Intertrigo L30.49

Intertrigo (intertriginous), from Latin inter - between; terere, tero, trivi - to rub, refers to a cumulative-toxic, intertriginous (toxic- not allergic) contact dermatitis, which is caused by the irritative milieu of skin areas lying next to each other. Especially in obese people, friction and accumulation of secretions in the contact zones of skin folds lying on top of each other, especially at high outdoor temperatures and sweating, lead to maceration and swelling of the skin. An unpleasant sweetish fetor indicates a bacterial or mycotic superinfection.

Other favoring factors are: permanently sweaty/soaked tight-fitting clothes, diabetes mellitus, general immune deficiency, incontinence, chronic bedriddenness, hormonal contraception or pregnancy.

In acute intertrigo, the skin in the skin folds is massively reddened, sometimes erosive, and also weeping. This is accompanied by constant itching. If the condition persists for a long time, the dermatitis becomes chronic, with inflammatory, thickened, coarse lamellar scaling, and in places weeping skin. Risk of rhagade formation. Risk of bacterial (often gram-negative colonization) or mycotic (colonization by yeasts) superinfections.

Frequently obese, easily sweating individuals.

Submammary, axillae, groin, perianal region, diaper region, penis, vulva

Painful, sharply demarcated and highly red erosions (over large areas) up to macerations, sometimes greasy scaling

In case of Candida: satellite foci

In case of contact allergic component: often also satellite formation

In case of superinfection: unpleasant sweetish fetor

Weight reduction!

Avoidance of irritative co-factors, especially tight-fitting clothing (e.g. jeans).

Combating incontinence.

If necessary, plastic surgery procedures to remove excess skin aprons.

Drainage of the infected region by consistent insertion of linen cloths or gauze strips. Sitz baths or whipping with potassium permanganate solution (especially in cases of superinfection). Subsequent application of a 1% hydrocortisone cream, which can be supplemented by a 20-minute moist application (using an overlay soaked with physiological saline solution) in cases of severe oozing. If necessary in cases of bacterial superinfection, combination of topical steroids with topical antibiotics (e.g., Fucidine).

When the acute weeping condition subsides, transition to a zinc-containing application (e.g., 5% zinc oxide cream in Ungt. emulsif. aq.) or even to soft zinc paste.

In case of overlaying of intertrigo by yeast fungi, Candio-Hermal Plus Paste is recommended initially for a short time and Candio Hermal Soft Paste afterwards.

Prophylactically: Linola Breathable Protective Balm

1. Arnold-Long M et al (2018) Incontinence-Associated Dermatitis and Intertriginous Dermatitis as Nurse-Sensitive Quality Indicators: A Delphi Study.J Wound Ostomy Continence Nurs 45:221-226.