Intertriginous Dermatitis
Main Article Content
Abstract
Moisture associated skin damage (MASD) is a label for a spectrum of skin injury from 4 sources: exposure to urine and stool (incontinence associated dermatitis), sweat (intertriginous dermatitis), wound exudate (periwound dermatitis) and stoma exudate (peristomal dermatitis). Intertriginous dermatitis (ITD), also known as intertrigo, is a common inflammatory disorder that occurs due to skin-on-skin friction in the skin folds, because of moisture becoming trapped due to poor air circulation. 1 Intertrigo's Latin translation, inter (between) and terere (to rub) helps explain the pathophysiology of the condition. The 11th revision of the World Health Organization's (WHO) International Classification of Diseases (ICD-11) now contains codes for the separate forms of MASD within the EK02 irritant contact dermatitis section. 2
This article provides a general overview of intertriginous dermatitis and outlines its etiology, pathophysiology and offers management techniques. ITD does not have a strong evidence base for practice therefore, practitioners often have to rely on experience. 1,3
Article Details
How to Cite
BLACK, Joyce M..
Intertriginous Dermatitis.
Medical Research Archives, [S.l.], v. 12, n. 11, nov. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5957>. Date accessed: 12 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i11.5957.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Romanelli M. The diagnosis, management and prevention of intertrigo in adults: a review. J Wound Care, 2023, 32 (7): 411-419.
2. World Health Organization. ICD-11. International Classification of Diseases 11th revision. Geneva: WHO; 2019. https://icd.who.int/en Accessed November 3, 2024
3. Voegeli D. Intertrigo: causes, prevention and management. Brit J Nurs, 2020; 39 (12). https://doi.org/10.12968/bjon.2020.29.12.S16
4. Waldman RA, Kettler AH. Dermatologic manifestations of obesity: part I mechanical causes. J Obes Weight-Loss Med. 2016;2: 010.
5. Shareef AR, Prasad PVS, Kaviarasan PK. Cutaneous markers of obesity. Int J Res Med Sci. 2018;6(11):3562. https://doi.org/10.18203/2320-6012.ijrms20184243
6. Rippke F, Berardesca E, Weber TM. pH and Microbial Infections. Curr Prob Dermatol. 2018:54:87-94. doi: 10.1159/000489522.
7. Tüzün Y, Wolf R, Engin B, et al. Bacterial infections of the folds (intertriginous areas). Clin Dermatol; 2015, 33: (4), 420-428. https://doi.org/10.1016/j.clindermatol.2015.04.003
8. Mori S, Shiraishi A, Epplen K, et al. Characterization of skin function associated with obesity and specific correlation to local/systemic parameters in American women. Lipids Health Dis. 2017;16(1):214. https://doi.org/10.1186/s12944-017-0608-
9. Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 2007; 56(6):901–916. https://doi.org/10.1016/j.jaad.2006.12.004
10. Boza JC, Trindade EN, Peruzzo J, et al. Skin manifestations of obesity: a comparative study. J Eur Acad Dermatol Vener 2012; 26(10):1220–1223. https://doi.org/10.1111/j.1468-3083.2011.04265.x
11. Kottner J, Everlink, I, van Haastregt J, et al. Prevalence of intertrigo and associated factors: A secondary data analysis of four annual multicenter prevalence studies in the Netherlands. Int J Nurs Stud 2020 (104): 103437
12. Arnold-Long M. Johnson E. Epidemiology of incontinence -associated dermatitis and intertriginous dermatitis (intertrigo) in an acute care facility. J Wound Ostomy Continence Nurs, 2019, 46 (3): 201-206.
