ʻO ka huaʻōlelo intertrigo mai ka Latin inter, ma waena a me tergo, I rub. No laila, koho ia i nā dermatoses ma nā wahi ʻelua o ka ʻili e pā ai a ʻāwili pū, i kapa ʻia ʻo nā pelu.

He aha kēīa ? 

ʻO Intertrigo kahi maʻi dermatosis i hoʻopili ʻia i nā ʻili ʻili, inā paha i hoʻopili ʻia a hui pū paha, nui (inguinal, interlocking, axillary, submammary folds) a i ʻole liʻiliʻi (interdigito-palmar, inter toes, umbilicus, retroauricular, labial commissures, piko).

Nā ʻano like ʻole o ka intertrigo

Aia nā intertrigos o ka infectious kumu (mycoses, bacteria, etc.), a me nā intertrigos non-infectious i hopena pinepine mai ka localization o nā dermatoses (eczema, psoriasis, etc.) i loko o nā pā.

Ma ke kino, hoʻokaʻawale ʻia ma waena o nā intertrigos maloʻo a me nā intertrigos pulu a me ka oozing.

ʻO nā kumu o ka intertrigo

Infectious intertrigo

Fungus intertrigo, mycosis o nā pā

ʻO ka maʻi hū ke kumu nui o ka intertrigo. ʻElua ʻano o nā haʻiki i pili:

• Dermatophytes, hāʻawi pinepine i nā intertrigos maloʻo
• ʻO Candida, ʻo ia nā mea hū, e hana pinepine i kahi intertrigo ʻālohilohi a pulu

Intertrigos bacteria

• ʻO Corynebacterium minutissium intertrigo, erythrasma: ʻO Erythrasma ka mea maʻamau maʻamau maʻamau i loko o ka inguinal a me nā ʻāpana axillary.
• Pseudomonas aeruginosa intertrigo: ʻO Pseudomonas, i kapa ʻia ʻo pyocyanic bacillus, he huakino e noho ana i ka lepo a me ka wai. No laila, hoʻohaumia mākou iā mākou iho i ka hoʻopili ʻana me ka lepo pulu (māla, etc.) a i ʻole ka wai wela (spa, etc.) a hoʻopili pinepine ia i nā intertrigos dermatophytic ma o ka maceration a me ka hou. No laila, he mea maʻamau ia i nā hakahaka waena, e lilo koke i ʻeha, erosive, oozing a pilau paha.

Intertrigos i nā bacteria pathogenic ʻē aʻe

Hoʻokumu ʻia lākou e staphylococci, streptococci a me Gram-negative bacilli (colibacilli). ʻOi aku ka maʻamau o kēia mau intertrigos i ka poʻe momona, ka maʻi maʻi maʻi a me nā maʻi me ka maʻemaʻe maikaʻi ʻole, a maʻamau ka paʻakikī i kahi dermatosis lalo.

Intertrigos non-infectious

• Psoriasis: Fold psoriasis a i ʻole "inverted" psoriasis ka mea maʻamau i ka intergluteal fold.
• Huhu: He lua ia i ka hoʻohana ʻana i nā lāʻau lapaʻau kūloko (antiseptic, cosmetics) a i ʻole ma muli o ka hoʻopili ʻana me kahi mea caustic.
• Eczema: Hiki ke lilo i ka ma'i eczema ma muli o ka allergy i ka deodorant ma nā ʻā'ī no ka laʻana a i ʻole ka dermatitis atopic e pili ana i kekahi mau ʻāpana (nā ʻāhu retrouricular, nā kuli, nā ʻāpana o nā kuʻekuʻe ...).

Nā kumu kakaikahi

• ʻO ka maʻi Hailey-Hailey kahi maʻi ʻili i hoʻoili ʻia.
• ʻO ka maʻi o Paget he maʻi ʻino e pili ana i kahi adenocarcinoma intraepidermal.
• ʻO ka maʻi o Crohn, kahi maʻi hoʻoheheʻe inflammatory, hiki ke hoʻopili i ka intergluteal a me ka inguinal folds
• ʻO ka pemphigus vegetative kahi ʻano lapaʻau laʻaʻole o ka pemphigus ʻinoʻino e pili ana i nā ʻāpana nui.
• Hiki i nā syphilis lua ke hoʻopili i nā ʻāpana nui.
• ʻO Langerhans histiocytosis kahi maʻi e pili ana i ka hōʻiliʻili ʻana i nā ʻiʻo o nā pūnaewele Langerhans.
• ʻO ka necrolytic migratory erythema kahi kikoʻī i nā glucagonomics, nā maʻi maʻi ʻino o ka pancreas.
• ʻO Sneddon lāua ʻo Wilkinson's sub-cornea pustulosis no ka hui o nā neutrophilic dermatoses, i hōʻike ʻia e ka hele ʻana o nā neutrophils i ka ʻili a pili i nā ʻāpana nui.

