Kalmar intertrigo ta fito ne daga Latin intertrigo, tsakanin da tergo, I rub. Don haka yana sanya dermatosis a wuraren da wuraren da aka taɓa fata guda biyu suna shafa tare, wanda ake kira folds.

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Intertrigo wani dermatosis ne wanda aka keɓance shi zuwa gaɓoɓin fata, ko an shafa su guda ɗaya ko tare, babba (inguinal, interlocking, axillary, submammary folds) ko ƙanana (interdigito-palmar, yatsun hannu, umbilicus, retroauricular, labial commissures, cibiya).

Daban-daban na intertrigo

Akwai intertrigos na asalin cututtuka (mycoses, kwayoyin cuta, da dai sauransu), da kuma intertrigos marasa kamuwa da cuta wanda yawanci yakan haifar da yanayin dermatosis (eczema, psoriasis, da dai sauransu) a cikin folds.

A asibiti, an banbance tsakanin busassun intertrigos da rigar intertrigos masu fitar da ruwa.

Abubuwan da ke haifar da intertrigo

Intertrigo mai kamuwa da cuta

Fungus intertrigo, mycosis na folds

Yisti kamuwa da cuta shine babban dalilin intertrigo. Akwai nau'ikan fungi guda biyu:

• Dermatophytes, sau da yawa bada bushe intertrigos
• Candida, waxanda suke yeasts, galibi suna haifar da sheki, rigar intertrigo

Bacteria intertrigos

• Corynebacterium minutissium intertrigo, erythrasma: Erythrasma ita ce mafi yawan kwayoyin cuta ta intertrigo a cikin inguinal da axillary folds.
• Pseudomonas aeruginosa intertrigo: Pseudomonas, wanda kuma ake kira pyocyanic bacillus, kwayoyin cuta ne da ke zaune a cikin ƙasa da ruwa. Don haka muna gurɓata kanmu a cikin hulɗa da ƙasa mai dausayi (lambu, da dai sauransu) ko a cikin ruwan zafi (spa, da dai sauransu) kuma sau da yawa yana rikitarwa intertrigos dermatophytic ta hanyar maceration da gumi. Don haka ya zama ruwan dare a cikin tsaka-tsakin yatsan ƙafa, wanda ba zato ba tsammani ya zama mai raɗaɗi, ɓarna, zubarwa ko ma wari.

Intertrigos zuwa sauran kwayoyin cuta

Ana haifar da su ta hanyar staphylococci, streptococci da gram-negative bacilli (colibacilli). Wadannan intertrigos sun fi yawa a cikin mutane masu kiba, masu ciwon sukari da marasa lafiya marasa tsafta, kuma yawanci suna rikitarwa dermatosis mai tushe.

Intertrigos marasa kamuwa da cuta

• Psoriasis: ninka psoriasis ko "inverted" psoriasis na kowa a cikin tsaka-tsakin tsaka-tsakin.
• Haushi: Yana da na biyu zuwa aikace-aikace na gida jiyya (antiseptik, kayan shafawa) ko ta bazata lamba tare da caustic abu.
• Eczema: Yana iya zama alamar eczema ta hanyar rashin lafiyar mai deodorant a cikin armpits misali ko kuma dermatitis na atopic wanda ya fi dacewa ya shafi wasu folds (furrows retroauricular, folds na gwiwoyi, folds na gwiwar hannu ...).

Dalilan da ba kasafai ba

• Cutar Hailey-Hailey cuta ce ta fata da ba kasafai ake gado ba.
• Cutar Paget cuta ce mai muni da ta dace da adenocarcinoma intraepidermal.
• Cutar Crohn, cuta mai kumburi mai kumburi, na iya shafar folds na intergluteal da inguinal.
• Pemphigus mai ganyayyaki wani nau'i ne na asibiti da ba kasafai ba na pemphigus mara kyau wanda ke shafar manyan folds.
• Sifilis na biyu na iya shafar manyan folds.
• Langerhans histiocytosis cuta ce da ke da alaƙa da tarawa a cikin kyallen ƙwayoyin Langerhans.
• Necrolytic migratory erythema musamman ga glucagonomics, m ciwace-ciwacen daji na pancreas.
• Sneddon da Wilkinson sub-cornea pustulosis na cikin rukunin neutrophilic dermatosis, wanda ke da alaƙa da kasancewar neutrophils a cikin fata kuma yana shafar manyan folds.

