Intertrigo

Nystatin is mainly used to treat vaginal and oral infections and localized skin lesions, including Candida intertrigo and Candida nappy dermatitis. It may also be used as prophylaxis during treatment with antibiotics. 

Yosipovitch, G. et al., Skin surface pH in intertriginous areas in NIDDM patients. Possible correlation to candidal intertrigo, Diabetes Care, 16, 560, 1993. 

Management For intertrigo, local antimycotic therapy has to be combined with drying of this region (e.g. linen strips, use of an antimycotic paste), local therapy with potassium permanganate deals with this aspect and is effective against concomitant bacteria as well. In the treatment of diaper candidiasis these points of view are important as well (e.g. frequent changes of napkins) steroids should be avoided if possible. 

Miconazole is an alternative. Clotrimazole is an effective topical agent for dermatophyte, yeast, and other fungal infections (intertrigo, athlete s foot, ringworm, pityriasis versicolor, fungal nappy rash). 

Intertrigo Cleansing lotions, powders. A dilute corticosteroid with anticandidal cream is often helpful. lb cleanse, lubricate and reduce friction. 

In 60 patients receiving polyethylene glycol-coated liposomal doxorubicin (Doxil) 35-70 mg/m by infusion over 1-2 hours there were four patterns of skin eruption hand-foot syndrome (40%), a diffuse follicular rash (10%), an intertrigo-like eruption (8%), and new melanotic macules (0.5%) (81). 

A 79-year-old woman took terbinafine for intertrigo and 2 weeks later she developed widespread erythema over the trunk with superficial pustules. The erythema intensified, the pustules became confluent and spread all over her body, and she had a fever and a leukocytosis. Liver function tests, urea and creatinine were normal. Biopsy showed acute generalized exanthematous pustulosis (AGEPX Terbinafine was withdrawn and the eruption subsided gradually over the next 10 days. Eight years later she again... 

Tinea pedis corresponds to an infection of the feet or toes with a dermatophyte. The term althlete s foot, used by some to imply any form of toe-cleft intertrigo (see bacterial athlete s foot) is infrequently used in the dermatologic literature. Three anthropophilic species, T. rubrum, T. mentagrophytes variant interdigitale and... 

Candida albicans can be isolated in the majority of cases of chronic paronychia. The yeast has traditionally been considered to play an etiological role in the condition, but bacteria and irritant or allergic contact dermatitis also play a role, although the contribution of each varies from patient to patient. A more recent proposal is the primary role of repeated contact with various kinds of foods. Proteins of foods could induce a protein contact dermatitis (Tosti et al. 1992) and, secondarily, an infection by Candida albicans. The primary role of the yeast is, therefore, minimised. Professions at risk, apart from those already quoted as prone to develop Candida intertrigo of the interdigital folds, include all categories... 

Candida intertrigo requires specific therapy. Topical imidazoles are commonly used for a period of 2 weeks, but a longer period of treatment is sometimes needed. When the toe webs are involved, attention should be given to treating concomitant bacteria potassium permanganate soaks (1 part in 10,000) are, therefore, advisable. In general, systemic treatment is not considered for this indication. 

Fig. 13. Candida intertrigo of an interdigital fold with paronychia...

Subaquatic activities External otitis, intertrigo, staphylococcal infections, burns, linear abrasions from wetsuit folds, pruritus and erythema from decompression, napkin eruption type dermatitis... 

Heat-induced intertrigo occurs commonly among heavy athletes. Weight reduction, loose-fitting underclothing, and optimal hygiene, are helpful preventive measures. 

Necrolytic migratory erythema is usually part of the glucagonoma syndrome, which is characterized by an alpha cell tumor of the pancreas, leading to adult onset diabetes mellitus, weight loss, and glossitis. It is often mistaken for intertrigo or seborrheic dermatitis. Its pathogenesis is not well understood. The role of opiates in this case was not clear, but it was not due to poor nutrition or poor absorption of nutrients. The authors speculated that opiates had had a direct effect on epidermal metabohsm. 

Necrotic skin lesions have also been described [51, 52, 53 ]. Skin necrosis occurred in a child after the application of 2% gentian violet to the gluteal fold the authors recommended using concentrations below 1 % for the treatment of intertrigo [54 ]. 

Balsam of Peru is used extensively in topical preparations for the treatment of wounds, skin graft healing, indolent ulcers, scabies, diaper rash, hemorrhoids, anal pmritus, bedsores, intertrigo, eczema, and others in hair tonic and antidandruff preparations, feminine hygiene sprays, and as a fixative or fragrance... 

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