ʻO ka hōʻoiaʻana o ka hoʻopunipuni

He maʻalahi ka ʻike o ka intertrigo: ua wehewehe ʻia e ka ʻulaʻula o ka paʻi, hiki ke ʻeha, ʻeha, ooze… ʻO ia ka ʻike o ke kumu i ʻoi aku ka maʻalahi. E nānā ke kauka i nā hiʻohiʻona e hiki ai iā ia ke kuhikuhi iā ia iho i hoʻokahi a ʻoi aku paha nā kumu: bilateral a i ʻole symmetrical a unilateral intertrigo, ka hele ʻana o ka desquamation, oozing, evolution by centrifugal extension, clear boundaries or crumbled contours , alo o nā vesicle, pustules, pohā ma. ka lalo o ka pā…

Pono pinepine e lawe i kahi laʻana mycological (no ka hoʻokolokolo pololei a me ka mahi ʻana) a i ʻole bacteriological a i kekahi manawa he biopsy ʻili.

Evolution a me nā pilikia i hiki

ʻAʻole hiki i ka Intertrigo ke ho'ōla iā ia iho. Hiki iā ia ke hoʻololi a piʻi pinepine ma muli o ka maceration, friction a me ka mālama kūloko i kekahi manawa e hoʻonāukiuki iā ia, hiki ke hoʻoulu i ka allergies a i ʻole ka hoʻopiʻi ʻana (e like me ke kau ʻana i ka ʻaila cortisone ma kahi intertrigo infectious).

ʻO ka maʻi bacterial superinfection, ʻeha a me ka haki ʻana he mau pilikia maʻamau.

Hoʻololi nā hōʻailona ma muli o ke kumu o ka intertrigo:

Infectious intertrigos

Maʻi hū

Dermatophyte intertrigo

I ka pae o nā ʻāpana nui, hāʻawi lākou i ka ʻulaʻula maloʻo a me ka ʻulaʻula me kahi kikowaena ʻulaʻula, ʻoi aku ka nui o ka bilateral a me ka symmetrical, kahi itch. Hana ʻia ka evolution e ka hoʻonui centrifugal, me kahi palena maopopo, polycyclic, vesicular a me ka scaly. ʻO ke komo ʻana maʻamau ʻo ka fold inguinal.

Ma ke ki'eki'e o nā pe'e li'ili'i, 'o ia ka intertrigo ma waena o nā manamana wāwae i kapa 'ia he "waewae 'âlapa" no ka mea, he mea ma'amau ia i ka po'e ha'uki, 'o ia ho'i ma ka hakahaka hope loa (ma waena o nā manamana wāwae 'elua). He māwae ʻulaʻula a ʻulaʻula paha i hoʻopaʻa ʻia e ka maceration e hāʻawi ana i ka ʻili i kahi maʻa, keʻokeʻo ke nānā aku, a laila palahalaha paha ma ke kua o ka wāwae a i ʻole ka wāwae. ʻAi pinepine ʻo ia.

Intertrigo i candida

Ma ke kiʻekiʻe o nā ʻāpana nui, hāʻawi lākou i kahi intertrigo ʻulaʻula ʻulaʻula a maʻemaʻe, ʻo ka lalo o ka mea i haki pinepine ʻia, a uhi ʻia me kahi uhi keʻokeʻo keʻokeʻo. Hoʻopili ʻia nā palena o ka intertrigo me kahi ruff keʻokeʻo a me kekahi mau pustules. Eia hou, ʻo ke kahua o ka koho ʻana ʻo ia ka ʻili o ka inguinal, akā hiki ke ʻike ʻia ma lalo o nā umauma.