Bincike na makirci

Binciken intertrigo yana da sauƙi: an bayyana shi ta hanyar ja na ninka, wanda zai iya yin ƙaiƙayi, zama mai raɗaɗi, zubar ... Yana da ganewar asali na dalilin wanda ya fi m. Likitan zai mayar da hankali kan halayen da ke ba shi damar daidaita kansa zuwa ɗaya ko fiye da dalilai: haɗin gwiwa da yiwuwar daidaitawa ko tsaka-tsakin intertrigo, kasancewar desquamation, oozing, juyin halitta ta hanyar tsawaitawa na centrifugal, bayyanan iyakoki ko crumbled contours , gaban vesicles, pustules, fatattaka a. kasan ninki…

Sau da yawa wajibi ne a dauki samfurin mycological (don yin nazari kai tsaye da noma) ko ma kwayoyin cuta da kuma wani lokacin biopsy na fata.

Juyin halitta et rikitarwa mai yiwuwa ne

Intertrigo da wuya yakan warke da kanta. Yana da yanayin canzawa kuma sau da yawa ya fi muni saboda maceration, gogayya da kuma wani lokacin kulawa na gida wanda ke damun shi, zai iya haifar da allergies ko ma haifar da rikitarwa (misali lokacin yin amfani da cortisone cream a kan intertrigo mai cututtuka).

Sufetowar ƙwayoyin cuta, zafi da tsagewa suma rikice-rikice ne na yau da kullun.

Alamun sun bambanta dangane da dalilin intertrigo:

Intertrigos masu kamuwa da cuta

Yisti kamuwa da cuta

Dermatophyte intertrigo

A matakin babban folds, suna ba da bushewa da jajayen jajaye tare da cibiyar ruwan hoda, mafi yawan lokuta biyu da kuma daidaitacce, wanda ke da kullun. Juyin halitta ana yin shi ta hanyar tsawo na centrifugal, tare da iyakar iyaka, polycyclic, vesicular da scaly. A classic sa hannu ne inguinal ninka.

A matakin ƙananan folds, shine intertrigo intertrigo intertrigo wanda aka fi sani da "ƙafar 'yan wasa" saboda yawanci a cikin 'yan wasan motsa jiki, musamman a cikin sararin tsaka-tsaki na ƙarshe (tsakanin yatsu biyu na ƙarshe). Yana samar da tsatsa mai ruwan hoda ko ja wanda ke iyaka da maceration yana ba fatar fata ɗishi, farar kamanni, sannan yana iya yadawa zuwa bayan ƙafa ko tafin ƙafa. Yakan yi qaiqayi.

Intertrigo zuwa candida

A matakin babban folds, suna ba da glazed da damp ja intertrigo, wanda kasansa sau da yawa ya fashe, ko da an rufe shi da wani maƙarƙashiya fari shafi. Iyakoki na intertrigo suna rugujewa tare da farar fata da ƴan pustules. Anan kuma, wurin da aka zaɓa shine folding inguinal, amma kuma ana iya gani a ƙarƙashin ƙirjin.

A matakin ƙananan folds, yana da intertrigo yana da halaye iri ɗaya kamar a cikin manyan folds, amma mafi yawan lokuta yana zaune tsakanin yatsunsu ko a kusurwar lebe (perlèche).

kwayoyin

Intertrigo daga Streptomyces foda, l Erythrasma

Erythrasma yana ɗaukar siffa mai zagaye, mai iyakantaccen plaque mai launin ruwan kasa. Gwajin hasken itace (Fitilar UV) tana yi masa launin ja " murjani ".

Intertrigo zuwa Pseudomonas aeruginosa

Pseudomonas intertrigo sau da yawa yana rikitarwa intertrigos dermatophytic musamman tsakanin yatsun kafa ta hanyar maceration da gumi a cikin takalma, wanda ba zato ba tsammani ya zama mai raɗaɗi, ɓarna, zubar ko ma wari.

Intertrigos zuwa sauran kwayoyin cuta

Sau da yawa kuma suna rikice rikice-rikice na mutane masu kiba, masu ciwon sukari da marasa lafiya marasa tsafta: intertrigo ya zama ja, yana fitar da scabs ko pustules.

Intertrigos marasa kamuwa da cuta

psoriasis

Psoriasis na folds ko "inverted" psoriasis yana haifar da intertrigo, wanda ya fi dacewa tsakanin gindi da kuma a kan cibiya, ja, mai sheki, da kyau, kuma sau da yawa ya fashe a kasan ninka.

