What is intertrigo?
In the medical field, intertrigo outlines a morbid condition of the skin, generated by the continuous rubbing of two contiguous body surfaces: in other words, intertrigo is a common form of inflammatory dermatosis, which mainly involves the skin folds subjected to continuous friction, areas where sweat stagnates and macerates the superficial epidermal layer, inevitably favoring bacterial infections.
Incidence
Risk factors
In some peculiar conditions, the likelihood of contracting intertrigo increases considerably: first of all, the overweight and obese subjects are the "favorite" target for bacterial proliferation, since sweat stagnates between the folds of the skin, literally macerating the layers superficial. The bacteria, in similar situations, find the ideal conditions to proliferate and generate damage.
Intertrigo often occurs in newborns, particularly in intergluteal and inguinal-crural folds (localized, that is, near the groin and at the level of the thigh root): in infants, intertrigo is linked to both sweat and stagnation, and to slightly alkaline stools, which tend to "corrode" the skin, favoring bacterial attack.
Sometimes, even the usual use of shoes that are too tight, of synthetic material and diapers could represent a risk factor for bacterial colonization, thus causing intertrigo.
Last but not least, bad hygienic conditions and incorrect personal hygiene can have a significant impact on the formation of dermatosis.
Causes
Intertrigo is caused by some peculiar bacterial strains: Candida albicans plays a fundamental role in the manifestation of the disease and it is estimated that candidosal intertrigo is the most frequent. Also the fungi of the genus Epidermophyton are particularly involved in the intertrigo.
Furthermore, Staphylococcus aureus, streptococcus piogene and Pseudomonas aeruginosa could favor the onset of the morbid condition.
Areas affected
The sites most affected by the intertrigo manifestation are those most prone to sweat stagnation: groin area, axillary area, interdigital area (between the toes, especially those of the feet), inframammary fold, abdominal site (for overweight subjects), intergluteal groove, neck folds (typical intertrigo of infants) and retroauriclari grooves. A common condition of overweight and obese subjects is the continuous rubbing of the thighs: even in this case, intertrigo is favored. The rubbing between two neighboring areas can be such as to cause real traumas (friction trauma).
In some subjects, the inflammatory dermatosis could be located in very particular and unusual areas: we speak of "pyogenic perionyxis" when the intertrigo involves the superficial cutaneous layers and the periungual furrows, while for "angular stomatitis" means the maceration of the corners of the mouth favored by the stagnation of saliva.
Typical of the elderly is the intertrigo at the inguinal level: this condition is favored when the patient is obviously overweight and wears the diaper. Furthermore, intertrigo worsens when the elderly, regardless of the disease, tend not to wash themselves thoroughly: as we have seen, poor personal hygiene is one of the major risk factors that predispose to intertrigo.
The diaper favors the friction with the groin: the continuous rubbing could generate intertrigo, a phenomenon even more favored by the heat and skin erosion of the aforementioned area. Sweat, along with urine and skin moisture, is certainly not a positive element, far from it, because it instigates the maceration of the skin, therefore the bacterial proliferation responsible for the intertrigo. In turn, the dermatosis could spread like an oil stain and infect the haemorrhoidal plexus and the perianal area and cause vaginitis (in women).
A cascade of events, therefore, that favors the colonization of pathogenic micro-organisms, those responsible for the actual damage.
Symptoms
To learn more: Intertrigo symptoms
Intertrigo manifests as redness, de-epithelialization, peeling of the skin, irritation, redness of the area and itching. When it is not treated in time, through specific ointments or creams, the intertrigo can evolve in a negative sense, creating an increasingly marked and painful maceration of the skin, with cracks, intense pain, bleeding, fissures, blisters and pustules that are often smelly.
The intertrigo begins with shiny red spots with obvious limitations: as you move away from the fulcrum of the stain, the area tends to show peeling, while outside the dermatosic patch (in the periphery), you can notice some small succulent lesions that tend to burst.
The area affected by intertrigo seems greasy, rich in scales and crusts, given by rubbing and lesions caused by continuous, almost obsessive scratching.
Still, when neglected despite the painful sores, the disease could degenerate into a severe form of intertrigo called septic dermatitis or impetiginized intertrigo (excessive scratching, almost "compulsive" and bacterial infections).
Care
To learn more: Intertrigo Prevention and Natural Remedies
To learn more: Drugs for the care of Intertrigo
Before proceeding with the administration of pharmaceutical specialties, the patient must undergo a medical examination to allow the culture isolation of the bacterial colonies.
Intertrigo is diagnosed through a swab, a careful microscopic examination and, when necessary, also through a biopsy: an invasive examination that involves the taking of a sample of infected tissue.
After discovering the bacterium responsible, generally, the patient is given ointments or antifungal / antibiotic lotions, associated with nourishing and re-epithelizing / healing creams. If the pain was very strong, the specialist could also recommend pain relievers or mild natural anesthetics.