Ma ke kiʻekiʻe o nā peʻa liʻiliʻi, he intertrigo i loaʻa nā ʻano like me nā peʻa nui, akā ʻoi aku ka nui o ka noho ʻana ma waena o nā manamana lima a i ʻole ma ke kihi o nā lehelehe (perlèche).

bacteria

Intertrigo mai ka pauka Streptomyces, l Erythrasma

Lawe ʻo Erythrasma i ke ʻano o kahi ʻāpana poʻe ʻulaʻula i kaupalena ʻia. ʻO ka hoʻāʻo māmā ʻana o Wood (UV lamp) hoʻolilo iā ia i ʻulaʻula "koʻa".

Intertrigo a Pseudomonas aeruginosa

Hoʻopili pinepine ʻo Pseudomonas intertrigo i nā intertrigos dermatophytic ma waena o nā manamana wāwae ma o ka maceration a me ka hou ʻana i nā kāmaʻa, a lilo koke i ʻeha, erosive, oozing a i ʻole honi.

Intertrigos i nā bacteria pathogenic ʻē aʻe

Hoʻopili pinepine lākou i ka intertrigos o ka poʻe momona, ka maʻi maʻi a me nā mea maʻi me ka hoʻomaʻemaʻe kino kino: ʻulaʻula ka intertrigo, e kahe ana me nā ʻōpala a i ʻole nā ​​pustules.

Intertrigos non-infectious

Psoriasis

ʻO ka psoriasis o nā ʻāpana a i ʻole "inverted" psoriasis e hoʻāla ai i kahi intertrigo, ʻoi aku ka maikaʻi ma waena o ka ʻāʻī a ma ka piko, ʻulaʻula, ʻālohilohi, wehewehe maikaʻi ʻia, a maʻa pinepine ma lalo o ka pā.

Hoʻonāukiuki

Hoʻopili pinepine ka huhū i ka hoʻohana ʻana i nā antiseptics, cosmetics a i ʻole nā ​​mea hoʻonāukiuki. He ʻulaʻula ʻālohilohi ʻo Intertrigo, miminoni me nā vesicle i kekahi manawa a i ʻole nā ​​ʻeha a he mea maʻamau ia e hoʻoulu ai i kahi ʻeha.

'Elezema

Hiki ke loaʻa i nā kumu ʻelua ʻo Fold eczema:

• ʻO ka maʻi maʻi eczema e kahe pinepine ana, ʻeha a loaʻa paha nā maʻi. Loaʻa ia mai kahi maʻi allergy pili i kahi huahana i hoʻopili ʻia i loko o ka paʻi a paʻakikī i kahi intertrigo e lilo i oozing a i ʻole vesicular a hiki ke ʻeha.
• ʻO ka dermatitis atopic, ka nui ma nā ʻāpana o nā kuʻekuʻe, nā kuli, ka ʻāʻī, ma hope o nā pepeiao a ʻoi aku ka maloʻo.

Nā kumu kakaikahi

ʻO ka maʻi Hailey-Hailey kahi maʻi dermatosis hoʻoilina, ʻike ʻia e ka hanana pinepine ʻana o nā vesicles a i ʻole nā ​​ʻūhū ma ka ʻāʻī, nā axillary hollows a me ka ʻāʻī i hui pū ʻia i nā ʻāpana i wehewehe maikaʻi ʻia, i hele ʻia e nā māwae ʻano ma nā rhagades like.

ʻO ka maʻi o Paget he adenocarcinoma intra-epidermal (ke ʻano o ka maʻi maʻi), ʻo ka vulvar pinepine, pili me ka maʻi maʻi visceral (mimi a i ʻole gynecological no ka laʻana) ma kahi o 1/3 o nā hihia. Hōʻike ʻia ma ke ʻano he ʻulaʻula o ka vulva, ka ʻāʻī a i ʻole ka penis e laha mālie.

ʻO ka maʻi ʻo Crohn, kahi maʻi ʻōpū ʻeha mau loa, hiki ke komo i nā wahi ʻili, ʻoi aku ka nui o ka intergluteal a me ka inguinal folds. ʻIke ʻia lākou e like me nā māwae, linear a me nā ʻeha hohonu e like me ke kuʻi ʻana, nā abscesses paʻakikī e nā fistulas… hiki ke hoʻomaka i mua o nā hōʻike digestive ma nā mahina.

