Fat man's inner thigh abrasion

The situation of abrasion on the inner thigh of fat people is commonly known as fold wear, and its scientific name is intertrigo erythema. It is more likely to occur in places with many wrinkles and easy friction. The inner thigh is more in line with this condition. It is an acute skin inflammation, characterized by the formation of red papules, some of which are blisters, followed by erosion and exudation. In order to identify it to the greatest extent possible, we need to have a comprehensive understanding of the situation of intertriginous erythema.

Etiology and pathogenesis

The disease is mainly caused by close contact between the skin and the surface of the skin in the skin folds, which leads to poor dissipation of local moisture and heat, sweat retention, and immersion. In addition, the constant friction and irritation of the skin surface during activities causes acute inflammation. Secondary bacterial or Candida albicans infection is common.

Urinary and fecal incontinence can easily cause folds due to excessive moisture, chemical irritants in urine and feces, and microbial infection.

Clinical manifestations

When the rash first appears, the skin appears red and swollen or dark red spots, followed by infiltration, erosion and exudation. The range of skin lesions is consistent with the wrinkled skin and has clear boundaries. In case of secondary infection, there will be purulent secretions, and lymphadenitis may occur if the inflammation is obvious. In severe cases, there may be blisters and shallow ulcers. Conscious itching and burning pain. Skin lesions often occur in wrinkles, such as under the breasts, groin, gluteal folds, armpits, elbows, navel, neck, perineum, etc. It is common in obese infants and women. It often occurs in the hot and humid summer season.

Diagnostic criteria

It is not difficult to diagnose the disease based on the location of the skin lesions, morphological characteristics and season of onset. Microscopic examination and culture can confirm the presence of bacterial, Candida albicans or dermatophyte infection.

Differential Diagnosis

This disease should be differentiated from the following diseases:

1. Candidal intertriginous erythema: It initially appears as a small blister, which quickly turns into a pustule, and then becomes eroded but without obvious exudate. There are often inflammatory papules and membranous desquamation around it; fungal microscopy is positive.

2. Acute eczema: unknown cause, random location, polymorphic rash, obvious exudation, unclear boundaries, severe itching, and easy to relapse.

3. Contact dermatitis: there is a history of contact. It is more common in exposed areas, often with bullae and obvious inflammation.

4. Tinea cruris: obvious inflammation at the edges, with papules, blisters and scales, spontaneous healing in the center, and positive fungal microscopic examination.

Treatment

Treatment is mainly local treatment, which includes:

(1) Apply Burow solution to exudative lesions 3 or 4 times a day.

(2) Sprinkle dry powder on the wrinkled areas and separate them with absorbent cotton cloth.

(3) Applying calamine lotion externally can have a soothing and drying effect. When erythema occurs, you can sprinkle powder, such as boric acid talcum powder, prickly heat powder, and pine pollen; or apply boric acid cream and then sprinkle powder.

(4) In the early stages, you can apply glucocorticoid or hormone antibiotic lotion or cream, or gel to the affected area 2 or 3 times a day. However, avoid long-term use.

(5) Neonatal skin folds can be treated with tannic acid ointment. Prescription: 100g tannic acid, 200g glycerin, 2g sodium metabisulfite, 20ml distilled water, 678g single ointment, heat and stir to make 1000g tannic acid ointment.

(6) Those with local infection can be treated with sensitive antibiotics.

(7) When there is erosion and exudation, first clean the area with 1:8000 potassium permanganate solution or 3% boric acid solution and then apply powder, or use 2% boric acid solution for wet compress, or apply elaeagnus officinalis oil externally and then apply powder. For those who are infected, antibacterial drugs such as furazolidone can be added to the ointment.

(8) During the desquamating period, you can use lotions such as calamine lotion, 2% borneol or 5% alum calamine lotion.