13. Gabriel S. Hahnel E, Blume-Peytavi U, Kottner J. Prevalence and associated factors of intertrigo in aged nursing home residents: a multi-center cross-sectional prevalence study. BMC Geriatr; 2019, 19 (1): 105. doi.org/10.1186/s12877-019-1100-8
14. Everink IHK, Kottner J, van Haaastrgt JCM, Halfrens R, Schols, JMGA. Skin areas, clinical severity, duration and risk factors of intertrigo: A secondary data analysis. J Tissue Viability; 2021 30,:102-107
15. Volzer B, Genedy-Kalyoncu M, Fastner A, et al. Prevalence and associations of xerosis cutis, incontinence associated dermatitis, skin tears, pressure ulcers and intertrigo in aged nursing home residents: A representative prevalence study. Int J Nurs Stud, 2023, 141, 104472
16. Metin A, Dilek N, Bilgili S. Recurrent candidal intertrigo: challenges and solutions. Clin Cosmet Investig Dermatol. 2018; 11: 175–185.
17. Rao MR, Vasimalli VK, Gowda RS, et al. A Bacteriological Study of Intertrigo. J Pure Appl Micro 2018: 12 (4), 1839-1844 http://dx.doi.org/10.22207/JPAM.12.4.18
18. Rasoulpoor S, Shohaimi S, Salari N, et al. Candida albicans skin infection in patients with type 2 diabetes: a systematic review and meta-analysis. J Diabetes Metab Disord. 2021 Apr 19;20(1):665-672. doi: 10.1007/s40200-021-00797-0.
19. Man A, Ciurea CN, Pasaroiu D, et al. New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study. Mem Inst Oswaldo Cruz. 2017 Sep;112(9):587-592. doi: 10.1590/0074-02760170098.
20. Kalkan G, Duygu F, Bas Y. Greenish-blue staining of underclothing due to Pseudomonas aeruginosa infection of intertriginous dermatitis. J Pak Med Assoc. 2013 Sep;63(9):1192-4.
21. Cunliffe T. Intertrigo. Rickmansworth: Primary Care Dermatological Society. 2018. http://www.pcds.org.uk/clinical-guidance/intertrigo. Accessed October 12, 2024
22. Voegell D. Intertrigo: causes, prevention and management. Brit J Nurs 2020, 29 (12) S16-22
23. Black J, Gray M, Bliss, D, et al. Incontinence-Associated Dermatitis and Intertriginous Dermatitis: A Consensus. J Wound, Ostomy Continence Nurs, 2011; 38 (4), 359-372.
24. Kalra MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. Am Fam Physician. 2014;89(7):569–573
25. Sibbald RG, Kelley J, Kennedy-Evans K-L, Labrecque C, Waters N. A practical approach to the prevention and management of intertrigo, or moisture-associated skin damage, due to perspiration: expert consensus on best practice. Wound Care Canada. 2013;11(2):36-43
26. Armstrong AW, Bukhalo M, Blauvelt A. A clinician's guide to the diagnosis and treatment of candidiasis in patients with psoriasis. Am J Clin Dermatol. 2016;17(4):329–336. https://doi.org/10.1007/s40257-016-0206-4
27. Ely JW, Rosenfeld S, Seabury Stone M. Diagnosis and management of tinea infections. Am Fam Physician. 2014;90(10):702–710
28. Taudorf EH, Jemec GBE, Hay RJ, Saunte DML. Cutaneous candidiasis – an evidence-based review of topical and systemic treatments to inform clinical practice. Eurp Acad Dermatol Vener 2019 33: 1863-1873. Doi: 10.1111/jdv.15782
29. Mistiaen P, van Halm-Walters M. Prevention and treatment of intertrigo in large skin folds of adults: a systematic review. BioMed Central Nurs. 2010 9, http://www.biomedcentral.com/1472-6955/9/12
30. Leeyaphan C, Varathai S, Trakanwittayarak S, et al. A randomized controlled trial to compare the effectiveness and safety of absorbent lotion containing tapioca starch, spent grain wax, Butyrospermum parkii extract, argania spinosa kernel oil, aloe barbadensis, rosehip oil, and allantoin with a low-potency topical corticosteroid in the treatment of intertrigo. J Cosmet Dermatol 2022; (21): 679-688.