ʻO ka pemphigus vegetative kahi ʻano like ʻole o ka pemphigus e pili ana i nā ʻōpala nui, e hāʻawi ana iā lākou i kahi ʻulaʻula ulu a pua.

Hiki i nā syphilis lua ke hāʻawi i nā pāpaʻi he nui, pehu a erosive, i kekahi manawa e ulu ana i loko o nā pā.

ʻO Langerhans histiocytosis kahi maʻi e pili ana i kahi kūkulu ʻana i ka ʻili o nā pūnaewele Langerhans. Hāʻawi ia i ka ʻili ʻōpala a me ka purpuric, ka hapa nui i loko o nā ʻāpana retroauricular, a i ʻole nā ​​​​pepa nui.

ʻO ka necrolytic migratory erythema ke komo ʻana o ka ʻili e ka glucagonoma, kahi maʻi maʻi maʻi o ka pancreas. Hoʻopuka ʻo ia i nā ʻāpana ʻulaʻula ʻulaʻula o ka hoʻonui centrifugal me kahi palena ʻōpala a i ʻole erosive e waiho ana i kahi ʻulaʻula.

ʻO Sneddon-Wilkinson sub-cornea pustulosis he dermatosis neutrophilic, i hōʻike ʻia e ke ʻano o nā keʻokeʻo keʻokeʻo i kapa ʻia he neutrophils i ka ʻili. Hoʻopuka ʻo ia i nā pustules pāpaʻu, flaccid a i ʻole nā ​​ʻōpū i loaʻa i kahi pae wai i kapa ʻia he pustule hypopion. Hoʻohui ʻia nā pustules a me nā ʻōhū ma ke kaha ʻana i nā arcs a i ʻole nā ​​apo a i ʻole ka pōʻai nui ma ke kumu, ma nā aʻa o nā lālā a me nā ʻāpana nui.

Nā mea pilikino

Loaʻa ka pilikia o ka maceration, friction a me ka wela e hoʻoikaika i ka huhū a me ka hoʻonui microbial inā he fungal a i ʻole bacteria.

ʻO ka acidity o nā ʻōpala, ka momona, nā hemahema ʻole, ka hāpai ʻana, ka maʻi diabetes a me kekahi mau lāʻau lapaʻau (general corticosteroid therapy, antibiotics) e hoʻolalelale i ka candidiasis o nā pā.

Ka manaʻo o kā mākou kauka

ʻO Intertrigos kahi kumu pinepine no ke kūkākūkā ʻana i ka dermatology. Hoʻokaʻawale maikaʻi ʻia lākou e nā kumu ma kēia ʻatikala akā i ka ʻoiaʻiʻo he multifactorial pinepine lākou i ka hoʻomaʻamaʻa ke ʻike ʻia ma ke keʻena o ke kauka: lilo ka dermatophytic intertrigo i superinfect me ka maʻi bacteria a hōʻike i kahi irritation a / a i ʻole kahi maʻi eczema i nā huahana i hoʻohana ʻia e ka mea maʻi. . Eia kekahi, ua nīnau pinepine ka mea maʻi i kāna kauka lapaʻau i hoʻāʻo i hoʻokahi a ʻoi aku paha nā lāʻau kūloko e hoʻololi hou i ke ʻano o ka intertrigo: no laila hiki ke paʻakikī ko lākou kumu kumu i kekahi manawa, a me kā lākou mālama ʻana.

ʻOi aku ka maikaʻi o ka hoʻomaloʻo ʻana i kahi paʻi ma mua o ka hoʻopili ʻana i nā mea momona a i ʻole nā ​​​​kilika ma nā papa mānoanoa.

Kāohi i ka intertrigo

ʻO nā hana mālama paʻi maʻalahi e hoʻemi pinepine i ka pilikia o ka intertrigo:

• holoi i kēlā lā i kēia lā a hoʻomaloʻo i nā pelu
• e pale i ka lole loko paʻa loa, ka hulu hipa a me nā fiber synthetic / makemake i nā pūkini pulupulu a me nā lole komo
• kaua kū'ē i nā mea kōkua: ka maʻi diabetes, ka momona, ka ʻaila cortisone, etc.

