Itemu elithi intertrigo livela kwelesiLatini elithi inter, phakathi nethi tergo, I rub. Ngakho-ke iveza ama-dermatoses atholakala ezindaweni lapho izindawo ezimbili zokuthintwa kwesikhumba futhi zihlikihlwa khona, okubizwa ngokuthi ukugoqa.

Kwenzenjani ? 

I-Intertrigo i-dermatosis etholakala endaweni emigoqeni yesikhumba, kungakhathaliseki ukuthi ithinteka iyodwa noma ndawonye, ​​emikhulu (i-inguinal, interlocking, axillary, submammary folds) noma encane (interdigito-palmar, inter toes, umbilicus, retroauricular, labial commissures , inkaba).

Izinhlobo ezahlukene ze-intertrigo

Kunama-intertrigos emvelaphi ethathelwanayo (ama-mycoses, amagciwane, njll.), kanye nama-intertrigo angatheleleki avame ukubangelwa ukwenziwa kwasendaweni kwama-dermatoses (eczema, psoriasis, njll.) emiphethweni.

Ngokomtholampilo, kwenziwa umehluko phakathi kwama-intertrigos omile nama-intertrigos amanzi nagelezayo.

Izinkinga ze-intertrigo

I-intertrigo ethathelwanayo

I-fungus intertrigo, i-mycosis yokugoqa

I-yeast infection iyimbangela eyinhloko ye-intertrigo. Kunezinhlobo ezimbili ze-fungi ezithintekayo:

• Ama-dermatophyte, avame ukunikeza ama-intertrigos owomile
• I-Candida, okuyimvubelo, evame ukudala i-intertrigo ecwebezelayo, emanzi

Ama-bacterium intertrigos

• I-Corynebacterium minutissium intertrigo, erythrasma: I-Erythrasma iyi-intertrigo yebhaktheriya evame kakhulu emgodleni we-inguinal kanye ne-axillary.
• I-Pseudomonas aeruginosa intertrigo: I-Pseudomonas, ebizwa nangokuthi i-pyocyanic bacillus, igciwane elihlala emhlabathini nasemanzini. Ngakho-ke siyazingcolisa lapho sithinta inhlabathi eswakeme (ingadi, njll.) noma emanzini ashisayo (i-spa, njll.) futhi kuvame ukwenza inkimbinkimbi ye-dermatophytic intertrigos ngokusebenzisa i-maceration kanye nokujuluka. Ngakho-ke kuvamile ezindaweni eziphakathi kozwane, okuthi kungazelelwe kube buhlungu, ukuguguleka, ukuququda noma ukunuka.

I-Intertrigos kwamanye amagciwane e-pathogenic

Zibangelwa i-staphylococci, i-streptococci kanye ne-Gram-negative bacilli (colibacilli). Lawa ma-intertrigo avame kakhulu kubantu abakhuluphele, abanesifo sikashukela kanye neziguli ezingahlanzeki kahle, futhi ngokuvamile zenza kube nzima ukuvela kwe-dermatosis.

Ama-intertrigo angatheleleki

• I-Psoriasis: I-Fold psoriasis noma i-psoriasis "inverted" ivame ukugoba phakathi kwe-intergluteal.
• Ukucasuka: Kungokwesibili ekusetshenzisweni kwemithi yokwelapha yasendaweni (i-antiseptic, izimonyo) noma ngokuthintana ngephutha ne-caustic substance.
• I-eczema: Kungaba ukuhlangana kwe-eczema ngokungezwani nesiqedaphunga esisemakhwapheni isibonelo noma i-atopic dermatitis ethinta ngokukhethekile imiphetho ethile (imisele engemuva, ukugoqa kwamadolo, ukugoqa kwezindololwane…).

