Izwi rekuti intertrigo rinobva kuLatin inter, pakati uye tergo, I rub. Naizvozvo inodoma madermatoses ari munzvimbo dzine nzvimbo mbiri dzekubatwa kweganda nekukwesha pamwe chete, dzinonzi mapete.

Chii ? 

Intertrigo inonzi dermatosis inowanikwa kune ganda rakapetwa, ringave rakakanganiswa rimwechete kana pamwe chete, hombe (inguinal, interlocking, axillary, submammary folds) kana diki (interdigito-palmar, inter toes, umbilicus, retroauricular, labial commissures, guvhu).

Mhando dzakasiyana dze intertrigo

Iko kune intertrigos yehutachiona hwehutachiona (mycoses, mabhakitiriya, nezvimwewo), uye intertrigos isingatapuki, iyo inowanzokonzerwa nekugadziriswa kwedermatoses (eczema, psoriasis, nezvimwewo) mumapeta.

Pakiriniki, mutsauko unoitwa pakati pemaintertrigos akaoma uye akanyorova uye anoyerera intertrigos.

Zvikonzero zve intertrigo

Infectious intertrigo

Fungus intertrigo, mycosis yemapuranga

Yeast chirwere ndicho chikonzero chikuru che intertrigo. Kune marudzi maviri efungi anobatanidzwa:

• Dermatophytes, kazhinji inopa yakaoma intertrigos
• Candida, iyo mbiriso, kazhinji ichikonzera kupenya, kunyorova intertrigo

Utachiona intertrigos

• Corynebacterium minutissium intertrigo, erythrasma: Erythrasma ndiyo inonyanyozivikanwa nebhakitiriya intertrigo muinguinal uye axillary folds.
• Pseudomonas aeruginosa intertrigo: Pseudomonas, inonziwo pyocyanic bacillus, ibhakitiriya rinogara muvhu nemvura. Naizvozvo tinozvisvibisa pachedu pachedu tichisangana nevhu rakanyorova (bindu, nezvimwewo) kana mumvura inopisa (spa, nezvimwewo) uye kazhinji inoomesa dermatophytic intertrigos kuburikidza nemaceration uye dikita. Naizvozvo zvinowanzoitika munzvimbo dzepakati pezvigunwe, izvo zvinongoerekana zvarwadza, zvinokukurwa, kuyerera kana kunhuwa.

Intertrigos kune mamwe mabhakitiriya epathogenic

Izvo zvinokonzerwa ne staphylococci, streptococci uye Gram-negative bacilli (colibacilli). Aya intertrigos anowanikwa muvanhu vakafuta, vane chirwere cheshuga uye varwere vane hutsanana husina kunaka, uye kazhinji vanoomesa dermatosis.

Non-infectious intertrigos

• Psoriasis: Fold psoriasis kana "inverted" psoriasis inowanzoonekwa mu intergluteal fold.
• Kushatirwa: Kuri kwechipiri pakushandiswa kwemishonga yemuno (antiseptic, cosmetics) kana nekusangana netsaona necaustic substance.
• Eczema: Inogona kunge iri kubata eczema nekusawirirana kune deodorant muhapwa semuenzaniso kana atopic dermatitis inobata mamwe mapete (retroauricular furrows, kupeta kwemabvi, kupeta kwemagokora…).

Zvikonzero zvisingawanzoitiki

• Chirwere cheHailey-Hailey chiitiko chisingawanzogarwa nhaka cheganda.
• Chirwere chePaget chirwere chinouraya chinoenderana ne intraepidermal adenocarcinoma.
• Chirwere cheCrohn, chirwere chinoputika chekudya, chinogona kukanganisa intergluteal uye inguinal folds.
• Vegetative pemphigus inzira isingawanzo kiriniki yevulgar pemphigus inobata mapeji makuru.
• Secondary syphilis inogona kukanganisa mapete makuru.
• Langerhans histiocytosis chirwere chinosanganiswa nekuungana muzvikamu zvemasero eLangerhans.
• Necrolytic migratory erythema yakanangana neglucagonomics, mamota akaipa erwatata.
• Sneddon uye Wilkinson's sub-cornea pustulosis ndeyeboka re neutrophilic dermatoses, inoratidzirwa nekuvapo kweutrophils muganda uye inokanganisa mapepa makuru.

