Erosive toe-web intertrigo: Clinical features and management.
Ann Dermatol Venereol
; 151(3): 103263, 2024 Jul 23.
Article
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| MEDLINE
| ID: mdl-39047654
ABSTRACT
BACKGROUND:
Toe-web (TW) intertrigo is a common disease of fungal or bacterial origin. Gram-negative bacterial (GNB) TW intertrigo consists of weeping, erosive, painful lesions that may be recurrent, leading to functional disability. Eczema is often associated with this condition. The management of intertrigo is poorly codified.OBJECTIVE:
To evaluate the efficacy and safety of a standardized treatment plan using topical steroids in relation to the course and the frequency of recurrence of GNB-TW intertrigo.METHODS:
We conducted a prospective open interventional multicentre study from June 2020 to June 2021. Standardised treatment using TCS together with follow-up via phone calls were performed over a 6-month period. In addition, a retrospective historical monocentric study was performed for patients with suspected TW-GNB intertrigo treated without standardized management. The primary endpoint was disease duration. We performed a Wilcoxon test to compare the median duration of GNB-TW intertrigo in both series.RESULTS:
We included 13 patients in the prospective cohort and 14 in the retrospective cohort. In both cohorts, most patients were male with a median age of 59â¯years. The most frequent signs were fissures and exudates. Eczema was often associated (51.8%). Identified risk factors were psoriasis, local humidity, fungal intertrigo, vascular disease (arterial or venous insufficiency), and a history of multiple local treatments prior to diagnosis. Pseudomonas aeruginosa was the predominant pathogen (48.1%). Median durations of TW-GNB intertrigo were 56â¯days and 61â¯days. There was no significant difference in the median duration of the disease between the prospective and the retrospective cohorts (respectively61â¯days and 56â¯days; pâ¯>â¯0.58). Relapses were more frequent in the retrospective cohort (respectively 7.7% and 21.4%).CONCLUSION:
GNB-TW intertrigo is a difficult-to-treat disease often associated with eczema. While topical corticosteroids (TCS) seem to be an effective and well-tolerated treatment they do not appear to reduce disease duration compared to other treatments.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Ann Dermatol Venereol
Año:
2024
Tipo del documento:
Article