Izimbangela ezingavamile

• Isifo i-Hailey-Hailey yisimo sesikhumba esingajwayelekile esizuzwe ngofuzo.
• Isifo sikaPaget yisifo esiyingozi esihambisana ne-intraepidermal adenocarcinoma.
• Isifo sikaCrohn, isifo sokuvuvukala sokugaya ukudla, singathinta ukugoqa kwe-intergluteal kanye ne-inguinal.
• I-Vegetative pemphigus iwuhlobo lomtholampilo olungajwayelekile lwe-vulgar pemphigus oluthinta ukugoqa okukhulu.
• I-syphilis yesibili ingathinta ama-folders amakhulu.
• I-Langerhans histiocytosis yisifo esihambisana nokunqwabelana kwezicubu zamaseli eLangerhans.
• I-Necrolytic migratory erythema iqondene ngqo ne-glucagonomics, izimila eziyingozi zamanyikwe.
• I-sub-cornea pustulosis ye-Sneddon kanye ne-Wilkinson iyingxenye ye-neutrophilic dermatoses, ebonakala ngokuba khona kwama-neutrophils esikhumbeni futhi ethinta ukugoqa okukhulu.

Ukuxilongwa kwetulo

Ukuxilongwa kwe-intertrigo kulula: kuchazwa ububomvu besiphetho, okungaluma, kube buhlungu, ukuququda… Ukutholakala kwembangela okubucayi kakhulu. Udokotela uzogxila ezicini ezimvumela ukuthi aziqondise kusizathu esisodwa noma ngaphezulu: i-intertrigo yamazwe amabili futhi okungenzeka ukuthi i-symmetrical noma i-unilateral, ukuba khona kwe-desquamation, ukugeleza, ukuziphendukela kwemvelo ngokunwetshwa kwe-centrifugal, imingcele ecacile noma ama-contours aphukile , ukuba khona kwama-vesicles, ama-pustules, ukuqhekeka phansi kwesibaya...

Ngokuvamile kuyadingeka ukuthatha isampula ye-mycological (ukuhlolwa okuqondile nokutshala) noma ngisho ne-bacteriological futhi ngezinye izikhathi i-biopsy yesikhumba.

Ukuziphendukela kwemvelo nezinkinga kungenzeka

I-Intertrigo ayivamisile ukuziphilisa ngokwayo. Inomkhuba wokushintsha futhi ngokuvamile ibe yimbi kakhulu ngenxa ye-maceration, ukungqubuzana futhi ngezinye izikhathi ukunakekelwa kwendawo okuvame ukuyicasula, kungabangela ukungezwani komzimba noma kubangele inkinga (isibonelo uma ugcoba ukhilimu we-cortisone ku-intertrigo ethelelanayo).

I-bacterium superinfection, ubuhlungu nokuqhekeka nakho kuyizinkinga zakudala.

Izimpawu ziyahlukahluka kuye ngembangela ye-intertrigo:

Ama-intertrigos athathelwanayo

Ukutheleleka kwemvubelo

I-dermatophyte intertrigo

Ezingeni lemigoqo emikhulu, banikeza ububomvu obomile nobune-scaly ngesikhungo esipinki, esivame ukuhlangana kabili kanye ne-symmetrical, esilumayo. Ukuziphendukela kwemvelo kwenziwa ngesandiso se-centrifugal, esinomngcele ocacile, i-polycyclic, i-vesicular kanye ne-scaly. Ukubandakanyeka kwe-classic yi-inguinal fold.

Ezingeni lokugoqeka okuncane, yi-intertrigo inter toe evame ukubizwa ngokuthi “unyawo lomsubathi” ngoba ivamisile kubadlali bezemidlalo, ikakhulukazi endaweni yokugcina phakathi kwezinzwane (phakathi kwezinzwane ezimbili zokugcina). Yakha umfantu obomvana noma obomvu ohlanganiswe yi-maceration okunikeza isikhumba ukubukeka okumanzi, okumhlophe, futhi kungase kusakazekele ngemuva konyawo noma ematheni onyawo. Uvame ukulunywa.

I-Intertrigo kuya ku-candida

Ezingeni lamafolda amakhulu, anikeza i-intertrigo ebomvu ecwebezelayo nemanzi, okuvame ukuqhekeka phansi, ngisho nokumbozwa ngengubo emhlophe ekhilimu. Imingcele ye-intertrigo igoqwe nge-ruff emhlophe nama-pustules ambalwa. Lapha futhi, indawo yokuzikhethela yi-nguinal fold, kodwa ingabonakala ngaphansi kwamabele.

