Intertrigo

Question 1

Intertrigo

Answer 1

superficial inflammatory condition occurring on two closely appoximated skin surfaces (intertriginous areas)

Question 2

epidemiology

Answer 2

occurs in hot, humid environments, in the very young and older adults due to decreased immunity.

Question 3

At risk for developing intertrigo

Answer 3

incontinence, obesity, DM, those with limited ability

Question 4

Pathogenesis

Answer 4

friction, moisture, lack of ventilation. Stratum corneum becomes macerated leading to inflammatory response and erosion and secondaly bacterial, yeast and fungal infections

Question 5

Clinical symptoms

Answer 5

pruritus and burning of skin folds, erythematous plaque with peripheral scaling

Question 6

dx of fungal intertrigo

Answer 6

potassium hydroxide from scaly edge showing spores

Question 7

dx of yeast intertrigo

Answer 7

satellite lesions

Question 8

dx of bacterial intertrigo

Answer 8

culture showing group A strep. woods laps will fluoresce coral red color for Corynebacterium minutissimum erythrasma

Question 9

ddx

Answer 9

pyoderma, seb derm, inverse psoriasis

Question 10

treatment

Answer 10

weight loss, zinc oxide topically, topical petrolatum, cotton or gauze in skin folds, encourage cotton underwear

Question 11

tx yeast

Answer 11

clotrimazole, ketoconazole, nystain (only good for yeast)

Question 12

recalcitrant yeast conditions

Answer 12

oral fluconazole 100mg x 7 days

Question 13

fungus tx

Answer 13

econazole, ketoconazole apply BID until resolves

Question 14

group A strep tx

Answer 14

mupirocin, clindamycin

Question 15

Recalcitrant group a strep tx

Answer 15

oral keflex, PCN, rocephin, clinda

Question 16

to cleanse the area and help it dry out

Answer 16

BP wash

Question 17

if very inflammed can add this to topical treatment

Answer 17

low potency topical steroid but with caution to avoid atrophy in skin folds