What causes yeast infection inner thigh rash. How to identify symptoms of intertrigo. What are the most effective treatments for skin fold infections. How to prevent recurrence of yeast-related skin conditions.

Understanding Intertrigo: The Culprit Behind Inner Thigh Rashes

Intertrigo is a common skin condition that often manifests as a rash in areas where skin folds come into contact with each other. This friction-induced irritation frequently occurs in the inner thighs, armpits, under the breasts, and in abdominal folds. The warm, moist environment created by skin-to-skin contact provides an ideal breeding ground for yeast and bacteria, potentially leading to secondary infections.

While intertrigo can affect individuals of all ages, it is particularly prevalent among infants (often referred to as diaper rash), older adults, and those with limited mobility. Certain factors increase the risk of developing intertrigo, including:

• Obesity
• Diabetes
• Incontinence
• Weakened immune system
• Hot and humid climates

Recognizing the Symptoms: How to Identify Intertrigo

Identifying intertrigo is crucial for prompt treatment and relief. The primary symptoms of this skin condition include:

• Red, raw-looking rash in skin folds
• Soreness or itching in the affected area
• Possible oozing or discharge
• Unpleasant odor (in cases of bacterial infection)

The rash can develop in various skin folds throughout the body, with common locations including:

1. Inner thighs
2. Under the breasts
3. Abdominal folds
4. Groin area
5. Between the buttocks
6. Finger and toe webs

The Role of Yeast in Inner Thigh Rashes

Yeast, particularly Candida species, plays a significant role in many cases of intertrigo. The moist, warm environment created by skin folds provides an ideal habitat for yeast overgrowth. This can lead to a yeast infection, exacerbating the symptoms of intertrigo and causing additional discomfort.

Is a yeast infection always present in intertrigo cases? Not necessarily. While yeast overgrowth is common, bacterial infections can also occur. In some instances, both yeast and bacteria may be present, complicating the condition and requiring targeted treatment.

Diagnosing Intertrigo: When to Seek Professional Help

Dermatologists are typically responsible for diagnosing intertrigo. The diagnostic process usually involves:

1. Visual inspection of the affected area
2. Discussion of symptoms and medical history
3. Possible skin swab for laboratory analysis (to identify yeast or bacterial infections)

When should you consult a healthcare professional for a potential intertrigo rash? If you experience persistent redness, itching, or discomfort in skin fold areas that doesn’t improve with basic hygiene measures, it’s advisable to seek medical attention. Additionally, if you notice signs of infection such as increased pain, warmth, or pus-like discharge, prompt evaluation is essential.

Effective Treatment Strategies for Intertrigo

Treating intertrigo focuses on reducing moisture, minimizing friction, and addressing any secondary infections. The Journal of the Dermatology Nurses’ Association recommends the following treatment approach:

1. Cleanse the affected area with ketoconazole 1% shampoo, leaving it on for 2-5 minutes before rinsing.
2. Thoroughly dry the area using a hairdryer on a low setting.
3. Apply a mixture of equal parts clotrimazole 1% cream (or miconazole 1% cream) and hydrocortisone 1% cream twice daily until the rash clears (typically 3-8 weeks).

How do these treatments work to alleviate intertrigo symptoms? Ketoconazole shampoo helps control yeast growth, while the antifungal creams (clotrimazole or miconazole) target fungal infections. Hydrocortisone reduces inflammation and itching, providing relief from discomfort.

Prevention Strategies: Keeping Intertrigo at Bay

Preventing intertrigo recurrence is crucial for long-term skin health. The American Osteopathic College of Dermatology suggests several preventive measures:

• Use absorbent materials like cotton to keep skin folds dry
• Apply antiperspirants to reduce sweating in prone areas
• Wash daily with antibacterial soap
• Use antifungal powders in affected areas after cleansing

For individuals prone to intertrigo due to obesity, weight management can significantly reduce the risk of recurrence. Consulting with a healthcare provider about safe and effective weight loss strategies may be beneficial in these cases.

Beyond Intertrigo: Other Conditions Affecting Skin Folds

While intertrigo is a common cause of rashes in skin folds, several other conditions can present similarly. Understanding these conditions can help in differentiating them from intertrigo:

Inverse Psoriasis

Also known as intertriginous psoriasis, this condition causes red, shiny patches in skin folds. Unlike typical psoriasis, it lacks the characteristic scaling.