Ezingeni lemigoqo emincane, i-intertrigo enezici ezifanayo njengemigoqo emikhulu, kodwa evame ukuhlala phakathi kweminwe noma ekhoneni lezindebe (perlèche).

amabhaktheriya

I-Intertrigo evela ku-Streptomyces powder, l Erythrasma

I-Erythrasma ithatha isimo soqweqwe olunsundu oluyindilinga, olulinganiselwe kahle. Ukuhlolwa kokukhanya kukaWood (isibani se-UV) kuwumbala obomvu “wekhorali”.

I-Intertrigo ku-Pseudomonas aeruginosa

I-Pseudomonas intertrigo ivame ukuhlanganisa ama-dermatophytic intertrigos ikakhulukazi phakathi kwezinzwane ngokusebenzisa i-maceration kanye nokujuluka ezicathulweni, okuvele kube buhlungu, ukuguguleka, ukuvuza noma ngisho nokunuka.

I-Intertrigos kwamanye amagciwane e-pathogenic

Imvamisa futhi zenza kube nzima ukuhlangana kwabantu abakhuluphele, abanesifo sikashukela kanye neziguli ezingahlanzeki kahle emzimbeni: i-intertrigo iba bomvu, iphume ngotwayi noma ama-pustules.

Ama-intertrigo angatheleleki

psoriasis

I-Psoriasis yokugoqa noma i-psoriasis "ehlanekezelwe" idala i-intertrigo, etholakala ngokukhethekile phakathi kwezinqe nenkaba, ebomvu, ecwebezelayo, echazwe kahle, futhi evame ukuqhekeka phansi kwesibaya.

Ukuthukuthela

Ukucasuka kuvame ukuhlotshaniswa nokusetshenziswa kwe-antiseptics, izimonyo noma i-irritants. I-Intertrigo ibomvu ngokucwebezelayo, ishwabene ngezinye izikhathi ngama-vesicles noma izilonda futhi kuvamile ukuthi ibangele ukuzwa ukuvutha.

I-Eczema

I-Fold eczema ingaba nemvelaphi emibili:

• I-allergic contact eczema evame ukuphuma, ilume futhi ingase ibe namabhamuza. Kubangelwa ukungezwani komzimba nomuntu othile kuya emkhiqizweni ofakwe esibayeni futhi kwenza kube nzima i-intertrigo ephuma amanzi noma i-vesicular futhi ikwazi ukulunywa.
• i-atopic dermatitis, ikakhulukazi emiphethweni yezindololwane, amadolo, intamo, ngemva kwezindlebe futhi ngokuvamile ibukeka yomile.

Izimbangela ezingavamile

Isifo i-Hailey-Hailey yi-dermatosis yofuzo engavamile, ebonakala ngokuvela okuphindaphindiwe kwama-vesicles noma amabhamuza entanyeni, izimbobo ze-axillary kanye ne-groin eqoqwe ngama-patches achazwe kahle, edabula imifantu ebonakala kakhulu kuma-rhagade ahambisanayo.

I-Paget's disease i-intra-epidermal adenocarcinoma (uhlobo lomdlavuza), ngokuvamile i-vulvar, ehlotshaniswa nomdlavuza we-visceral (isibonelo somchamo noma izifo zabesifazane) cishe ku-1/3 yezimo. Iveza njengesiqephu esibomvu se-vulva, i-groin noma ipipi elisakazeka kancane kancane.

Isifo sikaCrohn, isifo samathumbu esivuthayo esingapheli, singabandakanya izindawo zesikhumba, ikakhulukazi kuma-intergluteal kanye ne-inguinal folds. Abonakala njengemifantu, izilonda eziqondile nezijulile njengokugwaza, amathumba ahlanganiswe ama-fistula… angandulela ukuvela kokugaya ukudla ezinyangeni ezimbalwa.

I-Vegetative pemphigus iwuhlobo olungavamile lwe-pemphigus oluthinta ukugoqa okukhulu, okubanika ububomvu bemifino kanye nokuhluma.

