Candidosis intertriginous B37.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Candidaintertrigo; Candida intertrigo; Candidosis in the diaper area; intertrigo candidamycetica; Nappy Lingerie; Thrush windelder dermatitis

Definition
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Erosive, macerative infection of the intertrigins (axillae, groin bends, overlapping skin folds; perianal region; submammary) by Candida albicans. Most frequent complication of an intertrigo.

Etiopathogenesis
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In incontinence, diapers lead to maceratively erosive intertrigo at the contact points. Intertriginous candidiasis (candidiasis) is thus a primary irritative disease of multifactorial origin with secondary superinfection by bacteria and yeasts of the genus Candida.

Localization
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V.a. Intertrigines = Intertrigo candidamycetica, especially submammary, inguinal, axillary, umbilical and perianal.

Clinical features
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Sharply defined, peripherally scaly erythema. Frequently pustule fringe, spatter-like papulovesicular to pustular satellites in the area.

Diagnosis
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Native preparation (spores, pseudomycel), mycological culture (differentiation on rice agar, chlamydospores). Stool examination for Candida. Serology: Candida haemagglutination test.

Differential diagnosis
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Intertrigo: No detection of yeasts

Erythrasma: dry, non-macerative dermatitis; brownish-red colour.

Pemphigus chronicus benignus familiaris: chronic, macerative dermatitis, completely resistant to therapy, evidence of the accordion phenomenon.

Psoriasis intertriginosa: chronic, often macerative dermatitis, completely resistant to treatment. Mostly affects the perional region; sharp limitation.

Allergic contact eczema: acute itchy dermatitis; possibly weeping; typical satellite foci.

Toxic contact dermatitis: acute itchy dermatitis; cause can usually be determined; possibly weeping; no satellite foci.

General therapy
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Informing the patient about the factors that favour this. Weight reduction for adults! For babies use breathable absorbent diapers. Insert diaper-free episodes. Careful personal hygiene. Mild cleansing measures (vegetable or paraffin-containing oils), dry the diaper area well or blow dry.

External therapy
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Notice! Do not use highly fatty bases in intertriginous macerations, as this will lead to an occlusive effect without evaporation. Instead use aqueous solutions or pastes!

Note(s)
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Candida dubliniensis also forms chlamydial spores on the rice agar. With the detection of chlamydospores, however, the diagnosis of Candida albicans is highly probable, as Candida dubliniensis is rarely found.

Literature
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  1. Halvaee S et al (2018) Investigation of Intertriginous Mycotic and Pseudomycotic (Erythrasma) Infections and Their Causative Agents with Emphasize on Clinical Presentations. Iran J Public Health 47:1406-1412.
  2. Krajewska-Kulak E et al (2003) Difficulties in diagnosing and treating tinea in adults at the Department of Dermatology in Bialystok (Poland).Dermatol Nurs 15:527-530,
  3. Seebacher C et al (2006) Candidosis of the skin. J Dtsch Dermatol Ges 4: 591-596

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020