• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Can you identify this chronic malodorus rash?

Article

Case 4: An obese 59-year-old man presents with a chronic malodorous, itchy rash in his groin.

Case 4:
An obese 59-year-old man presents with a chronic malodorous, itchy rash in his groin.

Can you identify this rash?

A. Tinea cruris.
B. Candidiasis.
C. Erythrasma.
D. Intertrigo.
E. Seborrhea.
F. Psoriasis.

Case 4: Intertrigo

Obesity predisposed this patient to intertrigo, D. This inflammatory condition of the skin folds is induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Secondary infection- as occurred in this patient-is common; it usually is candidal, but it can be bacterial, viral, or other fungal infection.

The axillae, perineum, inframammary creases, and abdominal folds are the most common sites of involvement. The apposed skin surfaces rub against each other, causing erosions that become inflamed. Sweat, feces, urine, and vaginal discharge may aggravate intertrigo in both adults and infants.

The key to treatment is to eliminate friction, heat, and maceration by keeping the skin folds cool and dry. Antimycotic agents (miconazole, clotrimazole) may be helpful, especially if they are used with a mild- to midpotency (class III to VI) corticosteroid for a short duration. Avoid stronger topical corticosteroids because the occlusive effect of skin folds can accelerate the development of skin atrophy and striae.

Formulations that combine protective agents, antimicrobials, and topical corticosteroids may be helpful. One example is Triple Paste, which includes petrolatum, zinc oxide paste, and aluminum acetate (Burow) solution. A thick coat of these protective barrier creams should be applied. Commercially available barrier pastes that are used for diaper dermatitis (eg, Desitin) can also be helpful.

Recent Videos
New Research Amplifies Impact of Social Determinants of Health on Cardiometabolic Measures Over Time
Overweight and Obesity: One Expert's 3 Wishes for the Future of Patient Care
Donna H Ryan, MD Obesity Expert Highlights 2021 Research Success and Looks to 2022 and Beyond
"Obesity is a Medically Approachable Problem" and Other Lessons with Lee Kaplan, MD, PhD
© 2024 MJH Life Sciences

All rights reserved.