Haushi

Sau da yawa haushi yana da alaƙa da aikace-aikacen maganin kashe kwayoyin cuta, kayan shafawa ko abubuwan ban haushi. Intertrigo ja ne mai sheki, yana murƙushe tare da wasu lokutan vesicles ko ma raunuka kuma ya zama ruwan dare a gare shi yana haifar da jin zafi.

eczema

Nannade eczema na iya samun asali guda biyu:

• Allergic lamba eczema wanda sau da yawa yawo, ƙaiƙayi da kuma iya samun blisters. Yana haifar da rashin lafiyar tuntuɓar samfurin da aka shafa a cikin ninka kuma yana rikitar da intertrigo wanda ya zama yana fitowa ko ma vesicular kuma yana iya ƙaiƙayi.
• atopic dermatitis, yawanci a cikin folds na gwiwar hannu, gwiwoyi, wuyansa, bayan kunnuwa kuma sau da yawa ya fi bushewa.

Dalilan da ba kasafai ba

Cutar Hailey-Hailey cuta ce da ba kasafai ake samun gado ba, wanda ke da alaƙa da abin da ke faruwa na vesicles ko ma kumfa a wuyansa, ramukan axillary da makwancin gwaiwa a cikin faci da aka fayyace, ta hanyar faci mai faci a cikin layi daya rhagades.

Cutar Paget cuta ce ta ciki-epidermal adenocarcinoma (nau'in ciwon daji), galibin vulvar, wanda ke da alaƙa da kansar visceral (maganin fitsari ko gynecological misali) a cikin kusan 1/3 na lokuta. Yana nunawa a matsayin jan faci na vulva, makwancin gwari ko azzakari da ke yaɗuwa a hankali.

Cutar Crohn, cututtukan hanji na yau da kullun, na iya haɗawa da wuraren fata, musamman a cikin folds intergluteal da inguinal. Suna bayyana a matsayin tsagewa, madaidaiciya da gyambon ciki mai zurfi kamar soka, ƙurji mai rikitarwa ta yoyon fitsari… wanda zai iya gaban bayyanar narkewar abinci da watanni da yawa.

Pemphigus mai ganyayyaki wani nau'i ne na pemphigus da ba kasafai yake shafar manyan folds ba, yana ba su ciyayi da jajayen fure.

Sifilis na biyu na iya ba da yawa, kumbura da plaques masu banƙyama, wani lokaci ciyayi a cikin folds.

Langerhans histiocytosis cuta ce mai alaƙa da haɓakawa a cikin fatar ƙwayoyin Langerhans. Yana haifar da ɓawon burodi da fata mai laushi, galibi a cikin folds na retroauricular, ko ma manyan folds.

Necrolytic migratory erythema shine shigar da fata ta hanyar glucagonoma, wani mummunan ƙwayar cuta na pancreas. Yana haifar da faci, jajayen faci na tsawo na centrifugal tare da ɓawon burodi ko kan iyaka wanda ke barin tabo mai launi.

Sneddon-Wilkinson sub-cornea pustulosis ne neutrophilic dermatosis, halin da kasancewar farin jini Kwayoyin da ake kira neutrophils a cikin fata. Yana haifar da ƙura, ƙuraje ko kumfa waɗanda ƙila su sami sifa mai siffa mai ma'ana da ake kira hypopion pustule. Ana tattara pustules da kumfa ta hanyar zana baka ko zobe ko dawafi musamman akan gangar jikin, a tushen gaɓoɓin gaɓoɓi kuma a cikin manyan folds.

hadarin dalilai

Rumbun yana ɗauke da haɗarin maceration, gogayya da zafi waɗanda ke haɓaka hangula da yaɗuwar ƙwayoyin cuta ko na fungal ne ko na kwayan cuta.

Acidity na folds, kiba, rashi na rigakafi, ciki, ciwon sukari da wasu kwayoyi (nau'in corticosteroid far, maganin rigakafi) musamman inganta candidiasis na folds.

Ra'ayin likitan mu

Intertrigos shine dalili akai-akai don tuntuɓar likitan fata. An rarraba su da kyau ta hanyar dalilai a cikin wannan labarin amma a gaskiya sau da yawa sau da yawa a aikace lokacin da aka gani a ofishin likita: intertrigo dermatophytic ya zama superinfects tare da kwayoyin cuta kuma yana ba da haushi da / ko rashin lafiyan eczema ga samfuran da mai haƙuri ya yi amfani da su. . Bugu da kari, majiyyaci ya riga ya tuntubi babban likitansa wanda ya gwada daya ko fiye da jiyya na gida yana kara inganta bayyanar intertrigo: ganewar asali na su na iya zama mai wahala a wasu lokuta, da kuma maganin su.

Doka ɗaya ita ce gaskiya sau da yawa a cikin intertrigos: gabaɗaya yana da kyau a bushe ninki fiye da amfani da abubuwa masu ƙiba ko kirim a cikin yadudduka masu kauri.