Kuongororwa kwekunyengedza

Kuongororwa kwe intertrigo kuri nyore: kunotsanangurwa nekutsvuka kwekupeta, izvo zvinogona kukwenya, kurwadza, kutsveta… Ndiko kuongororwa kwechikonzero kunonyanya kutetepa. Chiremba anozotarisa pane hunhu hunomubvumira kuti azvitarise kune chimwe kana zvimwe zvikonzero: bilateral uye pamwe symmetrical kana unilateral intertrigo, kuvapo kwe desquamation, kubuda, kushanduka nekuwedzera kwecentrifugal, miganhu yakajeka kana crumbled contours, kuvapo kwemavesicles, pustules, kuputika pa. pasi pekupeta ...

Zvinowanzodikanwa kutora mycological sampuli (yekuongorora yakananga uye kurima) kana kunyange bacteriological uye dzimwe nguva ganda biopsy.

Evhangeri uye zvinetso zvinogoneka

Intertrigo haiwanzo kuporesa yega. Iine katsika kekuchinja uye kazhinji kacho kuipa nekuda kwemaceration, kukweshana uye dzimwe nguva kutarisirwa kwenzvimbo uko kunowanzoitsamwisa, kunogona kukonzera allergies kana kutokonzeresa complication (semuenzaniso paunozora cortisone cream pane infectious intertrigo).

Bacterial superinfection, kurwadziwa uye kutsemuka ndiwo matambudziko ekare.

Zviratidzo zvinosiyana zvichienderana nechikonzero che intertrigo:

Infectious intertrigos

Mbiriso chirwere

Dermatophyte intertrigo

Pamwero wemapeta makuru, vanopa kuoma uye kwakatsvuka kutsvuka nepingi centre, kazhinji kacho maviri uye symmetrical, iyo itch. Iko kushanduka kunoitwa nekuwedzera kwe centrifugal, nemuganhu wakajeka, polycyclic, vesicular uye scaly. The classic kubatanidzwa ndeye inguinal fold.

Pamwero wezvimedu zvidiki, ndiyo intertrigo inter toe inowanzonzi "mutambi tsoka" nekuti inowanzoitika muvatambi vemitambo, kunyanya munzvimbo yekupedzisira yepakati-yezvigunwe (pakati pezvigunwe zviviri zvekupedzisira). Inoumba kutsemuka kwepinki kana kutsvuku kwakaganhurwa nemaceration ichipa ganda kunyorova, kuchena kutaridzika, uye rinogona kupararira kuseri kwetsoka kana pasi petsoka. Anogara achikwenya.

Intertrigo kuti candida

Pamwero wezvimedu zvakakura, vanopa intertrigo yakatsvuka uye yakanyorova, pasi payo inowanzoputika, kunyange yakafukidzwa nemucheka mutsvuku. Miganhu ye intertrigo inoputsika nechena ruff uye mashoma pustules. Pano zvakare, nzvimbo yekusarudza ndiyo inguinal fold, asi inogonawo kuonekwa pasi pemazamu.

Pamwero wezvimedu zvidiki, iyo intertrigo ine maitiro akafanana neaya akakura, asi kazhinji anogara pakati peminwe kana pakona yemiromo (perlèche).

bakitiriya

Intertrigo kubva kuStreptomyces poda, l Erythrasma

Erythrasma inotora chimiro cheakatenderedzwa, akaganhurirwa shava plaque. Kuongororwa kwechiedza chehuni (rambi reUV) rinopa ruvara rwe "coral" tsvuku.

Intertrigo à Pseudomonas aeruginosa

Pseudomonas intertrigo inowanzo omesa dermatophytic intertrigos kunyanya pakati pezvigunwe kuburikidza ne maceration uye dikita mubhutsu, izvo zvinongoerekana zvarwadza, kuputika, kubuda kana kunhuwa.

Intertrigos kune mamwe mabhakitiriya epathogenic

Vanowanzo omesawo ma intertrigos evanhu vakafuta, vane chirwere cheshuga uye varwere vane hutsanana hwemuviri husina kunaka: iyo intertrigo inoshanduka kuva tsvuku, ichibuda nemucheka kana pustules.

Non-infectious intertrigos

Psoriasis

Psoriasis yemapeto kana kuti "inverted" psoriasis inomutsa intertrigo, inonyanya kuwanikwa pakati pemagaro uye paguvhu, tsvuku, inopenya, yakanyatsotsanangurwa, uye inowanzotsemuka pazasi pekupeta.

Kushatirwa

Kutsamwiswa kunowanzoenderana nekushandiswa kwe antiseptics, cosmetics kana irritants. Intertrigo inopenya tsvuku, yakaunyana pamwe nemamwe mavhesi kana maronda uye zvinowanzoitika kuti ikonzere kupisa.

