Is there ANY chance for stopping intertrigo for recurring?

[NYFirefighter]

Dear Doctor-

I am a 36 year old white male.  6' 225 pounds and generally in very good shape (former college football player). For over a year now I have been having what my primary care doc told me is intertrigo of the skin folds of my groin, specifically where my upper inner thighs meet my scrotum.  While it is true I do sweat quite a lot, I surely sweated MUCH more during my football days and especially with all the equipment on also and NEVER once  got this condition/problem.

My problem is that even though I make every possible effort to keep the area dry using powders and even Zeasorb powder many times during the day and after drying the area.  Nothing works. it is back almost weekly and when it comes back it takes just as long to get rid of it.  It does seem to reccur on the right side more than the other.  1) Doctor, I am begging you to tell me (and hoping) that there is SOMETHING I can do to stop this. Its gotten to the point where it has affected my personal life with my fiance, not to mention it can get quite painful. I do try some cortisone and not much because I do not want to thin out the skin and also use clotrimazole but it keeps coming back.  2) Also, I have had complete blood work up including CBCs and STD testing as well as testing for Diabetes. All have been fine and/or negative.  Should I be worried something serious is causing this condition to be recurrent?I look forward to your response and am patiently waiting your reply.

Thank You and God Bless,
NY Firefighter

[Jasmina Jankicevic, MD, MSc, CCRP]

Greetings to NY Firefighter!

Information you had shared in your post indicated that you had been in overall  "good shape" plus thoroughly examined and had gone through multiple diagnostic tests to exclude differential diagnoses such as Diabetes melitus, STDs, etc. That is why we mentioned "healthy, physically active male" phrase.

Still, two more diagnostic tests could help your physicians to identify possible underlying problem: skin scrapings with cultures, and skin biopsy. Most often intertrigo is connected to microbial skin infections, but psoriasis inversa, contact dermatitis, familiar benign pemphigus, etc. have to be excluded.

In conclusion, do not be concerned; that final diagnosis should not be difficult to identify to your physician. You have determination to resolve this skin disorder, and I have no doubt that you will be successful. Feel free to keep us posted of your progress.

Wishing You ptimal Health,
Dr. Jasmina Jankicevic
  

[NYFirefighter]

I am slightly confused and hoping for a second reply from you.  You prefaced your statements by referring to a  "healthy, physically active male"...

Does this statement imply that you would believe me to NOT be healthy? I do use powders during the day and usually multiple times for that matter.  Also, it is rather impossible to not expose the area in question to sweat, warmth and friction as I'm sure you would agree.  Clearly as a Firefighter that is next to if not actually impossible. Still trying to do all of this, it does infact recurr.  

As with my original post I am asking you if you think there is cause for concern that there is an underlying problem or health issue that is causing this. Please take a moment to answer this for me.

Thank You,
NY Firefighter

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum!

For a healthy, physically active male, the best way to prevent recurrent intertrigo is to:

a) completely recover skin integrity and barrier function  - treat fungal/yeast infection (if diagnosed) in the area (with topical antifungal cream such as clotrimazole for two weeks or longer, applied twice a day; goal is visually completely normal looking & feeling skin);

b) use skin barrier protection topical products with zinc during the day, etc; and

c) do not expose skin to any of many known triggers (warmth, sweating, friction, synthetic materials, etc.).


Wishing You Optimal Health,
Dr. Jasmina Jankicevic