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Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation. This can occur in any area of the body where two skin surfaces are in close contact with each other. The aim of this scoping review was to systematically map, review and synthesise evidence on intertrigo in adults. We identified a wide range of evidence and performed a narrative integration of this related to the diagnosis, management and prevention of intertrigo. A literature search was conducted within the following databases: Cochrane Library, MEDLINE, CINAHL, PubMed and EMBASE. After reviewing articles for duplicates and relevance, 55 articles were included. The incorporation of intertrigo in the ICD-11 provides a clear definition and should improve the accuracy of estimates. With regards to the diagnosis, prevention and management of intertrigo, the literature demonstrates consensus among health professionals in approach and this forms the basis for the recommendations of this review: identify predisposing factors and educate patient in reducing these; educate patients in skin fold management and adopt structured skin care routine; treat secondary infection with appropriate topical agent; consider using moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture and reduce secondary infection. Overall, the quality of evidence on which to determine the strength of any recommendations for practice remains low. There remains the need for well-designed studies to test proposed interventions and build a robust evidence base.

Objective: To present the toe web space as an anatomically, physiologically, and pathologically unique part of the human body; characterize toe web infections and discuss why they occur; and highlight toe web psoriasis as an uncommon condition that providers should consider if toe web intertrigo does not respond to treatment., Data Source: This review encompassed many years of clinical observation and photographs; medical textbooks; and a literature search of MEDLINE, PubMed, and Google Scholar., Study Selection: Primary research keywords included intertrigo, toe web intertrigo, toe web infection, tinea pedis, microbiome, skin microbiome, toe web microbiome, ecology, psoriasis, psoriasis microbiome, intertriginous psoriasis, and Wood's lamp. More than 190 journal articles met the search criteria., Data Extraction: The authors sought data relating to what makes for a healthy toe web space and what makes for disease. They extracted and collated relevant information to compare and contrast among sources., Data Synthesis: After understanding the normal toe web space and the microorganisms that normally reside there, the authors investigated why infections occur, how they should be treated, what complications may result, and what other diseases occur in the toe web area., Conclusions: This review of toe web infection illustrates the effect of the microbiome and reports a rare form of psoriasis that is usually misdiagnosed as athlete's foot. The toe web space is a unique part of the human body that can be affected by a variety of both common and unusual conditions., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background/objectives: We observed isolated cases of perialar intertrigo in children and teenagers that did not appear to correspond to any known clinical entity. The objective of this study was to describe the clinical features of this dermatosis and the clinical characteristics of the patients., Methods: We conducted a prospective, multicenter cohort study in France from August 2017 to November 2019. All the patients under 18 years of age with chronic perinasal intertrigo were included. A standardized questionnaire detailing the clinical characteristics of the patients and the description of the intertrigo. If possible, a Wood's lamp examination of the intertrigo was done., Results: Forty-one patients were included (25 boys and 16 girls, average age: 12.1 years). Intertrigo was bilateral in 38 patients (93%). The majority of patients had no symptoms (54%). Pruritus was present in 39% of cases. Orange red follicular fluorescence was present in the perialar region on Wood's light examination in 78% of cases with active fluorescence. The presumptive diagnoses suggested by the investigators were acne (24.4%), seborrheic dermatitis (19.5%), rosacea (9.8%), psoriasis (9.8%) and perioral dermatitis (7.3%). No diagnosis was proposed in 22% of the cases., Conclusions: We describe a previously undescribed clinical sign which is characterized by a chronic bilateral erythematous intertrigo located in the perialar region. It can be isolated or associated with various facial dermatoses., (© 2022 The Authors. Pediatric Dermatology published by Wiley Periodicals LLC.)

Background: Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but potentially serious cutaneous eruptions associated with systemic diseases that should not be discounted., Methods: This prospective descriptive study aimed to explore variation in cutaneous disease in the diaper area. It was conducted as a prospective descriptive study between October 2016 and November 2019 in the pediatric department of a tertiary-level hospital., Results: Three hundred consecutive patients with rashes in the diaper area were enrolled. The most common diagnosed was IDD (125 cases; 41.7%), followed by rashes exacerbated by the diaper (101 cases; 33.67%) and non-diaper-related rashes (74 cases; 24.67%)., Conclusions: Our finding suggests that when diagnosing rashes that occur in the diaper area, general pediatricians should consider, in addition to IDD, the possibility of less-common conditions. The simultaneous presence of cutaneous lesions at other sites was linked to diagnoses of systemic diseases other than IDD, (P < 0.001).

