Disorders of the Groin and Skin Folds

1
Disorders of the Groin and Skin Folds

• Tintinalli 249

2
Tinea Cruris

• Cause
• Dermatophytes
• Rare in children
• Clinical
• Erythema with peripheral annular scaly edge
• Groin extending to thigh and buttock

3
Tinea Cruris

• Treatment
• Antifungal creams
• Econazole if maceration (has antibacterial
  effect)
• Antifungal powders daily to prevent reoccurance

4
Candida Intertrigo

• Candidial infection involving skin fold
• Moist skin folds
• Diaper areas
• Clinical
• Erythema and maceration with surrounding samall
  papules or pustules
• Burning / itching

5
Candida Intertrigo

• Treatment
• Keep area dry and cool
• Antifungal cream
• Econazole if maceration
• Astringent solutions
• Hydrocortisone cream may be added to speed
  recovery
• Daily drying powders

6
Noninfectious Intertrigo

• Cause
• Irritant dermatitis of skin folds from mositure,
  heat and friction (including diaper dermatitis)
• Clinical
• Erythema, maceration, and fissures in occluded
  skin folds
• No satellite papules or pustules
• Burning / pruritis

7
Noninfectious Intertrigo

• Treatment
• Keep area dry
• Disposable diapers over cloth
• Astringent compresses
• Antibiotics is secondary bacterial infection

• Dual therapy
• Anticandidal / steriod creams
• Lotrisone , mycolog
• Should be avoided in skin folds
• Contain high potency fluorinated steroids
• Cause skin atrophy
• Vytone HC 1 is dual option with 1 hydrocortisone

8
Seborrheic Dermatitis

• Scalp dandruff
• Creases of face, ears common. Also other skin
  fold areas can be seen such
• Cause
• Believed to be from yeast
• Clinical
• Erythema with waxy yellow scale
• May have maceration

9
Seborrheic Dermatitis

• Treatment
• Anti dandruff shampoos
• Nizoral now OTC
• Low potency corticosteroid creams
• Usually returns after treatment