Intertrigo

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1998. Revised and updated August 2015.

What is intertrigo?

Intertrigo describes a rash in the flexures or body folds, such as behind the ears, in the folds of the neck, under the arms (axillae), under a protruding abdomen, in the groin, between the buttocks, in the finger webs or toe spaces.

Although intertrigo may affect one skin fold, it is common for it to involve multiple sites.

Who gets intertrigo?

Intertrigo can affect males and females of any age. It is particularly common in people that are overweight or obese (see metabolic syndrome). Other contributing factors are:

What are the clinical features of intertrigo?

Intertrigo can be acute (recent onset), relapsing (recurrent), or chronic (present for more than 6 weeks). The exact appearance and behaviour depends on the underlying cause or causes.

The skin affected by intertrigo is inflamed, ie reddened and uncomfortable. It may become moist and macerated, leading to fissuring (cracks) and peeling.

What is the cause of intertrigo?

Intertrigo is due to genetic and environmental factors.

The microorganisms that are normally resident on flexural skin, the microbiome, include corynebacteria, other bacteria and yeasts. These multiply in warm moist environments and may cause disease.

We can classify intertrigo into infectious and inflammatory origin but there is often overlap.

Infections causing intertrigo

Thrush: Candida albicans

Intertrigo due to candida infection

Erythrasma: Corynebacterium minutissimum 

Axillary erythrasma

Tinea: Trichophyton rubrum + T interdigitale

Tinea cruris

Impetigo: Staphylococcus aureus and Streptococcus pyogenes

Impetigo in axilla

Boils: Staphylococcus aureus

Boil in axilla

Folliculitis: Staphylococcus aureus

Folliculitis in axilla

Common inflammatory skin conditions causing intertrigo

Flexural psoriasis

Intertrigo due to psoriasis

Seborrhoeic dermatitis

Intertrigo due to seborrhoeic dermatitis

Atopic dermatitis

Flexural eczema

Contact irritant dermatitis

Irritants include:

Contact irritant dermatitis due to urine. Napkin dermatitis in adult.

Contact allergic dermatitis

Allergen may be:

Intertrigo due to contact allergy to benzocaine

Hidradenitis suppurativa

Intertrigo due to

Hailey-Hailey disease

Intertrigo due to Hailey-Hailey disease

Granular parakeratosis

granular parakeratosis

Fox-Fordyce disease

Axillary Fox-Fordyce disease

What investigations should be done?

Investigations may be necessary to determine the cause of intertrigo.

What is the treatment for intertrigo?

Treatment depends on the underlying cause, if identified, and on which micro-organisms are present in the rash. Combinations are common.

Related information

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