Background: Common foot and toenail problems may cause diagnostic and management difficulties and are often complicated by comorbid factors., Objective: The aim of this article is to discuss common disorders of the skin and nails of the feet, regional physiological factors to consider and appropriate investigations and management., Discussion: Cutaneous disorders of the feet and nails present significant diagnostic and management challenges given the considerable overlap of common signs and symptoms and regionally difficult management.

Thiotepa is a common alkylating agent known to precipitate cutaneous reactions consistent with toxic erythema of chemotherapy, including erythema and hyperpigmentation. Herein, we describe an atypical case of malignant intertrigo involving preferential erythema and desquamation not only of skin folds but also of occluded areas after thiotepa-based conditioning. The diagnosis was complicated by concurrent stomatitis and oral petechiae in the setting of autologous stem cell transplant 11 days prior for diffuse large B-cell lymphoma. Histopathological examination from two cutaneous sites demonstrated epidermal dysmaturation and eccrine gland necrosis consistent with thiotepa-induced desquamation and not Stevens-Johnson syndrome or graft-versus-host-disease. Malignant intertrigo can present with extensive cutaneous involvement, as evidenced by our patient who had 25% body surface area affected. Mucosal involvement is common with most chemotherapeutic regimens and its presence should not deter the astute clinician from consideration of a diagnosis of toxic erythema of chemotherapy. No further interventions were needed and the patient healed spontaneously.

Pegylated liposomal doxorubicin (PLD) is an anthracycline anticancer agent used in ovarian cancer and a form of doxorubicin enclosed in pegylated liposomes. There are only a few reports on intertrigo-like eruptions caused by PLD. We describe the first case of severe bullous erythema, including intertrigo-like eruptions with angioedema, induced by PLD in Japan. We present the case of a 53-year-old woman who was diagnosed with stage IIIC ovarian cancer. After receiving three cycles of PLD, the patient developed swelling of the upper lip and painful erythema with blisters and erosions on the axilla, upper back, flank and wrists. The patient was diagnosed with angioedema and severe skin lesions, including intertrigo-like eruptions induced by PLD. Although treatment with oral prednisolone and topical steroids was effective against these eruptions, the administration of PLD was discontinued because of its ineffectiveness against the primary disease. Several risk factors, such as obesity, perspiration and racial differences, may contribute toward a severe manifestation such as that seen in our patient. Moreover, our case was the first accompanied by angioedema. The mechanism of coexistence of intertrigo-like eruptions and angioedema is not clear; further studies are required to clarify the pathological mechanism of intertrigo-like eruptions., (© 2019 Japanese Dermatological Association.)

Background: In geriatric and long-term care settings, intertrigo seems to be common, but generalizable epidemiological estimates are lacking. Aim of this study was to measure the prevalence of intertrigo in aged nursing home residents and to identify possible relationships with demographic and health characteristics., Methods: A cross-sectional prevalence study was conducted between September 2014 and May 2015 in a random sample of ten institutional long-term care facilities in Berlin, Germany. In total 223, aged long-term care residents were included. Mean age was 83.6 (SD 8.0) years and mean Barthel score was 45.1 (SD 23.8). Board certified dermatologists and study assistants performed skin assessments and measurements according to standard operating procedures. Mean differences and odds ratios between residents with and without intertrigo were calculated., Results: The prevalence of intertrigo was 16.1% (95% CI 11.6 to 21.2%). The submammary fold was most often affected (9.9%), followed by the inguinal region (9.4%), axilla (0.5%) and abdominal region (0.5%). Increased age was statistically significantly associated with the presence of intertrigo (OR 1.05; 95% CI 1.00 to 1.10). Care dependency in bathing activities was associated with intertrigo. Obesity, sex and skin functional parameters were not associated with intertrigo., Conclusions: Every sixth nursing home resident was affected by intertrigo indicating the high load of this skin condition in this population. Older age seems to be associated with intertrigo. Care dependency in bathing activities was likely to be associated with intertrigo. Structured skin care regimens are needed to prevent and treat intertrigo in this population., Trial Registration: This study is registered at https://clinicaltrials.gov/ct2/show/NCT02216526 . Registration date: 8th November 2014.