31. Nguyen JT, Palladino H, Sonnema AJ, Petty PM. Long-term satisfaction of reduction mammaplasty for bilateral symptomatic macromastia in younger patients. J Adolesc Health. 2013;53(1):112–117. https://doi.org/10.1016/j.jadohealth.2013.01.025
32. Elander A, Biörserud C, Fagevik Olsén M. Excess skin after weight loss following bariatric surgery: focus on the abdomen. Surg Obes Relat Dis. 2021 May;17(5):986-993. Doi:10.1016/j.soard.2021.01.005.
33. Tammel K, Benike D, Sievers B. A novel approach to treating moderate to severe incontinence-associated dermatitis and intertriginous dermatitis. J Wound Ostomy Nurs, 2019; 46(5):446-452.
2. World Health Organization. ICD-11. International Classification of Diseases 11th revision. Geneva: WHO; 2019. https://icd.who.int/en Accessed November 3, 2024
3. Voegeli D. Intertrigo: causes, prevention and management. Brit J Nurs, 2020; 39 (12). https://doi.org/10.12968/bjon.2020.29.12.S16
4. Waldman RA, Kettler AH. Dermatologic manifestations of obesity: part I mechanical causes. J Obes Weight-Loss Med. 2016;2: 010.
5. Shareef AR, Prasad PVS, Kaviarasan PK. Cutaneous markers of obesity. Int J Res Med Sci. 2018;6(11):3562. https://doi.org/10.18203/2320-6012.ijrms20184243
6. Rippke F, Berardesca E, Weber TM. pH and Microbial Infections. Curr Prob Dermatol. 2018:54:87-94. doi: 10.1159/000489522.
7. Tüzün Y, Wolf R, Engin B, et al. Bacterial infections of the folds (intertriginous areas). Clin Dermatol; 2015, 33: (4), 420-428. https://doi.org/10.1016/j.clindermatol.2015.04.003
8. Mori S, Shiraishi A, Epplen K, et al. Characterization of skin function associated with obesity and specific correlation to local/systemic parameters in American women. Lipids Health Dis. 2017;16(1):214. https://doi.org/10.1186/s12944-017-0608-
9. Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 2007; 56(6):901–916. https://doi.org/10.1016/j.jaad.2006.12.004
10. Boza JC, Trindade EN, Peruzzo J, et al. Skin manifestations of obesity: a comparative study. J Eur Acad Dermatol Vener 2012; 26(10):1220–1223. https://doi.org/10.1111/j.1468-3083.2011.04265.x
11. Kottner J, Everlink, I, van Haastregt J, et al. Prevalence of intertrigo and associated factors: A secondary data analysis of four annual multicenter prevalence studies in the Netherlands. Int J Nurs Stud 2020 (104): 103437
12. Arnold-Long M. Johnson E. Epidemiology of incontinence -associated dermatitis and intertriginous dermatitis (intertrigo) in an acute care facility. J Wound Ostomy Continence Nurs, 2019, 46 (3): 201-206.
13. Gabriel S. Hahnel E, Blume-Peytavi U, Kottner J. Prevalence and associated factors of intertrigo in aged nursing home residents: a multi-center cross-sectional prevalence study. BMC Geriatr; 2019, 19 (1): 105. doi.org/10.1186/s12877-019-1100-8
14. Everink IHK, Kottner J, van Haaastrgt JCM, Halfrens R, Schols, JMGA. Skin areas, clinical severity, duration and risk factors of intertrigo: A secondary data analysis. J Tissue Viability; 2021 30,:102-107
15. Volzer B, Genedy-Kalyoncu M, Fastner A, et al. Prevalence and associations of xerosis cutis, incontinence associated dermatitis, skin tears, pressure ulcers and intertrigo in aged nursing home residents: A representative prevalence study. Int J Nurs Stud, 2023, 141, 104472
16. Metin A, Dilek N, Bilgili S. Recurrent candidal intertrigo: challenges and solutions. Clin Cosmet Investig Dermatol. 2018; 11: 175–185.