Hailey-Hailey Disease

This rare genetic disorder affects skin cell adhesion, leading to blisters and irritations in neck folds, armpits, and genital areas.

Pemphigus

An autoimmune condition causing blisters on the skin and mucous membranes, pemphigus can affect various body areas, including skin folds.

Bullous Pemphigoid

Another autoimmune disorder, bullous pemphigoid causes itchy welts or blisters, often in areas where the skin flexes.

How can you differentiate these conditions from intertrigo? While visual similarities may exist, these conditions often have distinct characteristics and may require different treatment approaches. A dermatologist can provide an accurate diagnosis through clinical examination and, if necessary, skin biopsies or other diagnostic tests.

Special Considerations: Intertrigo in Different Populations

The presentation and management of intertrigo can vary among different population groups:

Infants and Diaper Rash

In infants, intertrigo often manifests as diaper rash. The warm, moist environment created by diapers provides an ideal condition for skin irritation and yeast overgrowth. Regular diaper changes, gentle cleansing, and the use of barrier creams can help prevent and manage this condition in babies.

Elderly Individuals

Older adults may be more susceptible to intertrigo due to decreased skin elasticity, reduced mobility, and potential incontinence issues. Careful attention to skin fold hygiene and the use of moisture-wicking fabrics can be particularly beneficial for this population.

Individuals with Diabetes

People with diabetes may have an increased risk of developing intertrigo and subsequent infections due to elevated blood sugar levels. Maintaining good blood sugar control and paying extra attention to skin care can help mitigate this risk.

How does the approach to intertrigo management differ for these groups? While the basic principles of keeping the affected areas clean and dry remain consistent, the specific interventions may vary. For instance, infants may require gentler products, while elderly individuals might benefit from assistive devices for maintaining hygiene in hard-to-reach areas.

The Impact of Lifestyle on Intertrigo Risk

Certain lifestyle factors can significantly influence the likelihood of developing intertrigo:

• Clothing choices: Tight-fitting clothes that trap moisture can exacerbate the condition
• Physical activity: High-intensity workouts leading to excessive sweating may increase risk
• Diet: Nutritional imbalances may affect skin health and susceptibility to infections
• Hygiene habits: Infrequent bathing or inadequate drying can create favorable conditions for intertrigo

How can lifestyle modifications reduce intertrigo risk? Opting for breathable, moisture-wicking fabrics, maintaining good personal hygiene, and ensuring proper nutrition can all contribute to skin health and reduce the likelihood of developing intertrigo.

When Intertrigo Persists: Dealing with Chronic Cases

For some individuals, intertrigo may become a recurring or chronic issue. In these cases, a more comprehensive management approach may be necessary:

1. Regular dermatology check-ups to monitor skin health
2. Consideration of long-term preventive measures, such as regular use of antifungal powders
3. Exploration of underlying contributing factors (e.g., undiagnosed diabetes, immune disorders)
4. Potential use of systemic treatments in severe cases

What strategies can help manage chronic intertrigo effectively? A multifaceted approach combining rigorous skin care routines, lifestyle modifications, and medical interventions as needed often yields the best results. Working closely with a dermatologist to develop a personalized management plan is crucial for individuals dealing with persistent intertrigo.

Emerging Treatments and Research in Intertrigo Management

The field of dermatology continues to evolve, bringing new insights and potential treatments for conditions like intertrigo:

• Novel topical formulations with enhanced antimicrobial properties
• Probiotics and their potential role in maintaining skin microbiome balance
• Advanced moisture-wicking fabrics for prevention
• Exploration of natural remedies with anti-inflammatory and antimicrobial properties

How might these emerging treatments impact intertrigo management in the future? While many of these approaches are still in research stages, they hold promise for more effective, targeted treatments that could improve outcomes for individuals suffering from recurrent or severe intertrigo.

As our understanding of skin health and the factors contributing to conditions like intertrigo deepens, we can expect to see more personalized and effective management strategies emerge. Staying informed about these developments and discussing new options with healthcare providers can help individuals find the most appropriate treatments for their specific needs.

Causes, symptoms, pictures, and treatment

Intertrigo is a skin condition that causes a rash in skin folds, such as under the breasts, in the groin, or in stomach folds. The rash may be sore or itchy.