Fusarium are ubiquitous hyalohyphomycoses, usually encountered in the soil. They are the second unusual fungal pathogens after the Trichosporon. Intertrigo Fusarium sp. is a rare achievement. We report a case of intertrigos interorteils in an immunocompetent 45years old and a same case associated with a total onychodystrophy in an immunocompromised 75year-old. Laboratory diagnosis has found Fusarium solani confirmed with the positivity of a pure culture twice. Good progress was noted with terbinafine treatment. One or more aggravating factors must always be sought. These cases are in addition to cases increasingly frequent intertrigo due to Fusarium sp., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: Trichophyton tonsurans is an anthropophilic dermatophyte, frequent in the USA and in Asia where it is responsible for causing tinea capitis. At present, we attend an emergence of this species in certain regions where it was not or little met. Here, we report a case of onychomycosis of the hand due to T. tonsurans associated with non-albicans Candida species at an adult woman., Observation: The patient is a 62-year-old woman, with hypertension and diabetes. She reports the rather frequent use of chemical cleaners for the housework. She presented one year previously a distal onycholysis of the last four fingers of the left hand. The clinical examination objectified a presence of intertrigo in the second interdigital space. The mycological examination showed at the direct examination mycelial elements and the culture allowed the isolation of T. tonsurans associated with non-albicans Candida species., Discussion-Conclusion: Our observation highlights especially the identification of a species, which has been described only once in Morocco about a case with onychomycosis of the feet. A possible emergence of this species in our country is not far from being possible., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Superficial fungal infections are widespread, regardless of age and gender, in populations all around the world and may affect the skin and skin appendages. Although there are thousands of fungal infections from various genera and families in nature, those that are pathogenic for humans and nesting in skin folds are limited in number. The prevalence and distribution of these fungi vary according to the patients and certain environmental factors. Because the areas including the lids, external auditory canal, behind the ears, navel, inguinal region, and axillae, also called flexures, are underventilated and moist areas exposed to friction, they are especially sensitive to fungal infections. Fungi can both directly invade the skin, leading to infections, and indirectly stimulate immune mechanisms due to tissue interaction and their antigenic character and contribute to the development or exacerbation of secondary bacterial infections, seborrheic dermatitis, atopic dermatitis, and psoriasis. Superficial fungal infections can be classified and studied as dermatophyte infections, candidal infections, Malassezia infections, and other superficial infections independently from the involved skin fold areas., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Darier disease, also known as Darier-White disease, is characterized by yellow to brown, oily keratotic papules and plaques in the seborrheic areas of the face and chest. This disorder may show different clinical manifestations, such as palmoplantar pits and nail abnormalities. The trigger factors are mechanical trauma, heat, humidity, ultraviolet B, and pyogenic infections. The disease usually becomes apparent in the second decade of life. The ATP2 A2 (SERCA2) gene mutation was detected in all patients. Histopathologic changes include epidermal adhesion loss, acantholysis, abnormal keratinization, eosinophilic dyskeratotic cells in the spinous layer known as corps ronds, and the presence of grains in the stratum corneum. Although the treatment for Darier disease is unsatisfactory, some relief has been achieved with the use of corticosteroids and retinoids., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The appropriate intake and metabolism of vitamins and minerals are critical to maintaining homeostasis. Imbalance in essential nutrients, either through dietary excess or deficiency or disorders in metabolism, can result in a spectrum of dermatologic and systemic manifestations. Certain nutrient deficiencies produce a characteristic pattern of cutaneous eruption. Recognition of these patterns is important, as they can alert the physician to an underlying nutritional disease. We review nutritional diseases involving zinc, biotin, essential fatty acids, vitamin B6 (pyridoxine), and riboflavin that present specifically with intertriginous eruptions., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. Bodily secretions, including perspiration, urine, and feces, often exacerbate skin inflammation. Physical examination of skin folds reveals regions of erythema with peripheral scaling. Excessive friction and inflammation can cause skin breakdown and create an entry point for secondary fungal and bacterial infections, such as Candida, group A beta-hemolytic streptococcus, and Corynebacterium minutissimum. Candidal intertrigo is commonly diagnosed clinically, based on the characteristic appearance of satellite lesions. Diagnosis may be confirmed using a potassium hydroxide preparation. Resistant cases require oral fluconazole therapy. Bacterial superinfections may be identified with bacterial culture or Wood lamp examination. Fungal lesions are treated with topical nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole. Secondary streptococcal infections are treated with topical mupirocin or oral penicillin. Corynebacterium infections are treated with oral erythromycin.

