkhorn M, Ramirez I, Lee M, Barber H (10 April 2019). "Best Practice for the Treatment of Intertrigo". NWCommons. Northwestern College. Retrieved 20 January 2025. <a href="https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/" target="_blank">https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/</a> <a href="#fnref:14" class="footnote-back-ref">↩</a></p></li> <li id="fn:15"><p>Bodkhe RB, Shrestha SB, Unertl K, Fetzik J, McNulty AK (September 2021). "Comparing the physical performance of liquid barrier films". Skin Research and Technology. 27 (5): 891–895. doi:10.1111/srt.13038. PMC 8596591. PMID 33760305. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596591" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596591</a> <a href="#fnref:15" class="footnote-back-ref">↩</a></p></li> <li id="fn:16"><p>Parnham A, Copson D, Loban T (June 2020). "Moisture-associated skin damage: causes and an overview of assessment, classification and management". British Journal of Nursing (Mark Allen Publishing). 29 (12): S30 – S37. doi:10.12968/bjon.2020.29.12.S30. PMID 32579457. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:16" class="footnote-back-ref">↩</a></p></li> <li id="fn:17"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:17" class="footnote-back-ref">↩</a></p></li> <li id="fn:18"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:18" class="footnote-back-ref">↩</a></p></li> <li id="fn:19"><p>Enkhorn M, Ramirez I, Lee M, Barber H (10 April 2019). "Best Practice for the Treatment of Intertrigo". NWCommons. Northwestern College. Retrieved 20 January 2025. <a href="https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/" target="_blank">https://nwcommons.nwciowa.edu/celebrationofresearch/2019/researchprojects2019/31/</a> <a href="#fnref:19" class="footnote-back-ref">↩</a></p></li> <li id="fn:20"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:20" class="footnote-back-ref">↩</a></p></li> <li id="fn:21"><p>Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID 24695603. <a href="https://www.aafp.org/afp/2014/0401/p569.html" target="_blank">https://www.aafp.org/afp/2014/0401/p569.html</a> <a href="#fnref:21" class="footnote-back-ref">↩</a></p></li> <li id="fn:22"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:22" class="footnote-back-ref">↩</a></p></li> <li id="fn:23"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:23" class="footnote-back-ref">↩</a></p></li> <li id="fn:24"><p>Sachs D, Sequeira-Campos MB, Murray J (July 18, 2023). "Panniculectomy". StatPearls Publishing. PMID 29762997. Retrieved January 20, 2025. <a href="https://www.ncbi.nlm.nih.gov/books/NBK499822/" target="_blank">https://www.ncbi.nlm.nih.gov/books/NBK499822/</a> <a href="#fnref:24" class="footnote-back-ref">↩</a></p></li> <li id="fn:25"><p>Romanelli M, Voegeli D, Colboc H, Bassetto F, Janowska A, Scarpa C, Meaume S (July 2023). "The diagnosis, management and prevention of intertrigo in adults: a review". Journal of Wound Care. 32 (7): 411–420. doi:10.12968/jowc.2023.32.7.411. PMID 37405940. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:25" class="footnote-back-ref">↩</a></p></li> <li id="fn:26"><p>Tong Y (May 2014). "Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review". Intractable & Rare Diseases Research. 3 (2): 52–6. doi:10.5582/irdr.2014.01005. PMC 4204538. PMID 25343127. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204538" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204538</a> <a href="#fnref:26" class="footnote-back-ref">↩</a></p></li> </ol>