It happens when areas of moist skin rub together. Bacteria and yeast can grow in this environment, leading to an infection.

In this article, we describe what intertrigo is, what it looks like, and what causes it. We also cover diagnosis, treatment, and prevention.

Intertrigo is a skin condition that happens when folds of skin chafe against each other.

It usually develops in the inner thighs or armpits, or under the breasts or tummy fold.

Some people may experience yeast or bacterial infections in the folds of skin.

Areas of moist skin rubbing together cause intertrigo. The warm, damp environment makes the skin conducive to irritation and the growth of yeast and bacteria, which can lead to an infection.

While it can happen at any age, intertrigo tends to affect infants, older people, and those with a reduced ability to move around. In babies, it is often called diaper rash. Most cases occur in hot or humid environments and during the summer.

Intertrigo is also more common in adults with incontinence, obesity, diabetes, or a weakened immune system.

Specific health conditions that can contribute to the development of intertrigo include:

Inverse psoriasis

Also known as intertriginous psoriasis, this form of psoriasis develops in the folds of the skin. It can look red and shiny.

Hailey-Hailey disease

Hailey-Hailey disease is a rare genetic disorder that causes skin cells to stick together and breaks down the layers of the skin.

People with Hailey-Hailey disease usually experience blisters and irritations on the neck, armpits, and genitals and in the folds of the skin.

Pemphigus

There are different types of pemphigus, but they all happen when the body’s immune system attacks the healthy cells in the top layer of the skin.

It typically causes blisters in the mouth, nose, throat, eyes, or genitals.

Bullous pemphigoid

A fault in the immune system causes bullous pemphigoid. People with the condition can develop mild, itchy welts or more severe blisters on the skin. These tend to appear on areas of the skin that flex or move.

Intertrigo looks like a red, raw rash on the skin. It may feel sore or itchy, and it can sometimes ooze.

It can develop in any fold of the skin. The most commonly affected areas of the body include:

• the inner thighs
• under the breasts
• in the fold of skin underneath a protruding belly
• the groin
• between the buttocks
• in the webs of the fingers
• in the webs of the toes

Intertrigo may develop in one or more of these places.

It will often be a specialist skin doctor, or dermatologist, who diagnoses intertrigo. They will do this by inspecting the skin and asking a series of questions about the person’s symptoms.

If the dermatologist suspects that a yeast or bacterial infection has developed in the skin fold, they may take a swab and send it to a laboratory for analysis.

An article in the Journal of the Dermatology Nurses’ Association offers the following advice on treating intertrigo:

• Wash the affected area with ketoconazole 1% shampoo, which is available from most drugstores. People should leave it on for 2–5 minutes and then rinse it off.
• Use a hairdryer on a low setting to ensure that the area is completely dry.
• Mix equal amounts of clotrimazole 1% cream (or miconazole 1% cream) and hydrocortisone 1% cream and apply a thin layer to the affected area. People should do this twice a day until the rash is clear, which may take 3–8 weeks.
• Once the rash has cleared, continue to use the ketoconazole 1% shampoo as soap in the affected area at least once a week.
• Dry the skin with a hairdryer after every bath or shower, or whenever it feels particularly damp.

The best way to prevent intertrigo is to keep the area dry. People who experience the condition due to obesity can speak to a doctor about ways to lose weight and reduce the risk of skin complications.

The American Osteopathic College of Dermatology suggest that people prevent intertrigo by:

• placing a wad of absorbent material, such as cotton, in the affected fold to absorb sweat
• using antiperspirants
• washing daily with an antibacterial soap
• dusting the affected area with an absorbent antifungal powder once it is clean and dry

Anyone who finds that the problem keeps coming back should speak to a doctor.

Intertrigo is a skin condition that happens when areas of moist skin rub against each other. It causes a red, raw-looking rash and can lead to yeast and bacterial infections.

It can happen to anyone, but it is most common in babies, older people, individuals with mobility problems, and those with obesity.

People can easily treat the rash at home with over-the-counter creams and lotions. They can also prevent it from coming back by keeping the area clean and dry.

Anyone who experiences multiple incidences of intertrigo should speak to a doctor.

