Candidal Intertrigo
The medical name for a Candida fungal infection in skin folds, especially in diabetic or obese patients, is candidal intertrigo. 1, 2
Definition and Clinical Presentation
Candidal intertrigo is a superficial cutaneous candidiasis that presents specifically in intertriginous areas (opposing skin surfaces) where moisture, friction, and warmth create an ideal environment for fungal overgrowth. 3, 4
Key clinical features include:
- Erythematous, moist plaques in skin folds (under breasts, abdominal folds, groin, axillae) 1
- Satellite lesions (small pustules or papules) surrounding the main affected area 5
- Pruritus and pain that significantly decrease quality of life 3
- White, macerated appearance in severe cases 4
Predisposing Factors
Obesity and diabetes mellitus are the two most important predisposing factors for candidal intertrigo, as they create both mechanical (deeper skin folds) and metabolic (hyperglycemia) conditions that facilitate fungal growth. 2, 3, 4
Additional risk factors include:
Causative Organisms
Candida albicans is the most frequently isolated species in candidal intertrigo. 1 However, non-albicans species such as Candida tropicalis, Candida parapsilosis, Candida krusei, and Candida glabrata are increasingly recognized, particularly in patients with prior azole exposure. 1
Diagnostic Confirmation
While diagnosis is usually based on clinical appearance, laboratory confirmation is especially useful in treatment-resistant or recurrent cases:
- Potassium hydroxide (KOH) wet mount preparation showing budding yeast and pseudohyphae 3, 5
- Fungal culture for species identification 3
- Gram staining can also demonstrate yeast forms 6
Common Pitfall
Do not confuse candidal intertrigo with simple mechanical intertrigo (inflammation from friction alone without infection), inverse psoriasis, or bacterial intertrigo—each requires different treatment approaches. 7, 4 The presence of satellite lesions strongly suggests candidal infection rather than purely mechanical or bacterial causes. 5