17. Rao MR, Vasimalli VK, Gowda RS, et al. A Bacteriological Study of Intertrigo. J Pure Appl Micro 2018: 12 (4), 1839-1844 http://dx.doi.org/10.22207/JPAM.12.4.18
18. Rasoulpoor S, Shohaimi S, Salari N, et al. Candida albicans skin infection in patients with type 2 diabetes: a systematic review and meta-analysis. J Diabetes Metab Disord. 2021 Apr 19;20(1):665-672. doi: 10.1007/s40200-021-00797-0.
19. Man A, Ciurea CN, Pasaroiu D, et al. New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study. Mem Inst Oswaldo Cruz. 2017 Sep;112(9):587-592. doi: 10.1590/0074-02760170098.
20. Kalkan G, Duygu F, Bas Y. Greenish-blue staining of underclothing due to Pseudomonas aeruginosa infection of intertriginous dermatitis. J Pak Med Assoc. 2013 Sep;63(9):1192-4.
21. Cunliffe T. Intertrigo. Rickmansworth: Primary Care Dermatological Society. 2018. http://www.pcds.org.uk/clinical-guidance/intertrigo. Accessed October 12, 2024
22. Voegell D. Intertrigo: causes, prevention and management. Brit J Nurs 2020, 29 (12) S16-22
23. Black J, Gray M, Bliss, D, et al. Incontinence-Associated Dermatitis and Intertriginous Dermatitis: A Consensus. J Wound, Ostomy Continence Nurs, 2011; 38 (4), 359-372.
24. Kalra MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. Am Fam Physician. 2014;89(7):569–573
25. Sibbald RG, Kelley J, Kennedy-Evans K-L, Labrecque C, Waters N. A practical approach to the prevention and management of intertrigo, or moisture-associated skin damage, due to perspiration: expert consensus on best practice. Wound Care Canada. 2013;11(2):36-43
26. Armstrong AW, Bukhalo M, Blauvelt A. A clinician's guide to the diagnosis and treatment of candidiasis in patients with psoriasis. Am J Clin Dermatol. 2016;17(4):329–336. https://doi.org/10.1007/s40257-016-0206-4
27. Ely JW, Rosenfeld S, Seabury Stone M. Diagnosis and management of tinea infections. Am Fam Physician. 2014;90(10):702–710
28. Taudorf EH, Jemec GBE, Hay RJ, Saunte DML. Cutaneous candidiasis – an evidence-based review of topical and systemic treatments to inform clinical practice. Eurp Acad Dermatol Vener 2019 33: 1863-1873. Doi: 10.1111/jdv.15782
29. Mistiaen P, van Halm-Walters M. Prevention and treatment of intertrigo in large skin folds of adults: a systematic review. BioMed Central Nurs. 2010 9, http://www.biomedcentral.com/1472-6955/9/12
30. Leeyaphan C, Varathai S, Trakanwittayarak S, et al. A randomized controlled trial to compare the effectiveness and safety of absorbent lotion containing tapioca starch, spent grain wax, Butyrospermum parkii extract, argania spinosa kernel oil, aloe barbadensis, rosehip oil, and allantoin with a low-potency topical corticosteroid in the treatment of intertrigo. J Cosmet Dermatol 2022; (21): 679-688.
31. Nguyen JT, Palladino H, Sonnema AJ, Petty PM. Long-term satisfaction of reduction mammaplasty for bilateral symptomatic macromastia in younger patients. J Adolesc Health. 2013;53(1):112–117. https://doi.org/10.1016/j.jadohealth.2013.01.025
32. Elander A, Biörserud C, Fagevik Olsén M. Excess skin after weight loss following bariatric surgery: focus on the abdomen. Surg Obes Relat Dis. 2021 May;17(5):986-993. Doi:10.1016/j.soard.2021.01.005.
33. Tammel K, Benike D, Sievers B. A novel approach to treating moderate to severe incontinence-associated dermatitis and intertriginous dermatitis. J Wound Ostomy Nurs, 2019; 46(5):446-452.