6 Types of Groin Rashes in Women

Last Updated: Jan 10, 2023

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Dr. Meenu GoyalGynaecologist • 19 Years Exp.DGO, MBBS

Skin rashes are a regular problem in both men and women. These can be caused by a variety of factors, both internal and external to the body. However, rashes on the genitals area in females and the groin area can be very problematic, painful and embarrassing. Some could be caused due to problems within the body while some could be contracted externally such as groin rashes caused by STDs (sexually transmitted diseases). Here we try to find out different rash treatment for inner thigh in female.

Women tend to be affected by rashes as the genital area along with the innerwear tends to be a fertile breeding ground for microorganisms. Infections can also grow uninhibited if medications or appropriate precautions aren’t taken. Some of the common types of groin rashes in women in females along with their causes are mentioned below.

1. Chaffing or intertrigo: This is one of the most common forms of Groin rashes, which are both painful and can be unsightly as well; these look like inflamed spots. This is primarily caused by the rubbing of the inner thighs against each other.
2. Jock itch: Although more commonly associated with men, Jock itch can affect women as well. Medically known as ‘tinea cruris’, jock itch occurs when the moisture from your sweat gets trapped within the folds or creases of skin in the groin area thus, encouraging fungi (dermatophyte fungi) to grow there. It is more common among obese people or if you happen to wear tight clothing during exercise. The rash will look like raised papules, which are red in color and quite itchy.
3. Fungi & Yeast Infections Yeast infections caused by fungi candida usually occur when the pH (the alkaline to acidity) balance of the vagina is disrupted. This will not only result in vaginal discharge, itching pain, and discomfort but will also result in rashes around the vagina along with swelling.
4. Contact Groin Rashes:Dermatitis may be transferred either through the skin to skin contact or by using shared utensils and clothing items such as towels. Contact dermatitis or skin infections look like red rashes and can happen anywhere within the body, including the genitals and groin.
5. Friction rashes: Some rashes occur as a result of adverse reactions to items of clothing rubbing against the skin such as jeans or using razors or the use of nylon thongs. These rashes occur due to the body reacting to these and look more like inflammation of the skin.
6. Groin Rashes caused by STIs and STDs: Certain groin rashes may develop on a woman’s groin as a manifestation of sexually transmitted diseases and infections. Some examples of these are Chlamydia, gonorrhea or syphilis and herpes; just to mention a few. These are usually accompanied by mild to severe pain and can only be cured after a proper consultation with the doctor.

Get to the doctor: Heat rashes, intertrigo and friction rashes usually go away by themselves. Treatment for groin rash on the inner thigh in females such as vaginal yeast infections may require topical creams while other forms of bacterial infections can be treated by creams or oral antibiotics after proper consultation with a physician. If the pain is unusual and the rashes tend to persist along with other symptoms, you should immediately visit your doctor for further analysis and treatment. If you wish to discuss any specific problem, you can consult a gynaecologist.

In case you have a concern or query regarding gynaecological issues, you can consult a gynaecologist online & get the answers to your questions through .

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Thrush (Candidiasis) – symptoms, diagnosis, treatment

Thrush (candidiasis) is an inflammatory disease of the vagina that occurs due to the overgrowth of yeast fungi of the genus Candida.

Causes of Thrush

Fungi of the genus Candida are present in small amounts in the vagina, mouth, intestines, without causing disturbances. But under certain conditions, the balance of normal bacteria and fungi in the body changes, creating favorable conditions for Candida to multiply and cause symptoms.

Thrush aggravating factors:

• Taking antibiotics or corticosteroids (this reduces the number of lactobacilli, the “good bacteria” of the vagina in the body).
• Decreased estrogen levels. Insufficient levels of these hormones change the microflora of the vagina.
• Impaired thyroid function. An excess or deficiency of thyroid hormones disrupts the metabolic processes in the vagina.
• Weakening of the immune system, for example due to HIV infection or chemotherapy
• Hormonal changes associated with pregnancy, oral contraceptive use or menopause
• Use of an intrauterine device or spermicide to prevent pregnancy
• Stress
• Wearing tight synthetic underwear
• Bathing in polluted waters
• Non-observance of personal hygiene rules

Symptoms of Thrush

• Itching, soreness and burning in the vagina and vulva
• Burning during urination and intercourse
• Edema, fissures and abrasions of the external genitalia
• Thick white cheesy discharge, usually odorless
• Bright red eruption in the vagina and on the vulva, sometimes spreading widely in the groin and on the inside of the thigh.

