12/27/2023 0 Comments Antifungal cream for armpits![]() De Britto LJ, Yuvaraj J, Kamaraj P, Poopathy S, Vijayalakshmi G.Diaper (napkin) dermatitis: a fold (intertriginous) dermatosis. Intertrigo and common secondary skin infections. ![]() Janniger CK, Schwartz RA, Szepietowski JC, Reich A.Calcineurin inhibitors such as tacrolimus ointment or pimecrolimus cream are also effective in skin folds. More potent steroids are best avoided in the flexures because they can cause skin thinning, resulting in stretch marks ( striae atrophicae) and rarely, ulcers. Inflammatory skin diseases are often treated with low potency topical steroid creams such as hydrocortisone.Yeasts and fungi may be treated with topical antifungals such as clotrimazole and terbinafine cream or oral antifungal agents such as itraconazole or terbinafine.Bacterial infection may be treated with topical antibiotics such as fusidic acid cream, mupirocin ointment, or oral antibiotics such as flucloxacillin and erythromycin.Sweating can be reduced with an antiperspirant cream or powder.A hairdryer on cool setting is an effective approach for drying underarms and breasts. Physical exertion should be followed by bathing and completely drying skin flexures.Zinc oxide paste can be used for napkin dermatitis or incontinence-associated irritant contact dermatitis.Treatment depends on the underlying cause if identified, and on which micro- organisms are present in the rash.A skin biopsy may be performed for histopathology if the skin condition is unusual or fails to respond to treatment.A scraping for microscopy and culture of fungi (mycology).A swab for microscopy and culture of bacteria (microbiology).Investigations may be necessary to determine the cause of intertrigo. Itchy, moist, peeling, red and white skin.Other inflammatory disorders also tend to be symmetrical affecting the armpits, groins, under the breasts, and the abdominal folds.Atopic dermatitis is usually bilateral and symmetrical, affecting the flexures of the neck, knees and elbows.Infections tend to be unilateral and asymmetrical.Intertrigo is classified into infectious and inflammatory origins, but they often overlap. Microbiome overgrowth in warm moist environments can cause intertrigo. The microbiome ( microorganisms normally resident on the skin) on flexural skin includes Corynebacterium, other bacteria, and yeasts. Diabetes, alcohol, and smoking increase the likelihood of intertrigo, especially the infectious form.Intertrigo occurs more easily in environments that are hot and humid.Friction from the movement of adjacent skin results in chafing.Moisture from insensible water loss and sweating cannot evaporate due to occlusion.Flexural skin has a relatively high surface temperature.Intertrigo is due to genetic and environmental factors. Intertrigo with secondary bacterial infection (eg, pseudomonas) can cause a foul odour. The affected skin can become moist and macerated, leading to fissuring (cracks) and peeling. The skin affected by intertrigo is inflamed, reddened, and uncomfortable. The exact appearance and behaviour depend on the underlying cause(s). Intertrigo can be acute (recent onset), relapsing ( recurrent), or chronic (present for more than six weeks). What are the clinical features of intertrigo? Lymphoedema is also a cause for toe-web intertrigo. Toe-web intertrigo is associated with closed-toe or tight-fitting shoes. In infants, napkin dermatitis is a type of intertrigo that primarily occurs due to skin exposure to sweat, urine, and faeces in the diaper area. Intertrigo is particularly common in people who are overweight or obese (see metabolic syndrome). Intertrigo can affect males or females of any age. Intertrigo is a sign of inflammation or infection. Although intertrigo can affect only one skin fold, intertrigo commonly involves multiple sites. Intertrigo describes a rash in the flexures, such as behind the ears, in the folds of the neck, under the arms, under a protruding abdomen, in the groin, between the buttocks, in the finger webs, or in the toe spaces.
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