Dermatology AND Intertrigo [keywords]
- [Etiology of intertrigo in adults: A prospective study of 103 cases]. [JOURNAL ARTICLE, ENGLISH ABSTRACT]
- J Mycol Med 2016 Aug 20.
The etiologies of intertrigo in adults are numerous and different. The objective of our work was to study the epidemiological, clinical and the risk factors of intertrigo in adults.We conducted a prospective study for a period of seven months in two Dermatology Units in Dakar (Senegal). All adults patient with intertrigo seen during this period who gave consent were included.One hundred and three patients with intertrigo were diagnosed with a hospital prevalence of 2.54%. The sex -ratio was 0.63 and the average age was 41. The study of habits and lifestyles of the patients found a history of intensive skin lightening, sport, wearing synthetic clothes and smoking in 26, 22, 20 and 22 cases, respectively. Infectious complications mainly bacterial (3.88%) and viral (1.94%) were reported in nine cases (8.7%). A dry erythroderma was noted in 3 cases (2.9%). It was found that the intertigo was commonly caused by fungal infections with a prevalence of 48.5% followed by immuno-allergic reactions with a prevalence of 34.9%, suppurative hidradenitis and inverse psoriasis with the same prevalence of 2.9%. Fifty-eight percent of cases with tinea and 63% of cases with candidiasis were women. Thirty-five percent of tinea cases and 45% of candidiasis cases were found to have a history of intensive skin lightening.The cause of intertrigo in adults are mainly infectious, particularly fungi, infections and immuno-allergic diseases. There are predisposing factors and some professions are more at risk.
- Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged. [JOURNAL ARTICLE]
- J Tissue Viability 2016 Jul 25.
Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far.The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years).A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used.Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed.Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was identified. Because of the overall low methodological quality clear cut conclusions cannot be drawn. Robust and large scales economic evaluations about skin conditions and disease in aged populations are needed in the future.
- Successful treatment of recalcitrant candidal intertrigo with Dr Michaels® (Fungatinex®) product family. [Journal Article]
- J Biol Regul Homeost Agents 2016 Apr-Jun; 30(2 Suppl 3):89-93.
Candidal intertrigo is an infection of the skin caused by Candida albicans that typically occurs in opposing cutaneous or muco-cutaneous surfaces. Because Candidiasis requires a damaged and moist environment for infection, it typically occurs in areas of friction such as the skin folds of the body. Candidal intertrigo is often difficult to treat and results are often unsatisfactory. In addition, there is a lack of evidence-based literature supporting prevention and treatments for candidal intertrigo. The aim of the study was to evaluate the efficacy of Dr Michaels® (also branded as Fungatinex®) products in the treatment of fungal intertrigo, in 20 women and 2 men with a mean age of 72. Five patients (3 female and 2 male) had type 2 diabetes and 16 (14 female and 2 male) were obese. The patients were treated with Dr Michaels® (Fungatinex®) moisturising bar, topical ointment (twice daily application) and oral herbal formulation, PSC 200 two tablets twice daily with food. After 2 weeks of treatment, the lesions had mostly resolved in all patients with only slight erythema evident. After six weeks of treatment using the moisturising bar, topical ointment and oral herbal formulations from the Dr Michaels® (Fungatinex®) product family, the lesions had totally resolved in 18 patients, while 4 patients had to continue the therapeutic protocol for another 2 weeks. Our results demonstrate that the Dr Michaels® (Fungatinex®) complementary product family is efficacious in the treatment of recalcitrant candidal intertrigo. Furthermore, this study highlights that the Dr Michaels® (Fungatinex®) product family is fast-acting and well tolerated with no serious adverse events reported. These data have important implications for resistant cases of candidal intertrigo where traditional therapies have failed.
- Papular acantholytic dyskeratosis of the genitocrural area: A rare unilateral asymptomatic intertrigo. [Journal Article]
- JAAD Case Rep 2016 Mar; 2(2):132-4.
- Pressure and Friction Injuries in Primary Care. [Journal Article, Review]
- Prim Care 2015 Dec; 42(4):631-44.
Pressure and friction injuries are common throughout the lifespan. A detailed history of the onset and progression of friction and pressure injuries is key to aiding clinicians in determining the underlying mechanism behind the development of the injury. Modifying or removing the forces that are creating pressure or friction is the key to both prevention and healing of these injuries. Proper care of pressure and friction injuries to the skin is important to prevent the development of infection. Patient education on positioning and ergonomics can help to prevent recurrence of pressure and friction injuries.
- Study of the Etiological Causes of Toe Web Space Lesions in Cairo, Egypt. [Journal Article]
- Dermatol Res Pract 2015.:701489.
Background.The etiology of foot intertrigo is varied. Several pathogens and skin conditions might play a role in toe web space lesions.
Objective.To identify the possible etiological causes of toe web space lesions. Methods. 100 Egyptian patients were enrolled in this study (72 females and 28 males). Their ages ranged from 18 to 79 years. For every patient, detailed history taking, general and skin examinations, and investigations including Wood's light examination, skin scraping for potassium hydroxide test, skin swabs for bacterial isolation, and skin biopsy all were done.