Symptoms may last only a few hours or persist for days, weeks or even months and may be aggravated by sexual intercourse.

Complications of thrush:

• Inflammation of the genitourinary system
• Cystitis
• Pyelonephritis

Complications of thrush during pregnancy:

• Premature rupture of amniotic fluid
• Soft tissue injuries during childbirth
• Infectious complications after childbirth
• Infection of the fetus during childbirth

Diagnosis of Thrush

To make an accurate diagnosis, a gynecologist examines and takes swabs from the vagina and urethra. The most accessible and informative diagnostic method is microscopy of smears discharged from the vagina and cervix with Gram stain. If candidiasis has a chronic course, then such studies as bacteriological culture and PCR diagnostics are carried out. PCR diagnostics allows you to determine the genetic material and type of fungus, and bacteriological seeding – the type of fungus and its sensitivity to treatment.

Treatment of thrush

Drug therapy is indicated for the treatment of thrush. Two types of preparations are used in medical treatment:

• Topical preparations
• Systemic preparations

For local treatment, vaginal preparations such as suppositories, creams, ointments, capsules, tablets are used. By composition, these drugs are divided into monocomponent, which have antifungal and antibacterial action, and combined, which contain not only the antifungal component, but also hormonal components in microdoses to quickly relieve itching and swelling. Topical preparations can be used:

• One time (short courses)
• Several times (repeated short courses)
• Daily for 3-10 days

Systemic preparations include tablets and capsules. Such drugs are taken orally and have an effect on the entire body as a whole. They are prescribed when a woman for some reason cannot take drugs for local treatment or these drugs are ineffective.

Nutrition in the treatment and prevention of thrush:

Foods to include in the diet in the treatment of thrush:

• Fresh, stewed and boiled vegetables
• Fruits, berries
• Leafy greens
• Herbs and spices such as saffron, cloves, turmeric, cinnamon
• Legumes
• Oats
• Onion, garlic
• Stevia

Foods to be completely avoided in the treatment of thrush:

• Sweets, honey
• Bakery products, rich pastries
• Products containing yeast
• Dairy products (other than yogurt and kefir), including cheese
• Vinegar, mustard, mayonnaise, ketchup and other sauces
• Starch and products containing starch
• Canned food
• Alcohol

Diseases of the vulva

Lesions and diseases of the vulva are diverse. These include dematoses: atopic dermatitis, atrophic changes against the background of a hypoestrogenic state, neurodermatitis, allergic contact dermatitis, intertrigo (mechanical dermatosis), psoriasis, lichen sclerosus, lichen planus and others; vulvar cysts, vestibular papillomatosis, benign tumors of the vulva, systemic diseases, vulvar infections and others. All of these diseases are accompanied by hyperemia (redness) and itching, burning, but it is possible to make a correct diagnosis only when examined by a doctor and sometimes using an additional method – vulvoscopy.

Lesions and diseases of the vulva are diverse. These include dematoses: atopic dermatitis, atrophic changes against the background of a hypoestrogenic state, neurodermatitis, allergic contact dermatitis, intertrigo (mechanical dermatosis), psoriasis, lichen sclerosus, lichen planus and others; vulvar cysts, vestibular papillomatosis, benign tumors of the vulva, systemic diseases, vulvar infections and others. All of these diseases are accompanied by hyperemia (redness) and itching, burning, but it is possible to make a correct diagnosis only when examined by a doctor and sometimes using an additional method – vulvoscopy.

Treatment and examination of dermatosis includes a consultation of two specialists – a gynecologist and a dermatologist.

Consider each disease separately.

• Vulvar atopic dermatitis
• Neurodermatitis of the vulva
• Atrophic changes due to a hypoestrogenic state
• Contact dermatitis of the vulva
• Allergic contact dermatitis of the vulva
• Intertriginous dermatitis of the vulva
• Vulvar psoriasis
• Lichen sclerosus of the vulva
• Lichen planus of the vulva
• Vulvar cysts
• Vestibular papillomatosis
• Benign tumors of the vulva
• Systemic diseases
• Infections of the vulva

