Differential Diagnosis for Candidal Intertrigo versus Inverse Psoriasis
- Single Most Likely Diagnosis
- Inverse psoriasis: This is a likely diagnosis due to its presentation in intertriginous areas, characterized by smooth, red, and shiny patches without the typical scale seen in other forms of psoriasis. The absence of scaling and the location in skin folds are key distinguishing features.
- Other Likely Diagnoses
- Candidal intertrigo: A common condition in warm, moist areas of the body, characterized by redness, itching, and sometimes a white, cheesy discharge. It's a plausible diagnosis given the intertriginous location and potential for fungal growth in these areas.
- Erythrasma: A bacterial infection that thrives in warm, moist areas, presenting with well-demarcated, reddish-brown patches. It could be considered due to its similarity in presentation and location to both candidal intertrigo and inverse psoriasis.
- Do Not Miss Diagnoses
- Dermatophyte infection: While less common in intertriginous areas compared to other fungal infections, dermatophytes can cause infections here, especially if the patient has been exposed to these pathogens. Missing this diagnosis could lead to inappropriate treatment and worsening of symptoms.
- Contact dermatitis: An allergic or irritant reaction could present similarly, especially in areas prone to moisture and friction. Missing this could lead to continued exposure to the offending agent and failure to improve with treatment aimed at fungal or psoriatic conditions.
- Rare Diagnoses
- Lichen planus: An inflammatory condition that can affect the skin, presenting with purplish, itchy, flat bumps. While it can occur in intertriginous areas, it's less common and might be considered if other diagnoses are ruled out and the presentation is atypical.
- Lichen sclerosus: A rare condition characterized by patchy, white skin that's thinner than normal. It can occur in genital and intertriginous areas, though it's more commonly associated with the genital area. Its consideration would depend on the specific location and appearance of the lesions.