Eczema

Peta eczema inogona kuva nemavambo maviri:

• Allergic kuonana eczema iyo inowanzobuda, kukwenya uye inogona kunge ine mablisters. Izvo zvinokonzerwa nekubata allergy kune chigadzirwa chakaiswa mupeta uye zvinokanganisa intertrigo iyo inove inoyerera kana kunyange vesicular uye inogona kuvava.
• atopic dermatitis, kunyanya mukupeta kwemagokora, mabvi, mutsipa, kuseri kwenzeve uye kazhinji inotaridzika kuoma.

Zvikonzero zvisingawanzoitiki

Chirwere cheHailey-Hailey hachiwanzogara nhaka dermatosis, chinoratidzwa nekuitika kunowanzoitika kwemavhesi kana kunyange mabubbles pamutsipa, axillary hollows uye groin zvakaiswa muzvikamu zvakanyatsotsanangurwa, zvichifambiswa neakatsemuka zvakanyanya mumaparallel rhagades.

Chirwere chePaget is intra-epidermal adenocarcinoma (chimiro chegomarara), kazhinji kacho vulvar, yakabatana negomarara revisceral (weti kana gynecological semuenzaniso) mune ingangoita 1/3 yezviitiko. Inotaridza sechigamba chitsvuku chebeche, groin kana peni inopararira zvishoma nezvishoma.

Chirwere cheCrohn, chirwere chisingaperi chinoputika, chinogona kusanganisira nzvimbo dzeganda, kunyanya mu intergluteal uye inguinal folds. Anoita seakatsemuka, mutsara uye maronda akadzika sekubaya, maabscesses akaomeswa nefistula… ayo anogona kutangira kuratidzwa kwekugaya nemwedzi yakati wandei.

Vegetative pemphigus imhando isingawanzo yepemphigus inobata mapete makuru, ichivapa hutsvuku hwezvinomera uye hutsva.

Secondary syphilis inogona kupa akawanda, kuzvimba uye erosive plaques, dzimwe nguva ichimera mumapepa.

Langerhans histiocytosis chirwere chinosanganiswa nekuvakwa kweganda reLangerhans masero. Inopa ganda rakakora uye purpuric ganda, kunyanya mune retroauricular folds, kana kunyange mapete makuru.

Necrolytic migratory erythema kubatanidzwa kweganda kunokonzerwa neglucagonoma, bundu rakashata repancreas. Inoburitsa zvigamba zvitsvuku zvakasimudzwa zvecentrifugal zvine muganho une crusty kana wakakora unosiya vanga rine pigmented.

Sneddon-Wilkinson sub-cornea pustulosis inonzi neutrophilic dermatosis, inoratidzwa nekuvapo kwemasero machena eropa anonzi neutrophils muganda. Iyo inoburitsa epamusoro, flaccid pustules kana mabhuru angave ane hunhu hwemvura mwero unonzi hypopion pustule. Iyo pustules uye bubbles zvakabatanidzwa nekudhirowa arcs kana zvindori kana kutenderedzwa kunyanya pahunde, pamidzi yemakumbo uye mumapuranga makuru.

Zvinhu zvinotyisa

Mapeta anotakura njodzi yemaceration, friction uye kupisa izvo zvinokurudzira kushatirwa uye kupararira kwehutachiona kungave kuri fungal kana bhakitiriya.

Iyo acidity yemapeta, kufutisa, kushomeka kwekudzivirira muviri, nhumbu, chirwere cheshuga uye mamwe madhiragi (general corticosteroid therapy, antibiotics) zvinonyanya kukurudzira candidiasis yemapeta.

Maonero echiremba wedu

Intertrigos chikonzero chenguva dzose chekubvunzana mune dermatology. Vanosarudzika nezvikonzero zviri muchinyorwa ichi asi muchokwadi ivo vanowanzova multifactorial mukuita pavanoonekwa muhofisi yechiremba: dermatophytic intertrigo inova superinfect nebhakitiriya uye inopa kutsamwa uye / kana allergic eczema kune zvigadzirwa zvinoshandiswa nemurwere. . Pamusoro pezvo, murwere anenge agara abvunza chiremba wake mukuru uyo ​​akaedza imwe kana akawanda emunharaunda kurapwa achiwedzera kushandura kutaridzika kwe intertrigo: kuongororwa kwavo kwechikonzero dzimwe nguva kunogona kuve kwakaoma kwazvo, pamwe nekurapa kwavo.