Atopic dermatitis of the vulva

is the most common type of dermatitis. Approximately 20% of the population is affected. It usually occurs in young girls who have a history of some kind of atopic disorder (bronchial asthma, allergic reactions, hay fever, urticaria) heredity or suffer from it. Atopic dermatitis is prone to recurrence and is accompanied by severe itching. The disease became clear recently, when a hereditary defect in keratinization was found in those suffering from it, which increases the permeability of the epidermis and leads to its dryness. Allergens, irritating substances and pathogenic microorganisms easily penetrate into small cracks in the parched epidermis. Soap or hygiene products, increasing the damage to the barrier function of the epidermis, contribute to the penetration of other irritating substances and allergens into its defects. Atopic dermatitis occurs as a result of a complex interaction of irritating and allergenic chemicals or drugs against the background of a hereditary immunodeficiency state, in some cases against the background of a hereditary defect in the barrier function of the epidermis, skin infections, fungal, bacterial, protozoal or viral, lead to exacerbations of atopic dermatitis due to direct action and additional allergization. Staphylococcus aureus most often causes and maintains exacerbations of atopic dermatitis.
The main symptoms of atopic dermatitis – “itching – scratching – itching” and weeping (moisture), lead to a sharp thickening of the skin with pigmentation disorders and the appearance of a rash. Scratching becomes the entrance gate of a secondary infection. Often the cause of the exacerbation is alkaline soap and personal care products, fragrances and even wet sanitary napkins. Skin changes depend on the age of the process. Most often, the labia majora are affected, less often the small or inner thighs and the intergluteal fold.

In treatment, first of all, it is necessary to eliminate the causes and triggers of dermatitis.

Vulvar neurodermatitis

is a disease that is a transition from atopic dermatitis, which leads to a vicious circle of “itching – scratching – itching”. Synonyms of neurodermatitis of the vulva – “simple chronic lichen”, “hyperplastic dystrophy”, “scaly hyperplasia”. Skin changes occur the same as in atopic dermatitis, but mental overstrain is an important trigger. The most characteristic symptom of neurodermatitis of the vulva is persistent itching, often for many years, aggravated by warmth, during menstruation and under the influence of stress factors. Combing is habitual, almost obsessive. The skin of the vulva thickens, becomes more or less pigmented, the process constantly extends to the inguinal folds and thigh. Treatment is multifaceted and complex. There are frequent relapses.

Atrophic changes due to hypoestrogenic state

Accompanied by a drop in the level of the hormone estrogen in the blood due to the onset of natural menopause and other conditions: removal of the ovaries, resection of the ovaries, ovarian dysfunction, the use of antiestrogen, selective suppression of estrogen receptors.

Before menarche (beginning of the menstrual cycle, puberty) and during breastfeeding, estrogen levels are relatively low. This leads to thinning and dryness of the epithelium of the vulva and vagina, with a weakening of its barrier function, predisposing to irritation and infection.

Atrophic vulvovaginitis, as this disease is called, is accompanied by symptoms such as burning and itching, soreness of the vulva, difficulty in urination associated with increased frequency and pain, pain during intercourse. The epithelium of the vulva and vagina becomes thinner and becomes pale. Sometimes there is a narrowing of the entrance to the vagina, cracks and hemorrhages. In severe cases, profuse discharge with an unpleasant odor appears.

Treatment includes hormonal therapy and, in case of secondary infection, antibacterial therapy.

Vulvar contact dermatitis

is an inflammation of the skin caused by an exogenous irritant. It is important to distinguish simple contact dermatitis from allergic dermatitis. Both of them can have an acute, subacute and chronic course. Vulvar contact dermatitis occurs as a result of permanent direct chemical or physical damage to the skin that is not associated with immune mechanisms. Its causes are manifold, for example, the effect of urine, feces. It predisposes to low estrogen levels, concomitant skin diseases, infection, trauma – everything that weakens the barrier function of the epithelium and makes the skin more sensitive to damaging effects. However, repeated contact with chemicals leads to the development of true allergic contact dermatitis.
Contact dermatitis of the vulva is a very common disease. Worried about increased sensitivity of the skin, itching and burning of the vulva. Patients often resort to self-treatment with antifungal drugs, antipruritic or anesthetic ointments, applying them to already inflamed skin, and the medical workers to whom these patients turn are already at a loss to establish the cause of contact dermatitis. Therefore, you should consult a doctor at the first worries that appear, so that the doctor can identify the cause and prescribe the correct treatment. So, the most common causes of simple contact dermatitis of the vulva: soap and its substitutes, urinary and fecal incontinence, sweating, vaginal discharge, irritation with pads and underwear.