Results.Among the 100 patients, positive Wood's light fluorescence was observed in 24 and positive bacterial growth was observed in 85. With skin biopsy, 52 patients showed features characteristic for eczema, 25 showed features characteristic for fungus, 19 showed features characteristic for callosity, and 3 showed features characteristic for wart while in only 1 patient the features were characteristic for lichen planus.
Conclusion.Toe web space lesions are caused by different etiological factors. The most common was interdigital eczema (52%) followed by fungal infection (25%). We suggest that patients who do not respond to antifungals should be reexamined for another primary or secondary dermatologic condition that may resemble interdigital fungal infection.
- [Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study]. [English Abstract, Journal Article]
- Ann Dermatol Venereol 2015 Nov; 142(11):633-8.
Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context.We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors.During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5).The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.
- Clinical characteristics of patients with lower limb cellulitis and antibiotic usage in Hospital Kuala Lumpur: a 7-year retrospective study. [Journal Article]
- Int J Dermatol 2016 Jan; 55(1):30-5.
Cellulitis commonly involved lower limbs. This study was carried out to determine the demography, clinical characteristics, risk factors, microbiological aspects, and antibiotics usage in this group of patients in Hospital Kuala Lumpur.A total of one hundred and twenty four patients with lower limb cellulitis treated in the Department of Dermatology, Hospital Kuala Lumpur, between January 2008 and May 2013 were included in this study.There were 70 male and 54 female patients, aged between 13 and 87 years (mean 57.23±12.854). Thirty-one of them (25%) had recurrent cellulitis. Fifty-seven (46%) had fever at presentation, 55 (44.4%) had bullous cellulitis. The top risk factors identified were toe web intertrigo (n = 79, 63.7%), hypertension (n=76, 61.3%), obesity (n = 55, 44.4%), and diabetes (n = 55, 44.4%). However, only toe web intertrigo (p = 0.003), peripheral vascular disease (p = 0.01), and varicose veins (p = 0.02) were significantly higher in recurrent cellulitis. Thirty patients (24.2%) were complicated with lipodermatosclerosis, and six (4.8%) had lymphostasis verrucosa cutis. Skin swab cultures were positive in 54 (43.5%) patients, and Pseudomonas sp. was the most frequently identified organism. Mean number of antibiotics given for one episode of cellulitis was 1.7±1. The antibiotics most given were cloxacillin (n=57, 46%) and other penicillins (n = 71, 57%), followed by cephalosporins (n = 40, 32%).Identifying clinical characteristics of those at risk may help to prevent recurrence of cellulitis and long-term complications.
- Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. [Comparative Study, Journal Article, Review]
- Clin Dermatol 2015 Jul-Aug; 33(4):483-91.
Human sweat glands disorders are common and can have a significant impact on the quality of life and on professional, social, and emotional burdens. It is of paramount importance to diagnose and treat them properly to ensure optimal patient care. Hyperhidrosis is characterized by increased sweat secretion, which can be idiopathic or secondary to other systemic conditions. Numerous therapeutic options have been introduced with variable success. Novel methods with microwave-based and ultrasound devices have been developed and are currently tested in comparison to the conventional approaches. All treatment options for hyperhidrosis require frequent monitoring by a dermatologist for evaluation of the therapeutic progress. Bromhidrosis and chromhidrosis are rare disorders but are still equally disabling as hyperhidrosis. Bromhidrosis occurs secondary to excessive secretion from either apocrine or eccrine glands that become malodorous on bacterial breakdown. The condition is further aggravated by poor hygiene or underlying disorders promoting bacterial overgrowth, including diabetes, intertrigo, erythrasma, and obesity. Chromhidrosis is a rare dermatologic disorder characterized by secretion of colored sweat with a predilection for the axillary area and the face. Treatment is challenging in that the condition usually recurs after discontinuation of therapy and persists until the age-related regression of the sweat glands.
- Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. [Journal Article, Review]
- Clin Dermatol 2015 Jul-Aug; 33(4):477-82.
Diaper (napkin) dermatitis is an acutely presenting inflammatory irritant contact dermatitis of the diaper region. It is one of the most common dermatologic diseases in infants and children. In the past, the disease was thought to be caused by ammonia; however, a number of factors, such as friction, wetness, inappropriate skin care, microorganisms, antibiotics, and nutritional defects, are important. Diaper dermatitis commonly affects the lower parts of the abdomen, thighs, and diaper area. Involvement of skin fold regions is typical with diaper dermatitis. At the early stages of the disease, only dryness is observed in the affected area. At later stages, erythematous maceration and edema can be seen. Secondary candidal and bacterial infections can complicate the dermatitis. In the differential diagnosis of the disease, allergic contact dermatitis, intertrigo, psoriasis, atopic and seborrheic dermatitis, and the other diseases should be considered. Causes of the disease should be determined and eliminated primarily. Families need to be informed about the importance of a clean, dry diaper area and the frequency of diaper changes. The use of superabsorbent disposable diapers has decreased the incidence of the disease. Soap and alcohol-containing products should be avoided in cleaning the area. In some cases, corticosteroids and antifungal agents can be administered. If necessary, antibacterial agents and calcineurin inhibitors can also be beneficial.