Prevention and treatment of intertrigo in large skin folds of adults: a systematic review

Abstract

BackgroundIntertrigo in the large skin folds is a common problem. There is a plethora of treatments, but a lack of evidence about their efficacy. A nursing guideline on this matter had to be updated and broadened in scope to other health care professionals.MethodsA systematic review was performed. Thirteen databases were sensitively searched, supplemented by reference tracking and forward citation searches. All types of empirical research relating to the prevention or treatment of intertrigo were included. Study selection, assessment of bias, data-extraction and analysis were done by two independent review-authors.ResultsSixty-eight studies fulfilled the inclusion criteria. Only 4 studies were RCTs and even these had a considerable risk of bias. Study populations were generally small.No studies were found about the prevention of intertrigo. The therapies concerned mostly the topical application of antimycotics, corticosteroids, antibiotics, antiseptics or a combination of these. Besides these pharmaceutical interventions, surgical breast reduction was also studied. Although most study-authors were positive, we could not draw firm conclusions about any of the pharmaceutical interventions. Even patients that received placebo intervention showed improvement. There is weak evidence that reduction mammaplasty may be helpful to treat inframammary intertrigo. All research found had considerable risk of bias, prohibiting firm conclusions.ConclusionsThere is no evidence at all about the prevention of intertrigo and there is no firm evidence about its treatment. Well designed studies are needed.

MASD Part 2

“…The combination of increased perspiration and larger skin folds increases the risk for maceration and for friction damage. [62][63][64][65] Although some morbidly obese patients may be unable to reach all body areas to provide self-care, panel members believe that the perception that ITD is typically caused by poor hygiene potentially serves to bias healthcare providers regarding obesity and skin fold disease. 57 Obese patients demonstrate significantly higher TEWL and greater erythema than leaner patients.…”

“…63 Patients should be encouraged to wear loose-fitting, lightweight clothing made from natural fibers to absorb moisture from skin folds. 63 Patients should be encouraged to wear loose-fitting, lightweight clothing made from natural fibers to absorb moisture from skin folds.…”

Erişkin Obez Hastalarda Dermatolojik Bulgular

“…Intertrigo is particularly common in obese patients with diabetes who are exposed to high heat and humidity, but it can occur in anyone 28 . The individuals who have diabetes mellitus were excluded in our study, so we can't comment on the role of diabetes mellitus in the development of intertrigo in obese patients.…”

Rapid relief of intertrigo‐associated pruritus due to Candida albicans with isoconazole nitrate and diflucortolone valerate combination therapy

“…Clinical manifestations of intertrigo include erythema in mirror format and moist skin. Patients often complain of itching, burning feeling, pain and odour . Intertrigo is clinically characterised by initial mild erythema that can progress to more severe inflammation with vesicles, pustules, erosions, oozing, exudation, maceration, and crusting .…”

“…Patients often complain of itching, burning feeling, pain and odour . Intertrigo is clinically characterised by initial mild erythema that can progress to more severe inflammation with vesicles, pustules, erosions, oozing, exudation, maceration, and crusting . Secondary cutaneous infections due to bacteria, yeasts or dermatophytes are common.…”