Axillary and Inguinal Creases

Axillary and Inguinal Creases


The word “intertrigo” comes from the Latin, terere, to rub, a catch-all word for the more descriptive term “intertriginous dermatitis.” Thus, when used in its more inclusive sense, intertrigo refers to an inflammatory condition of skinfolds. Intertriginous areas are places where skin is subject to the friction of repeated movement, chafing, obesity, increased local heat, and maceration from retained moisture and from topical applications, all of which serve to provide an excellent environment for potential irritant, fungal, as well as bacterial complications. Both the axillae and inguinal creases are “hot spots” for intertrigo.

Besides the inguinal creases and axilla, the body has other intertriginous appositional places such as the inframammary areas (see Fig. 11-53), finger webs (see Fig. 14-28), toe webs, perineum, and abdominal creases, all represent two opposing surfaces that are incessantly in intimate contact.

The potassium hydroxide (KOH) test, Gram stain, and bacterial culture are useful to exclude primary or secondary infection and to guide therapy. The sun-shaded axillae and inguinal creases are unlikely to absorb much in the way of ultraviolet exposure and are generally spared many skin cancers, although various benign skin growths such as skin tags and melanocytic nevi are commonly found there.

Since both the inguinal and axillary creases share many of the same cutaneous disorders, they will be discussed together in this chapter.

Irritant Intertrigo

Distinguishing Features

  • Begins as a mild erythema followed by erythematous well-demarcated patches or plaques that oppose each other on either side of the skinfolds like a mirror image (Fig. 12-1)

  • An atopic history is frequently elicited

  • Often pruritic; may progress to erosions, oozing, exudation, and painful fissures within the plaques or develop a secondary infection with coagulase-positive Staphylococcus aureus or Candida species (see below)

Allergic Contact Dermatitis

Distinguishing Features

  • Mild erythema initially, followed by erythematous eczematous plaques and/or vesico-bullae (Fig. 12-2)

  • Pruritus may be severe

Inverse Psoriasis

Distinguishing Features

  • The deep pink to red color and well-defined borders characteristic of psoriasis may be obvious; however, they generally lack scale (Figs. 12-3 and 12-4)

  • May be pruritic

  • Fissures may occur

Cutaneous Candidiasis

Distinguishing Features

  • “Beefy red” lesions

  • Satellite pustules may be seen beyond the border of the plaques (Figs. 12-5 and 12-6)

  • Maceration and fissures may be present

  • Soreness and/or pruritus

Tinea Cruris

Jan 8, 2023 | Posted by in Dermatology | Comments Off on Axillary and Inguinal Creases
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