From the Research
The appropriate management for a 65-year-old male with a pruritic, demarcated darker skin patch with mild erythema in the right axilla is likely treatment for intertrigo or candidiasis, which are common fungal infections in this area, and I recommend starting with a topical antifungal cream such as miconazole 2% applied twice daily for 2-4 weeks, as suggested by the most recent study 1. The patient's symptoms, including a pruritic rash in the axilla with mild erythema, are consistent with intertrigo, a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation 1. Key considerations in managing this patient's condition include:
- Identifying predisposing factors and educating the patient in reducing these, such as maintaining good hygiene and wearing loose-fitting clothing to reduce skin-on-skin friction and moisture accumulation 1
- Treating secondary infection with an appropriate topical agent, such as miconazole 2% cream, which is effective against fungal infections, including candidiasis 2, 3
- Considering the use of moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture, and reduce secondary infection 1 It is essential to monitor the patient's response to treatment and adjust the management plan as needed, as the quality of evidence on which to determine the strength of any recommendations for practice remains low, and there is a need for well-designed studies to test proposed interventions and build a robust evidence base 1.