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What Causes Intertrigo In A Skin Fold On Lower Abdomen?
Question: Two weeks ago while in a hurry, I sponge-bathed my genitals with a perfumed hand soap which I had never use for such purposes, before. I probably did an inadequate job of rinsing off the soap. Within a day I began to have burning/itching and soon inflammation on the neck skin of the penis which is usually covered with loose foreskin (I have the elderly, 'vanishing penis' syndrome). Two days later I awoke with a burning on my side; in the morning I discovered intertrigo in a skin fold on my lower abdomen, on the same side of my body. Two days later, posthitis progressed to a small spot on the glans. Finally, I just turned 80, was diagnosed with CLL eight years ago, am W&W, and have very low IG levels. So, (1) might the intertrigo and balanoposthitis be related? (2) Will conventional treatments for BP work in my case? (3) Might it be necessary/time for IVIG? (4) Am I at risk for systemic C. albicans given my low IGs? BTW, I have an appointed with my GP on Monday and a quarterly scheduled appointment with my oncologist on the 29h. Just want to be as prepared for my appointments as possible.
Brief Answer:
Need more clarification and image of involved area on lower abdomen
Detailed Answer:
Hello. Thank you for writing to us
I have read your question and I have also reviewed the Image. I can see red patches/ erosions on glans and adjacent prepuce.
So, its been about 12-13 days since you have these lesions on penile foreskin and glans and about 10-11 days since you have possible intertrigo on lower abdomen.
I request you to also upload an Image of the affected area on abdomen, presumably affected with intertrigo.
I would like to rule out a differential of Herpes (?simplex ?Zoster). The fact that the involvement is one sided on penis and abdomen makes me suspect the possibility of herpes.
Moreover the symptoms of burning are common with herpes zoster than with intertrigo or candidal balanoposthitis. Intertrigo and balanoposthitis are commonly itchy rather than having a burning sensation.
Are there fluid filled vesicles on the affected area on abdomen?
Regards
Need more clarification and image of involved area on lower abdomen
Detailed Answer:
Hello. Thank you for writing to us
I have read your question and I have also reviewed the Image. I can see red patches/ erosions on glans and adjacent prepuce.
So, its been about 12-13 days since you have these lesions on penile foreskin and glans and about 10-11 days since you have possible intertrigo on lower abdomen.
I request you to also upload an Image of the affected area on abdomen, presumably affected with intertrigo.
I would like to rule out a differential of Herpes (?simplex ?Zoster). The fact that the involvement is one sided on penis and abdomen makes me suspect the possibility of herpes.
Moreover the symptoms of burning are common with herpes zoster than with intertrigo or candidal balanoposthitis. Intertrigo and balanoposthitis are commonly itchy rather than having a burning sensation.
Are there fluid filled vesicles on the affected area on abdomen?
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Are there fluid filled vesicles on the affected area on abdomen?
No. this morning I took a photo then drafted a reply, but lost the reply while trying to find a way of attaching a photo to it. While still red, there is no raw spot now, but somewhat rough where there was one.
Please advise how to upload the photo with a reply, or otherwise.
Further, in 2004 I had a mild case of shingles and in 2006 a vaccine shot (before the CLL dx).
As for the penis inflammation, when I awoke this morning the skin at the sulcus/neck was very moist and red; when I blotted with a tissue there were several blood spots on it.
No. this morning I took a photo then drafted a reply, but lost the reply while trying to find a way of attaching a photo to it. While still red, there is no raw spot now, but somewhat rough where there was one.
Please advise how to upload the photo with a reply, or otherwise.
Further, in 2004 I had a mild case of shingles and in 2006 a vaccine shot (before the CLL dx).
As for the penis inflammation, when I awoke this morning the skin at the sulcus/neck was very moist and red; when I blotted with a tissue there were several blood spots on it.
Brief Answer:
I would advice a biopsy and blood work
Detailed Answer:
Hi. Thank you.
I have recieved and reviewed the Image.
Certainly does'nt look like herpes zoster. This doesn't look like candidal balanitis Or intertrigo, either.
In view of the past history of CLL I would suggest a biopsy from involved skin as this could be a manifestation of infiltration of skin with leukemia cells i.e leukemia cutis.
In addition I would suggest blood work e.g complete blood count and differential cell counts.
Regards
I would advice a biopsy and blood work
Detailed Answer:
Hi. Thank you.
I have recieved and reviewed the Image.
Certainly does'nt look like herpes zoster. This doesn't look like candidal balanitis Or intertrigo, either.
In view of the past history of CLL I would suggest a biopsy from involved skin as this could be a manifestation of infiltration of skin with leukemia cells i.e leukemia cutis.
In addition I would suggest blood work e.g complete blood count and differential cell counts.
Regards
Above answer was peer-reviewed by :
Dr. Sonia Raina
GP says it sure looks like Candida balanoposthitis, swabbed for culture, and will wait for results before considering biopsy 'down there.' ;-) She did prescribe oral and topical antifungals which I started, yesterday. Oncologist's surgical colleague will perform biopsy if/when necesary.s
Brief Answer:
I would wait and see how your condition responds
Detailed Answer:
Ok. I suggest you to go ahead with it for the time being with results awaited.
Still I am not totally convinced with this possibility. The lower abdominal rash to me does'nt look like intertrigo because it does'nt seem exactly localized in the folds and the rash seems to fade medially where intertrigo should be the most obvious because of occlusive groin folds, moreover intertrigo is usually bilateral rather than one sided. It seems like a perfectly linear red area/ band more like something rubbing against skin like a tight waist band of trouser etc. More like a purpure Or eccymosis rather than intertrigo
For penil rash, I would have also given a therapeutic trail of topical and oral antifungals rather than straight away jump to biopsy. Would do biopsy only if it does'nt respond as expected in order to rule out leukemic infiltration.
Keep me updated about the progress.
Regards
I would wait and see how your condition responds
Detailed Answer:
Ok. I suggest you to go ahead with it for the time being with results awaited.
Still I am not totally convinced with this possibility. The lower abdominal rash to me does'nt look like intertrigo because it does'nt seem exactly localized in the folds and the rash seems to fade medially where intertrigo should be the most obvious because of occlusive groin folds, moreover intertrigo is usually bilateral rather than one sided. It seems like a perfectly linear red area/ band more like something rubbing against skin like a tight waist band of trouser etc. More like a purpure Or eccymosis rather than intertrigo
For penil rash, I would have also given a therapeutic trail of topical and oral antifungals rather than straight away jump to biopsy. Would do biopsy only if it does'nt respond as expected in order to rule out leukemic infiltration.
Keep me updated about the progress.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Prasad
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