We report a 12-month-old infant girl with cervical intertrigo caused by Streptococcus pyogenes. This form of intertrigo has been reported in only five children, but it is clearly underestimated. It should be suspected for well-demarcated beefy-red lesions of the neck not responding to antifungal therapy. A rapid streptococcal antigen test of a lesion specimen is a useful diagnostic tool. Our patient was notable for the development of S. pyogenes bacteremia, a complication that has not been previously associated with this condition., (© 2014 Wiley Periodicals, Inc.)

A 43-year-old male, with intertrigo due to Candida albicans located at the inguinal folds and accompanied by severe pruritus, was treated with topical 1% isoconazole nitrate and 0.1% diflucortolone valerate (2 applications/day for 7 days). An improvement of pruritus was reported 2 days after the beginning of the treatment. Skin lesions improved after 3 days of treatment. Complete remission of both skin lesions and pruritus was observed at day 7. No side effects were observed., (© 2013 Blackwell Verlag GmbH.)

Purpose: We describe a woman with perianal and periumbilical dermatitis secondary to group G Streptococcus, summarize the salient features of this condition, and review other cutaneous conditions that clinically mimic streptococcal dermatitis of the umbilicus., Background: Periumbilical and perianal streptococcal dermatitis are conditions that commonly occur in children and usually result from beta-hemolytic group A Streptococcus. Rarely, non-group A streptococcal and staphylococcal infections have been reported in adults., Materials and Methods: A 31-year-old woman developed perianal and periumbilical group G streptococcal dermatitis. Symptoms were present for six months and were refractory to clotrimazole 1 percent and betamethasone dipropionate 0.05 percent cream., Results: The etiology of perianal and periumbilical dermatitis is unclear, but is perhaps explained by virulence of previously asymptomatic colonized bacteria. Perianal streptococcal dermatitis is more common in children. A number of adult infections have been reported, most of which were secondary to group A beta-hemolytic Streptococcus. Men are more often affected than women. Group G Streptococcus is rarely the infective etiology of perianal streptococcal dermatitis. This condition presents as a superficial well demarcated erythematous patch on clinical examination. Diagnosis is ascertained by diagnostic swabs and serological tests: antistreptolysin O (ASO) or anti-DNase titer. Treatments include oral amoxicillin, penicillin, erythromycin, and mupirocin ointment., Conclusions: Our patient expands on the clinical presentation typical of streptococcal dermatitis. We describe a rare occurrence of an adult woman infected with non-group A Streptococcus. Several conditions can mimic the presentation of perianal streptococcal dermatitis. Although rare, group G Streptococcus should be considered in the setting of virulent infections usually attributed to group A species. Streptococcal dermatitis can be added to the list of conditions affecting the umbilicus.

Inverse psoriasis is a disorder of intertriginous areas of the skin that can easily masquerade as candidal intertrigo. Candidal rashes are commonly encountered in primary care and typically respond promptly to therapy. When treatment fails, nonadherence to treatment and medication resistance often are suspected; however, the possibility of an incorrect diagnosis should also be entertained. This article presents the case of a patient with inverse psoriasis who was misdiagnosed with recurrent candidal intertrigo multiple times. The diagnosis and treatment of inverse psoriasis is reviewed, and other conditions that may be confused with Candida and inverse psoriasis, including bacterial intertrigo, tinea, and seborrheic dermatitis, are discussed. When confronted with a case of "resistant Candida," consideration of inverse psoriasis and other Candida mimics can allow physicians to diagnose and treat these conditions more effectively, avoiding the frustration experienced by our patient.

We present a case of severe intertrigo in the neck of a 5-month-old infant. The cause was Streptococcus pyogenes.

A 77-year-old man presented with a 6-month history of intractable toe web intertrigo located in the third and fourth web spaces of his left foot. Biopsy and histological examination confirmed the presence of a verrucous carcinoma. Verrucous carcinoma of the foot has been called epithelioma cuniculatum, a case arising in the intertriginous area of the foot is presented., (© 2011 The Authors. Australasian Journal of Dermatology © 2011 The Australasian College of Dermatologists.)