Ugcunsula wesibili ungadala ama-plaque amaningi, avuvukele futhi aguguleke, ngezinye izikhathi amila emiphethweni.

I-Langerhans histiocytosis yisifo esihlotshaniswa nokwakheka kwesikhumba samangqamuzana e-Langerhans. Idala isikhumba esiqinile nesiphundu, ikakhulukazi kumafolda angemuva, noma amafolda amakhulu.

I-Necrolytic migratory erythema ukubandakanyeka kwesikhumba okubangelwa i-glucagonoma, isimila esiyingozi samanyikwe. Ikhiqiza amapheshana abomvu aphakeme, anezikhwepha esandiso se-centrifugal esinoqweqwe oluqinile noma umngcele ogugulekayo oshiya isibazi esinemibala.

I-Sneddon-Wilkinson sub-cornea pustulosis i-neutrophilic dermatosis, ebonakala ngokuba khona kwamangqamuzana amhlophe egazi abizwa ngokuthi ama-neutrophils esikhumbeni. Ikhiqiza ama-pustule acwebile, ama-flaccid noma amabhamuza angase abe nezinga loketshezi elibizwa ngokuthi i-hypopion pustule. Ama-pustules nama-bubbles aqoqwe ngokudweba ama-arcs noma amasongo noma azungezwe ikakhulukazi esiqwini, ezimpandeni zemilenze nasemagoqweni amakhulu.

Izici zengozi

Amafolda athwala ingozi ye-maceration, ukungqubuzana nokushisa okukhuthaza ukucasuka nokwanda kwamagciwane kungakhathaliseki ukuthi kuyisikhunta noma amagciwane.

I-acidity yokugoqa, ukukhuluphala, ukuntuleka kwamasosha omzimba, ukukhulelwa, isifo sikashukela kanye nezidakamizwa ezithile (ukwelashwa okujwayelekile kwe-corticosteroid, ama-antibiotics) kugqugquzela ikakhulukazi i-candidiasis yokugoqa.

Umbono kadokotela wethu

I-Intertrigos iyisizathu esivamile sokubonisana ku-dermatology. Zihlukaniswa kahle ngezimbangela kulesi sihloko kodwa empeleni zivame ukwenza izinto eziningi uma zibonwa ehhovisi likadokotela: i-dermatophytic intertrigo iba yi-superinfect namagciwane futhi iveze ukucasuka kanye / noma i-eczema egulisayo emikhiqizweni esetshenziswa isiguli. . Ukwengeza, isiguli ngokuvamile sesivele sabonana nodokotela waso ojwayelekile oye wazama ukwelashwa kwendawo eyodwa noma ngaphezulu eqhubeka nokuguqula ukubukeka kwe-intertrigo: ukuxilongwa kwabo okuyimbangela kungase kube nzima kakhulu ngezinye izikhathi, kanye nokwelashwa kwabo.

Umthetho owodwa uvame ukuba yiqiniso kuma-intertrigos: ngokuvamile kungcono ukomisa ukugoqa kunokusebenzisa izinto ezinamafutha noma okhilimu ezingqimbeni eziwugqinsi.

Ukuvimbela intertrigo

Izinyathelo zokunakekela ezigoqiwe ezilula zivame ukunciphisa ubungozi be-intertrigo:

• geza nsuku zonke futhi usule imiphetho kahle
• gwema izingubo zangaphansi ezimpintshana kakhulu, uvolo kanye nemicu yokwenziwa / thanda amasokisi kakotini nezingubo zangaphansi
• ukulwa nezici ezinomthelela: isifo sikashukela, ukukhuluphala, ukhilimu we-cortisone, njll.

Ukwelashwa

Ukwelashwa kuncike kumbangela:

I-intertrigo ethathelwanayo

I-dermatophyte intertrigos

Ukwelashwa kwe-dermatophytic intertrigos kwenziwa ngokusetshenziswa, kaningi kabili ngosuku, ama-antifungal, ukhilimu, ubisi, isifutho, ngempushana:

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

Esimeni sokumelana nokwelashwa kwendawo, udokotela angase anikeze isinqamuleli somlomo esinjenge-griseofulvin (Grisefuline®) noma i-terbinafine (Lamisil®) amaviki amathathu kuya kwamane.

