Investigation of Intertriginous Mycotic and Pseudomycotic (Erythrasma) Infections and Their Causative Agents with Emphasize on Clinical Presentations
Background: Intertrigo is an erythematous inflammatory condition with multiple etiologies including fungi and bacteria. Intertrigo manifests in different clinical forms with various complaints. This study was conducted to evaluate the causative agents of intertriginous infections with emphasize on clinical presentations.
Methods: This descriptive cross-sectional study was carried out in 2015-2016, on 188 patients with clinical suspicion of superficial and cutaneous intertriginous infections in Tehran, Iran. Demographic and additional related data were obtained by questionnaire from all participants. Specimens were collected by gentle scraping of the affected areas. Direct examination and culture were performed for all specimens and grown colonies were identified based on the macroscopic and microscopic features. Supplementary tests were done whenever needed. Data were analyzed in SPSS.
Results: Overall, 80 (42.5%) cases with the mean age of 43.5 yr were confirmed for intertrigo. Dermatophytosis was the predominant cause in this study with 36 (45%) cases followed by erythrasma (28 cases, 35%), tinea versicolor (10 cases, 12.5%) and candidiasis (6 cases, 7.5%). Intertrigo lesions with dermatophytic agents significantly were observed in groin in comparison to different infections among body sites (P<0.05). Itching was the most common clinical presentation (57cases, 71.3%) and also significant association between different infections and clinical manifestations were observed (P<0.05).
Conclusion: Different clinical manifestations may be observed in infectious intertrigo. Regarding the significant association observed in this study, some clinical features can be used for presumptive diagnosis of diseases but further studies are required to make it clear.
Keita S, Faye O, Traoré A et al (2012). Dermatitis of the folds in black Africans in Bamako, Mali. Int J Dermatol, 51: 37-40.
Wolf R, Oumeish OY, Parish LC (2011). Intertriginous eruption. Clin Dermatol, 29(2): 173-9.
Mistiaen P, van Halm-Walters M (2010). Prevention and treatment of intertrigo in large skin folds of adults: a systematic review. BMC Nurs, 9(1): 12.
Kalra MG, Higgins KE, Kinney BS (2014). Intertrigo and secondary skin infections. Am Fam Physician, 89(7): 569-73.
Tüzün Y, Wolf R (2015). Commentary: Fold (intertriginous) dermatoses: When skin touches skin. Clin Dermatol, 33(4): 411-3.
Ruocco E, Baroni A, Donnarumma G, Ruocco V (2011). Diagnostic procedures in dermatology. Clin Dermatol, 29(5): 548-56.
Rashidian S, Falahati M, Kordbacheh P et al (2015). A study on etiologic agents and clinical manifestations of dermatophytosis in Yazd, Iran. Curr Med Mycol, 1(4): 20-5.
Metin A, Dilek N, Demirseven DD (2015). Fungal infections of the folds (intertriginous areas). Clin Dermatol, 33(4): 437-47.
Sariguzel FM, Nedret Koc A, Yagmur G, Berk E (2014). Interdigital foot infections: Corynebacterium minutissimum and agents of superficial mycoses. Braz J Microbiol, 45(3): 781-4.
Janniger CK, Schwartz RA, Szepietowski JC, Reich A (2005). Intertrigo and common secondary skin infections. Am Fam Physician, 72(5): 833-8.
Suh SB (1996). Dermatophytosis and its causative agents in Korea. Korean J Med Mycol, 1(1): 1-10.
Jang SJ, Ahn KJ (2004). Superficial dermatomycosis and the causative agents in Korea. Korean J Med Mycol, 9(2): 91-99.
Kim KH (2006). Changing patterns of dermatophytosis and its causative agents according to social and economic developments in Korea. Korean J Med Mycol, 11(1): 1-12.
Kim KH (2006). Superficial cutaneous mycoses in Korea. Hanyang Med Rev, 26(4): 4-14.
Kim S-H, Cho S-H, Youn S-K et al (2015). Epidemiological characterization of skin fungal infections between the years 2006 and 2010 in Korea. Osong Public Health Res Perspect, 6(6): 341-5.
Robins DN (1978). Cutaneous groin lesions. Prim Care, 5(2): 215-32.
Karaca S, Kulac M, Cetinkaya Z, Demirel R (2008). Etiology of foot intertrigo in the District of Afyonkarahisar, Turkey: a bacteriologic and mycologic study. J Am Podiatr Med Assoc, 98(1): 42-4.
HOJYO‐TOMOKA MT (1994). Women in dermatology: a personal view IX. Int J Dermatol, 33(11): 773-4.
Hay RJ (2016). Diagnosing dermatophytic infections in the molecular age. Br J Dermatol, 174(3): 483-4.
Aljabre SH (2003).Intertriginous lesions in pityriasis versicolor. J Eur Acad Dermatol Venereol, 17(6): 659-62.
Rahman HM, Hadizzaman MD, Jaman Bhuiyan KM et al (2011). Prevalence of superficial fungal infection in the rural areas of Bangladesh. Iran J Dermatol, 14: 86-91.
Nenoff P, Krüger C, Schaller J et al(2014). Mycology - an update part 2: dermatomycoses: clinical picture and diagnostics. J Dtsch Dermatol Ges, 12(9): 749-77.
Boza JC, Trindade EN, Peruzzo J et al (2012). Skin manifestations of obesity: a comparative study. J Eur Acad Dermatol Venereol, 26(10): 1220-3.
Bindu V, Pavithran K (2002). Clinico-mycological study of dermatophytosis in Calicut. Indian J Dermatol Venereol Leprol, 68(5): 259-61.
Guida B, Nino M, Perrino N et al (2010). The impact of obesity on skin disease and epidermal permeability barrier status. J Eur Acad Dermatol Venereol, 24(2): 191-5.
Yosipovitch G, Tur E, Cohen O, Rusecki Y (1993). Skin surface pH in intertriginous areas in NIDDM patients: possible correlation to candidal intertrigo. Diabetes Care, 16(4): 560-3.
|Issue||Vol 47 No 9 (2018)|
|Intertrigo Tinea Candidiasis Erythrasma Signs and symptoms|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|