Chemotherapeutic agents may induce both local and systemic cutaneous toxicity, and evaluation of these reactions in oncologic patients constitutes a real challenge. The authors describe a 78-year-old Caucasian woman, with a past medical history relevant for right radical mastectomy with axillary dissection because of stage 2 breast invasive ductal carcinoma (T2N3M0), referred to our department because of an intertriginous eruption in her groin. Two weeks before the eruption, a chemotherapy regime with cyclophosphamide, methotrexate, and 5-fluorouracil was performed. Examination revealed erythematous and dusky violaceous papules coalescing into edematous patches in the inguinal intertriginous area, including the internal surface of her thighs, groin, genital area, and intergluteal cleft. Skin cultures for bacteria and fungus were negative. Clinical and histological data were consistent with an intertriginous pattern of toxic erythema of chemotherapy (TEC). Oral prednisolone therapy (0.5 mg/kg) was started, tapered over a 1-week period, and along with general measures that included topical zinc oxide suspension, cutaneous lesions cleared completely within the first days. Although patient reassurance, she refused any kind of new chemotherapy infusions. Due to their high metabolic rate, the skin, mucous membranes, and annexes are one of the most important target organs of the toxicity associated with systemic chemotherapy. Several patterns of cutaneous eruptions to chemotherapy have been reported in the literature. Trying to resolve this issue, recently recommended was a new clinically descriptive term, TEC, in order to emphasize the overlapping features of these entities. Early recognition of this entity is critical, not just from a prognostic standpoint, but also to avoid unnecessary, potentially harmful therapeutic interventions.

Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric intertriginous eruption involving multiple body folds. With the knowledge of the most frequent causes of these conditions, a detailed history and review of exposures will guide the clinician in the search for the most likely etiologic agent.

The term 'baboon syndrome' was introduced in 1984 to describe a special form of systemic, contact-type dermatitis that occurs after ingestion or systemic absorption of a contact allergen in individuals previously sensitized by topical exposure to the same allergen in the same areas. Its clinical picture presents as an erythema of the buttocks and upper inner thighs resembling the red bottom of baboons. This reaction was originally observed with mercury, nickel, and ampicillin. In 2004, some authors proposed the acronym SDRIFE standing for 'symmetric drug-related intertriginous and flexural exanthema' specifically for cases elicited by systemically administered drugs. Since 1984, about 100 cases have been reported in the literature; for most of the concerned drugs, previous skin sensitization or possible cross-sensitization has not been shown. We report the first case of SDRIFE due to rivastigmine, with the exception of an erythematous maculopapular eruption due to rivastigmine that was previously reported. Rivastigmine is a reversible and noncompetitive acetylcholinesterase inhibitor used for the treatment of Alzheimer disease. SDRIFE is an important condition to keep in mind in order to avoid a misdiagnosis when dealing with other exanthematous disorders and to prevent re-exposure to the responsible allergen in the future.

Intertrigo is a superficial inflammatory skin disorder involving any area of the body where two opposing skin surfaces can touch and rub or chaff. The word "intertrigo" comes from the Latin inter (between) and terere (to rub) and reflects the rubbing together of skin against skin to create maceration and irritation, hence, friction dermatitis or chaffing. It is a common disorder that can affect any individual from infancy to old age. It is primarily caused by skin-on-skin friction and is facilitated by moisture trapped in deep skin folds where air circulation is limited. The condition is particularly common in obese patients who have diabetes and who are exposed to heat and humidity. The moist, damaged skin associated with intertrigo is a fertile breeding ground for various microorganisms, and secondary cutaneous infections are commonly observed in these areas. The present chapter does not deal with "ordinary" intertrigo, but rather with other skin diseases that have affinity to the intertriginous areas. Diseases mentioned are: acrodermatitis enteropathica, the baboon syndrome or intertriginous drug eruption, Darier disease, Hailey-Hailey, granular parakeratosis, Kawasaki syndrome, necrolytic migratory erythema, streptococcal intertrigo and others., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: Itchy maceration of the toe webs is common in warm and humid weather. Some cases do not respond to treatment for tinea or eczema., Methods: Patients with foot intertrigo with a poor response to antifungal or antiinflammatory treatment from 2004 to 2009 were included in this study. Their general characteristics were recorded. Bacterial and fungal cultures as well as potassium hydroxide preparations were performed., Results: We recorded 32 episodes of foot bacterial intertrigo in 17 patients. The disease was more common in men (82%) and the mean age of the patients was 59 years. The main clinical finding was maceration of the toe webs. The majority of bacterial cultures grew mixed pathogens (93%). Pseudomonas aeruginosa, Enterococcus facealis and Staphylococcus aureus were the most common pathogens. Autoeczematization was present in 50% of the 32 disease episodes., Conclusion: Foot bacterial intertrigo is not a rare condition and can easily be confused with interdigital tinea or eczematous dermatitis. Proper identification of bacterial organisms is critical for early effective antibiotic therapy. Patients should be instructed about proper foot hygiene, which is important to prevent recurrent infections.

