Candida intertrigo

Fungal infection of the intertrigines (axillary, inguinal, perianal, submammary and abdominal folds) with Candida spp. (typically albicans)

• The lack of hygiene and increased exposure to moisture provide ideal conditions for the colonisation of C. albicans. An intertrigo with swelling of the horny layer develops into a candida intertrigo due to colonisation by C. albicans. Erosions, macerations and rhagades can form here in the course of time.

• Predisposing factors:
  • Immunological deficits
  • Humid and warm environment (heavy sweating, air-impermeable clothing)
  • Adiposity
  • Diabetes mellitus
  • Lack of hygiene

More sharply circumscribed, slightly scaly, often foetid-smelling erythema.

• clinic
• Pathogen detection with sterile cotton swab (native and culture)
• Stool examination for Candida
• Serology: Candida haemagglutination test
• Daily blood glucose profile e.g. of diabetes mellitus

• If there is a predisposing underlying disease, this should be addressed therapeutically
• Pastes containing nystatin twice a day
• If necessary, disinfection with antiseptic compresses
• Drying out the area with solutions

1. Kalra MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. Am Fam Physician 2014;89:569-73.
2. Janniger CK, Schwartz RA, Szepietowski JC, Reich A. Intertrigo and common secondary skin infections. Am Fam Physician 2005;72:833-8.
3. Mistiaen P, van Halm-Walters M. Prevention and treatment of intertrigo in large skin folds of adults: a systematic review. BMC Nurs 2010;9:12.
4. Wilmer EN, Hatch RL. Resistant "candidal intertrigo": could inverse psoriasis be the true culprit? J Am Board Fam Med 2013;26:211-4.
5. Veraldi S. Rapid relief of intertrigo-associated pruritus due to Candida albicans with isoconazole nitrate and diflucortolone valerate combination therapy. Mycoses 2013;56 Suppl 1:41-3.
6. Katoh T. [Guidelines for diagnosis and treatment of mucocutaneous candidiasis]. Nihon Ishinkin Gakkai Zasshi 2009;50:207-12.
7. Cullin SI. Cutaneous candidiasis: treatment with miconazole nitrate. Cutis 1977;19:126-9.