“Nonspecific” intertrigo: the morphology (borders that aren’t sharp, absence of satellite lesions) is a key diagnostic clue.
A 64-year-old obese man with type 2 diabetes presents with abrupt onset of extremely itchy rash on both upper, inner thighs. He notes mild to moderate clear oozing and a foul odor.
Key point: The affected area does not demonstrate the typical sharp borders of tinea cruris or the satellite pustules of candidiasis. There is obvious clear exudate present. This morphology is good for “nonspecific” intertrigo.
Treatment: Twice-daily application of a combination product containing a broad-spectrum anti-infective (iodoquinol) and a low-potency corticosteroid (hydrocortisone 1%) manages this problem well.
Note: Other diagnostic entities to consider (should the above treatment strategy fail) include inverse psoriasis, intertriginous seborrheic dermatitis, and extramammary Paget disease.