Treatment is staged, with the exception of the cause of the disease.

Allergic contact dermatitis of the vulva

It is a severe allergic reaction to small amounts of a chemical.
Allergic contact dermatitis of the vulva usually begins acutely, unlike simple contact dermatitis. Itching and burning come on suddenly. Sometimes the patient herself indicates the cause. Itching may be combined with burning. The reason may be some irritant factor: highly alkaline or highly scented soaps and its substitutes, highly scented pads and other allergens, the list of possible allergens is very long. Often, by the time of treatment, the disease takes a subacute or chronic phase of the course. A severe acute inflammatory reaction is accompanied by hyperemia (redness), the formation of vesicles (vesicles), and even blisters, weeping (moisture), scratching with bloody or yellow crusts, sometimes a secondary infection joins.

Treatment is based on various methods, but first of all, the elimination of the main allergen, otherwise it is unsuccessful.

Intertriginous dermatitis of the vulva

– this is an inflammation of the skin in the folds caused by friction, exposure to heat, sweating, accumulation of moisture under clothing. The disease is especially common in women with deep skin folds.
Its main reason is the friction of the contacting surfaces of the skin and their maceration then in the heat. Inflamed weeping surfaces are easily infected with bacteria and fungi of the genus Candida (popularly called “thrush”). Hydration, tight-fitting clothes made of synthetic fibers, urinary and fecal incontinence predispose to the disease. Patients with obesity and diabetes mellitus, in particular the elderly, in whom obesity is combined with immobility and incontinence of feces and urine, especially often suffer from intertriginous dermatitis of the vulva.
Such dermatitis is characterized in the femoral-genital and inguinal folds, and the overhanging fold in the lower abdomen, and on the skin under the mammary glands, increased skin sensitivity, burning, and an unpleasant odor expressed to one degree or another. The skin in all these folds is subjected to constant friction. This type of dermatitis should not be confused with psoriasis, lichen sclerosus, benign familial pemphigus.

The treatment is complex, with the addition of a secondary infection, antibiotic therapy is also indicated.

Vulvar psoriasis

– chronic hereditary dermatosis, which is characterized by reddish papules and plaques, covered with densely attached silvery-white scales. Psoriasis affects 2% of the population. The defeat of the vulva with it is often observed, but in many cases it remains unrecognized, since patients and doctors do not notice it. Turning to dermatologists, patients do not present relevant complaints.
The provocateur of psoriasis of the vulva are minor injuries (rubbing, scratching), infections (bacterial or fungal), chemical irritants (cosmetics), some medications. Mental overstrain weakens the barrier function of the epidermis (skin). Rashes of psoriasis at the site of scratching due to itching that accompanies depression and anxiety. Promotes the manifestation of psoriasis and fluctuations in hormone levels. Most often, vulvar psoriasis occurs during puberty and menopause. It provokes the development of alcohol consumption and smoking. Rashes of psoriasis of the vulva are mainly promoted by traumatization of the skin. The main concern in psoriasis is itching of varying intensity. It leads to scratching, which in turn leads to burning and pain.

Treatment of vulvar psoriasis is complex and consists of local and systemic therapy.

Vulvar lichen sclerosus

One of the chronic inflammatory dermatoses most commonly affecting the vulva.
It is characterized, including on the vulva, by thinning and depigmentation of the skin and scarring, anxiety by itching, burning, less often pain. Lichen sclerosus leads to deformation of the vulva and its functional impairment. The prevalence of this disease is unknown, since the disease is not always accompanied by complaints, as a result of which some patients do not go to doctors. Lichen sclerosus occurs at any age, from 6 months to old age, but mostly between 40 and 70 years. Causes and development are due to many factors: hereditary, related to cellular immunity (T and B-lymphocytes) and autoimmune, hormonal, infectious, local. It has been associated with certain HLA class II antigens, antibodies to certain tissue antigens, and autoimmune disorders. The role of hormonal factors is confirmed by the fact that the disease often begins against the background of estrogen deficiency – in childhood or postmenopause. Disorders of androgen metabolism are suspected but not proven. However, the etiological role of hormones has not yet been proven. The development of lichen sclerosus is also associated with pathogenic microorganisms, especially the spirochete Borrelia burgdorferi, but apparently it is not the true causative agent of the disease. The role of other microorganisms has not been confirmed. However, there is no doubt about the importance of local influences, from scratching to radiation exposure, as triggering factors. The clinical picture is varied. Typical complaints of itching or its combination with sore pain, hypersensitivity of the skin, difficulty urinating associated with increased frequency and pain, pain during intercourse.
In 20% of cases, foci of lichen sclerosus are found on other areas of the skin, usually on the neck, in the armpits, and on the mammary glands. The vaginal mucosa is not affected. Occasionally, lesions of the oral mucosa are observed.