Psoriasis is a chronic, inflammatory disease affecting 1-3% of the world's population. Joints can be affected in up to 30% of patients. About one third of patients have either severe or moderate (involving more than 10% of body surface area) disease. Patients affected with extensive psoriasis have an impaired quality of life. Psoriasis has a large spectrum of clinical features and evolution, so no complete agreement on the classification of the clinical variants exists. Plaque psoriasis is the commonest form (more than 80% of affected patients). The course of plaque psoriasis varies. Spontaneous resolution is possible, but rarely occurs. Plaques tend to remain static or slowly enlarge. Flexural (inverse, intertriginous) psoriasis manifests with lesions thinner than those of plaque form with no or minimal scaling, and is localized in the skin folds. Guttate (eruptive) psoriasis has frequently a sudden onset and frequently appears abruptly after a bacterial or viral febrile episode of inflammation of the upper ways. Pustular and erythrodermic psoriasis are the most severe clinical variants. In the diffuse pustular form recurrent episodes of fever occur, followed by new outbreaks of pustules. Erythrodermic psoriasis corresponds to the generalized form of the disease. The entire skin is bright red and is covered by superficial scales. Fatigue, myalgia, shortness of breath, fever and chills may also occur. In sebopsoriasis (seborrheic dermatitis + psoriasis) the lesions tend to occur at the same sites as seborrheic dermatitis; greasy scales predominate, but silvery scales can be found in some areas. Nail psoriasis shows various features: nail pits; oil spots; subungual hyperkeratosis; onycholysis. Rare forms include psoriasis circinata, lip psoriasis and oral psoriasis. Differential diagnosis includes many other dermatological conditions.

Pegylated liposomal doxorubicin (PLD) is a chemotherapeutic agent used in the treatment of solid tumors. It has a considerably lower risk of cardiotoxicity than its parent compound, doxorubicin. PLD also has a different cutaneous side effect profile than doxorubicin, and its cutaneous toxicity can be dose limiting. We report the case of a 60-year-old woman who developed erythema and erosions in the axilla and groin while on PLD for breast cancer. Nystatin was ineffective. Biopsies revealed an interface dermatitis with epidermal dysmaturation. Bland emollients and reduction in the dose of PLD resulted in resolution of the eruption. An intertriginous eruption with histological features of epidermal dysmaturation and an interface dermatitis has been previously reported in the dermatopathology literature. This eruption appears to be a distinct cutaneous toxicity of PLD.

Background: Perianal dermatitis is probably the most common cutaneous disorder of the genitoanal area. Studies on the epidemiology of causative factors are rare., Methods: Over a 4-year period we prospectively studied 126 patients with a presumptive diagnosis of anal eczema. The diagnostic algorithm comprised medical history, inspection, microbiology, laboratory chemistry, patch tests, proctoscopy, and biopsy if appropriate., Results: The age range was 7-82 years and the majority of patients were male (57.1%). Periods of anal symptomatology ranged from 6 days to 120 months and most of the patients (51.6%) had complaints for more than 12 months. The clinical diagnosis in 68 patients (54%) was: intertrigo/candidiasis (42.9%), atopic dermatitis (6.3%), pruritus ani (5.6%), psoriasis (3.2%), skin atrophy from steroid use (2.4%), lichen sclerosus et atrophicus (n = 2), herpes simplex (n = 1), and condylomata acuminata (n = 1). Contact eczema was suspected in 58 patients (46%), but 25 of these (43.1%) showed no contact sensitization., Conclusion: The majority of patients with symptoms of anal eczema suffer from intertrigo/candidiasis, and relevant, causative contact sensitization may be found in only some of them. Patch-testing is a valuable investigative tool only when the patients' own products are included in the test series. Most patients suffer from their perianal complaints for more than 12 months, therefore diligent evaluation is warranted.