Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Alternative diagnoses include inverse psoriasis, candidal infection, adult diaper dermatitis, granuloma inguinale, pemphigus vegetans, benign familial pemphigus (Hailey-Hailey disease), toxic epidermal necrolysis, and extramammary Paget disease. Resistant candidal intertrigo: could inverse psoriasis be the true culprit? When treatment fails, nonadherence to treatment and medication resistance often are suspected; however, the possibility of an incorrect diagnosis should also be entertained. The diagnosis and treatment of inverse psoriasis is reviewed, and other conditions that may be confused with Candida and inverse psoriasis, including bacterial intertrigo, tinea, and seborrheic dermatitis, are discussed. For example, the differential diagnosis of the papulosquamous reaction pattern includes psoriasis, seborrheic dermatitis, lichen planus, pityriasis rosea, drug eruption, tinea corporis, secondary syphilis, and cutaneous T-cell lymphoma. The eczematous reaction pattern of skin includes the gamut of diseases called eczema or dermatitis. GPP in patients with preceding plaque-type disease is more likely to be triggered by systemic corticosteroid treatment, whereas those with no prior history of psoriasis is more likely preceded by infection.
See also: Fungal Groin Infection (Tinea Cruris) written for patients. Typically lesions are on exposed skin of the trunk, arms and legs (see ‘Differential diagnosis’, below). Eczema and psoriasis are commonly confused with tinea. Pityriasis versicolor occurs all over the trunk while candida occurs as a flexural rash at extremes of age or in the immunocompromised, those with diabetes or patients on antibiotics. 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. The microorganisms that are normally resident on flexural skin, the microbiome, include corynebacteria, other bacteria and yeasts. We can classify intertrigo into infectious and inflammatory origin but there is often overlap. Inflammatory disorders tend to be symmetrical affecting armpits, groins, under the breasts and the abdominal folds, except atopic dermatitis, which more often arises on the neck, and in elbow and knee creases. Intertrigo due to psoriasis. 9 Common Differential Diagnoses of Intertrigo. 9 Psoriasis..10 Seborrheic dermatitis of the flexural areas. 10 Seborrheic dermatitis of the flexural areas..10 Contact dermatitis of the flexural areas. 10 Contact dermatitis of the flexural areas. Treat secondary infection with appropriate systemic and topical agents. e. Revisit the diagnosis in cases that do not respond to usual therapy. The diagnosis is made by finding coral-red fluorescence, which is due to an excreted porphyrin, under a Wood s light.
A differential diagnosis of some common skin rashes by distribution and pattern is presented below:. A diagnosis of a cutaneous dermatophyte infection may be strongly suspected based upon the clinical findings. Related to intertriginous dermatitis: intertrigo Dermatitis. The diagnosis of dermatitis is made on the basis of how the rash looks and its location. The differential diagnosis includes psoriasis; it should be ruled out and neurologic conditions recognized as possible predisposing factors.
Dermatophytosis (tinea Infections). Medical Information. Patient
Tinea cruris is a fungal infection of the groin commonly called jock itch. It is also known as inverse psoriasis due to the different appearance of the rash, without the superficial scales. The condition can be confused with dermatitis. Secondary infection often occurs. The patient had no past history of any skin problems, except for eczema as a child. If unsure, the diagnosis can be made using a Wood’s lamp, which causes the organisms to fluoresce a coral red colour because of the porphyrins released by the bacteria. Diagnosis is made with scraping of the burrow at the dark spot and doing KOH. Differential includes seborrheic dermatitis, psoriasis and alopecia areata. Tinea cruris candida erythrasma inverse psoriasis all four of these conditions cause a certain type of skin lesion. Describe the appearance and population of candida intertrigo. Sudden onset of psoriasis may be associated with HIV infection. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS Diagnosis is made on clinical grounds. Inverse Psoriasis Tinea, candidiasis, intertrigo, extramammary Paget disease. Occasionally, infected intertrigo may cause malaise or fever, or even graduate into full-blown cellulitis or other invasive infection.
What Is The Differential Diagnosis Of An Infectious Rash On The Palms And Soles?
Candidal intertrigo, Hailey disease may be mistaken as flexural psoriasis. The differential diagnosis includes seborrheic and atopic dermatitis. Less frequent causes of intertrigo are erythrasma, inverse psoriasis, scabies and histiocytosis. The date the article was first made available online will be carried over.