Nā hōʻailona

Hoʻopili ʻia ka lāʻau i ke kumu:

Infectious intertrigo

Dermatophyte intertrigos

Hoʻohana ʻia ka mālama ʻana i nā intertrigos dermatophytic e ka noi, ʻelua pinepine i kēlā me kēia lā, o nā antifungals, i ka ʻaila, i ka waiū, i ka ʻōpala, i ka pauka:

• Imidazole: éconazole (Pevaryl®), miconazole (Daktarin®), oxiconazole (Fonx®)
• Nā Allylamines: terbinafine (Lamisil®)
• Pyridone derivatives: ciclopiroxolamine (Mycoster®)

Inā kū'ē ke kauka i ka lāʻau lapaʻau kūloko, hiki i ke kauka ke kuhikuhi i kahi antifungal waha e like me griseofulvin (Grisefuline®) a i ʻole terbinafine (Lamisil®) no 3 a 4 mau pule.

Hoʻopiʻi ʻo Candida

ʻO ka hoʻomaʻamaʻa mua o nā hakakā āpau e kūʻē i nā kumu e makemake ai i ka candidiasis: pale i ka haʻahaʻa, maceration, kemika a i ʻole ka trauma mechanical. Pono e mālama ʻia ka maʻi maʻi i lalo a i ʻole e pili ana i ka digestive a i ʻole genital candidiasis.

Hoʻokumu ʻia ia i nā antifungals kūloko, cream, milk, spray, pauka, hoʻohana ʻia ʻelua i ka lā:

• Imidazole: éconazole (Pevaryl®), miconazole (Daktarin®), oxiconazole (Fonx®)
• Nā Allylamines: terbinafine (Lamisil®)
• Pyridone derivatives: ciclopiroxolamine (Mycoster®).

Hiki ke hāʻawi ʻia ka lāʻau ʻōnaehana no 15 mau lā i ka wā o ka hoʻihoʻi hou ʻana a i ʻole ka nānā ʻana i ka digestive pili (nystatin, Mycostatin®, ketoconazole, Nizoral®).

bacteria

Intertrigo mai ka pauka Streptomyces, l Erythrasma

Hana ʻia ʻo Erythrasma me ka lāʻau antibiotic kūloko me ka wai erythromycin.

Intertrigo a Pseudomonas aeruginosa

Hoʻopili ʻia nā ʻano antiseptic hoʻonāukiuki ʻole i ka pā (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®…) a me / a i ʻole sulfadiazine kālā (Flammazine®). Hoʻohana kakaʻikahi ke kauka i nā lāʻau antibiotic waha, inā e hoʻolōʻihi ʻia ka maʻi a i ʻole ke kūʻē ʻana i ka lāʻau lapaʻau, ʻo ia ka ciprofloxacin (Ciflox®).

Intertrigos i nā bacteria pathogenic ʻē aʻe

Hoʻihoʻi pinepine lākou me nā antiseptics kūloko (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®, etc.), i hui pū ʻia me ka lāʻau antibiotic kūloko me ka fusidic acid (Fucidine® cream).

Intertrigos non-infectious

Psoriasis

Hiki ke pane maikaʻi i ka hui pū ʻana o ka corticosteroid a me ka vitamin D gel (Daivobet®…)

Hoʻonāukiuki

Pono ka mālama ʻana i ka irritation i nā antiseptics kūloko (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®…), emollients a i ʻole nā ​​corticosteroids topical ma lalo o ka mākaʻi olakino.

'Elezema

Pono ka mālama ʻana i ka eczema i nā emollients a me nā corticosteroids topical ma lalo o ka mākaʻi olakino.

Nā kumu kakaikahi

• Pono ka maʻi Hailey-Hailey e hoʻomaloʻo i nā ʻōpala i mea e kaupalena ʻia ai ka lapalapa a me ka pilikia o nā maʻi bacteria, fungal a me nā maʻi viral. ʻO ka ʻoki ʻoki ʻana i nā ʻāpana i hoʻopilikia ʻia a ukali ʻia e ka grafting ʻili ʻo ia wale nō ka lāʻau kūpono.
• Pono ka ma'i o Paget e lapa'au i ka ma'i 'a'ai visceral e pili ana a me ka wehe 'ana i ka plaque ma'i o Paget.
• Pono ka pemphigus vegetative i nā corticosteroids topical ma lalo o ke kiaʻi olakino.
• Hoʻohana ʻia ka syphilis lua me nā injections intramuscular o penicillin.
• Pono ka necrolytic erythema neʻe e neʻe i ka wehe ʻana i ka glucagonoma hewa.