Mumwe mutemo unowanzo kuve wechokwadi muintertrigos: kazhinji zviri nani kuomesa kupeta pane kuzora zvinhu zvine girizi kana makirimu mumatanda makobvu.

Kudzivirira intertrigo

Matanho ekuchengeta akareruka anowanzo kuderedza njodzi ye intertrigo:

• geza zuva nezuva uye woomesa zvakapetwa zvakakwana
• dzivisa chipfeko chemukati chakanyanyisa, makushe uye mafivha ekugadzira / kufarira masokisi ekotoni uye zvipfeko zvemukati
• kurwisa zvinokonzeresa: chirwere cheshuga, kufutisa, cortisone cream, nezvimwe.

Mishonga

Kurapa kunoenderana nechikonzero:

Infectious intertrigo

Dermatophyte intertrigos

Kurapa kwedermatophytic intertrigos kunoitwa nekushandiswa, kazhinji kaviri zuva nezuva, yeantifungals, mukirimu, mumukaka, mukupfapfaidza, muupfu:

• Imidazole: éconazole (Pevaryl®), miconazole (Daktarin®), oxiconazole (Fonx®)
• Allylamines: terbinafine (Lamisil®)
• Pyridone zvinobva kune: Ciclopiroxolamine (Mycoster®)

Muchiitiko chekuramba kurapwa kwepanzvimbo, chiremba anogona kupa mushonga wemuromo wekuti griseofulvin (Grisefuline®) kana terbinafine (Lamisil®) kwemavhiki matatu kusvika mana.

Candida intrigues

Kurapa kwekutanga kunopesana nezvinhu zvinotsigira candidiasis: kudzivirira humidity, maceration, makemikari kana mechanical trauma. Chirwere cheshuga chiri pasi kana kunyange chinokonzera kugaya kana genital candidiasis inofanirawo kurapwa.

Inobva pane antifungals yemuno, kirimu, mukaka, pfapfaidzo, hupfu, inoshandiswa kaviri pazuva:

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

Kurapa kwakarongeka kunogona kupiwa kwemazuva 15 muchiitiko chekudzokazve kana kubatanidzwa kwekudya kwekudya (nystatin, Mycostatin®, ketoconazole, Nizoral®).

bakitiriya

Intertrigo kubva kuStreptomyces poda, l Erythrasma

Erythrasma inorapwa nemishonga inorwisa mabhakitiriya munharaunda ine erythromycin lotion.

Intertrigo à Pseudomonas aeruginosa

Mishonga isingatsamwisi antiseptic inoiswa kupeta (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®…) uye / kana sirivheri sulfadiazine (Flammazine®). Chiremba haawanzoshandisa mishonga inorwisa mabhakitiriya, muchiitiko chekuwedzera kwehutachiona kana kuramba kurapwa, kazhinji kazhinji ciprofloxacin (Ciflox®).

Intertrigos kune mamwe mabhakitiriya epathogenic

Vanowanzo dzokera shure nemishonga inorwisa mabhakitiriya (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®, nezvimwewo), yakasanganiswa nemishonga yemuno inorwisa mabhakitiriya nefusidic acid (Fucidine® cream).

Non-infectious intertrigos

Psoriasis

Iyo inowanzopindura zvakanaka kumusanganiswa wecorticosteroid uye vhitamini D gel (Daivobet® ...)

Kushatirwa

Kurapa kwekushatirwa kunoda mishonga yekuuraya zvipembenene (chlorhexidine: Diaseptyl®, polyvidone iodine: Betadine®…), emollients kana topical corticosteroids pasi pekutariswa nachiremba.

Eczema

Kurapa kwe eczema kunoda emollients uye topical corticosteroids pasi pekutarisirwa kwechiremba.

Zvikonzero zvisingawanzoitiki

• Chirwere cheHailey-Hailey chinoda kuomeswa kwemapeta kudzikamisa flare-ups uye njodzi yehutachiona, fungal uye hutachiona. Kuvhiya kupeta kwakapetwa kunoteverwa nekubatanidza ganda kazhinji ndiko chete kurapa kunoshanda.
• Chirwere chePaget chinoda kurapwa kwegomarara remusceral rakabatana uye kubviswa kwechirwere chePaget.
• Vegetative pemphigus inoda topical corticosteroids pasi pekutarisirwa kwechiremba.
• Secondary syphilis inorapwa nejekiseni remukati memuscular repenicillin.
• Migratory necrolytic erythema inoda kubviswa kweiyo inogumbura glucagonoma.