Rigakafin intertrigo

Matakan kulawa masu sauƙi sau da yawa suna rage haɗarin intertrigo:

• wanke kullun kuma a bushe folds sosai
• guje wa matsattsun tufafi, ulu da zaruruwan roba / fi son safa da rigar auduga
• yaki da abubuwan da ke ba da gudummawa: ciwon sukari, kiba, kirim na cortisone, da sauransu.

jiyya

Jiyya ya dogara da dalilin:

Intertrigo mai kamuwa da cuta

Dermatophyte intertrigos

Ana gudanar da jiyya na intertrigos dermatophytic ta hanyar aikace-aikacen, galibi sau biyu a rana, na antifungals, a cikin cream, a cikin madara, a cikin fesa, a cikin foda:

• Imidazolés : éconazole (Pevaryl®), miconazole (Dakarin®), oxiconazole (Fonx®)
• Allylamines: terbinafine (Lamisil®)
• Abubuwan pyridone: ciclopiroxolamine (Mycoster®)

Idan akwai juriya ga jiyya na gida, likita na iya rubuta maganin rigakafi na baki kamar griseofulvin (Grisefuline®) ko terbinafine (Lamisil®) na makonni 3 zuwa 4.

Candida intrigues

Jiyya na farko yana yaƙi da abubuwan da ke fifita candidiasis: guje wa zafi, maceration, raunin sinadarai ko inji. Hakanan dole ne a yi maganin ciwon sukari mai ciki ko ma hade da narkewa ko candidiasis na al'aura.

Ya dogara ne akan magungunan gida na gida, cream, madara, feshi, foda, ana shafa sau biyu a rana:

• Imidazolés : éconazole (Pevaryl®), miconazole (Dakarin®), oxiconazole (Fonx®)
• Allylamines: terbinafine (Lamisil®)
• Abubuwan pyridone: ciclopiroxolamine (Mycoster®).

Za a iya ba da magani na tsari na tsawon kwanaki 15 a yayin da ake sake dawowa ko mayar da hankali ga narkewa (nystatin, Mycostatin®, ketoconazole, Nizoral®).

kwayoyin

Intertrigo daga Streptomyces foda, l Erythrasma

Ana kula da Erythrasma tare da maganin rigakafi na gida tare da ruwan shafa na erythromycin.

Intertrigo zuwa Pseudomonas aeruginosa

Ana amfani da maganin antiseptik mara ban haushi a cikin ninka (chlorhexidine: Diaseptyl®, polyvidone aidin: Betadine®…) da / ko azurfa sulfadiazine (Flammazine®). Likitan ba kasafai yake amfani da maganin kashe kwayoyin cuta na baka ba, idan aka kara kamuwa da cutar ko kuma jure jiyya, yawanci ciprofloxacin ne (Ciflox®).

Intertrigos zuwa sauran kwayoyin cuta

Mafi sau da yawa sun koma baya tare da maganin rigakafi na gida (chlorhexidine: Diaseptyl®, polyvidone aidin: Betadine®, da dai sauransu), hade tare da maganin rigakafi na gida tare da fusidic acid (Fucidine® cream).

Intertrigos marasa kamuwa da cuta

psoriasis

Gabaɗaya yana amsa da kyau ga haɗin corticosteroid da bitamin D gel (Daivobet®…)

Haushi

Maganin haushi yana buƙatar maganin kashe ƙwayoyin cuta na gida (chlorhexidine: Diaseptyl®, polyvidone aidin: Betadine®…), abubuwan motsa jiki ko ma corticosteroids na sama a ƙarƙashin kulawar likita.

eczema

Maganin eczema yana buƙatar abubuwan motsa jiki da corticosteroids a ƙarƙashin kulawar likita.

Dalilan da ba kasafai ba

• Cutar Hailey-Hailey tana buƙatar bushewar folds don iyakance ƙonewa da haɗarin ƙwayoyin cuta, fungal da ƙwayoyin cuta. Fitar fiɗa na folds ɗin da abin ya shafa ya biyo baya tare da dasa fata sau da yawa shine kawai ingantaccen magani.
• Cutar Paget na buƙatar maganin ciwon daji na visceral da ke hade da kuma cire plaque na cutar Paget.
• Pemphigus mai ganyayyaki yana buƙatar corticosteroids na sama a ƙarƙashin kulawar likita.
• Ana yin maganin syphilis na sakandare tare da allurar penicillin cikin tsoka.
• Migratory necrolytic erythema yana buƙatar cire glucagonoma mai laifi.