I-Candida iyathakazelisa

Ukwelashwa kuqala kukho konke ukulwa nezinto ezivuna i-candidiasis: ukugwema umswakama, i-maceration, ukuhlukumezeka kwamakhemikhali noma kwemishini. Isifo sikashukela esiyisisekelo noma ngisho ne-candidiasis ehlobene nokugaya noma yesitho sangasese somuntu kufanele selashwe.

Isekelwe kuma-antifungals wendawo, ukhilimu, ubisi, isifutho, impushana, isetshenziswa kabili ngosuku:

• Imidazole: éconazole (Pevaryl®), miconazole (Daktarin®), oxiconazole (Fonx®)
• Ama-Allylamines: terbinafine (Lamisil®)
• I-Pyridone derivatives: cyclopiroxolamine (Mycoster®).

Ukwelashwa okuhlelekile kunganikezwa izinsuku ezingu-15 uma kwenzeka ukuphindaphinda noma ukugxila okuhlobene nokugaya ukudla (nystatin, Mycostatin®, ketoconazole, Nizoral®).

amabhaktheriya

I-Intertrigo evela ku-Streptomyces powder, l Erythrasma

I-Erythrasma yelashwa ngokwelashwa kwasendaweni kwamagciwane nge-erythromycin lotion.

I-Intertrigo ku-Pseudomonas aeruginosa

Izixazululo ze-antiseptic ezingacasuli zisetshenziswa ekugoqweni (i-chlorhexidine: i-Diaseptyl®, i-polyvidone iodine: i-Betadine®…) kanye / noma i-silfa sulfadiazine (i-Flammazine®). Udokotela akavamile ukusebenzisa ama-antibiotics ngomlomo, uma kwenzeka ukwanda kokutheleleka noma ukumelana nokwelashwa, ngokuvamile i-ciprofloxacin (Ciflox®).

I-Intertrigos kwamanye amagciwane e-pathogenic

Imvamisa ihlehla ngama-antiseptics endawo (i-chlorhexidine: i-Diaseptyl®, i-polyvidone iodine: i-Betadine®, njll.), kuhlanganiswe nokwelashwa kwasendaweni kwamagciwane nge-fusidic acid (ukhilimu we-Fucidine®).

Ama-intertrigo angatheleleki

psoriasis

Ngokuvamile isabela kahle kwinhlanganisela ye-corticosteroid nejeli yevithamini D (Daivobet® ...)

Ukuthukuthela

Ukwelashwa kokucasuka kudinga ama-antiseptic endawo (i-chlorhexidine: i-Diaseptyl®, i-polyvidone iodine: i-Betadine®…), ama-emollients noma ama-topical corticosteroids ngaphansi kokuqondisa kwezokwelapha.

I-Eczema

Ukwelashwa kwe-eczema kudinga ama-emollients nama-topical corticosteroids ngaphansi kokuqondisa kwezokwelapha.

Izimbangela ezingavamile

• Isifo i-Hailey-Hailey sidinga ukomiswa kokugoqa ukuze kukhawulwe ukuqubuka kanye nengozi yokutheleleka ngamagciwane, ukukhunta kanye negciwane. Ukuhlinza ngokuhlinza okugoqeka okuthintekile okulandelwa ukuxhunyelelwa kwesikhumba kuvame ukuba ukuphela kokwelapha okusebenzayo.
• Isifo sikaPaget sidinga ukwelashwa komdlavuza we-visceral ohambisana nawo kanye nokusitshulwa koqweqwe lwesifo se-Paget.
• I-Vegetative pemphigus idinga i-topical corticosteroids ngaphansi kokuqondisa kwezokwelapha.
• I-syphilis yesibili yelashwa ngemijovo ye-penicillin e-intramuscular.
• I-erythema ye-necrolytic efudukayo idinga ukususwa kwe-glucagonoma ecasulayo.