Treatment includes topical and general therapies.

Lichen planus of the vulva

Relatively common dermatosis and mucositis (inflammation of the oral cavity) mediated by cellular immune mechanisms. The skin and oral mucosa are usually affected, in 25% of cases only the mucous membranes. Damage to the oral mucosa in women in 57% of cases is accompanied by damage to the vulva and vagina. The true prevalence is unknown, as it often goes undiagnosed. Even in patients with lesions of the oral mucosa and skin, the genitals are not always examined. Synonyms: erosive lichen planus, desquamative inflammatory vaginitis, vulvovaginal gingival syndrome.

The causes of lichen planus are unknown, but much evidence clearly points to its autoimmune nature, mediated by cellular immune mechanisms. According to the latest data, there may be a link between the DQB1 * 0201 antigen of the HLA system and lichen planus of the vulva, vagina and gums. Widespread damage to the basement membrane zone of the epidermis is found, apparently of an autoimmune nature.

Clinical variants:

• Classic – pruritic polygonal papules and plaques on the wrists and ankles, on the pubis and labia, but are not accompanied by atrophy and scarring;
• Vulvovaginal-gingival syndrome is an erosive lesion of the mucous membranes of the mouth, vulva, conjunctiva and esophagus with atrophy and scarring.

Damage can be on the scalp, and on the nails, eyes, mucous membranes of the mouth, nose, esophagus, larynx, bladder, anus. In most cases, the disease develops at the age of 30-60 years and is accompanied by various complaints. The most common of them: soreness when touched and pain and itching individually and in combination. However, complaints, even with characteristic changes, are not always. Sometimes itching may join, which manifests itself differently depending on the form.
The pattern of changes in the vulva depends on the variant of the disease. In most cases, there are red erosions with scalloped “lace” whitish edges. Their surface is often shiny, vitreous. But small, purple with peeling papules and plaques localized on the pubis, labia majora, and thighs can be observed. Scratching contributes to the spread of rashes and is accompanied by secondary changes. With these pictures, the vulva loses its normal structure over time and untimely treatment. Often, damage to the vulva and vagina is preceded by damage to other areas of the skin and mucous membranes. The diagnosis is made on the basis of the clinical picture and biopsy data. Sometimes lichen planus is accompanied by lichen sclerosus.

Treatment includes topical and systemic therapies.

Vulvar cysts

On the vulva, you can sometimes find cysts of different sizes and different origins, which appear as a result of inflammation or injury.
Bartholin gland cysts can be seen with the naked eye.
The clinical picture of the inflammatory process of the Bartholin gland and its excretory duct depends on the anatomical structure. The Bartholin’s gland is located deep in the thickness of the muscles of the perineum. Several small excretory ducts emerge from it, merging into an ampulla, from which then the main excretory duct of great length emerges, but narrowing towards its external opening. The excretory duct of the gland is affected more often than it itself. Diseases of the Bartholin gland and its duct – bartholinitis – include canaliculitis, abscess of the Bartholin gland, cyst of the Bartholin gland, rarely endometriosis.
Small sebaceous retention cysts are observed over the entire surface of the labia, more often between the hairy area and the small lips. They contain yellowish content. As a rule, only itching disturbs. Often, when viewed through a colposcope, small erosive surfaces are found. Sometimes the cysts are large.

Treatment is conservative, in advanced cases surgical.

Vestibular papillomatosis

It is a collective term that clinically includes typical small acute condylomas caused by papillomavirus infection and micropapillomas (pseudocandylomas), which are not associated with papillomavirus infection.
It is often asymptomatic, discovered by chance, although sometimes it is accompanied by leucorrhoea, pain and burning of the vulva, a manifestation of pain during intercourse.

Treatment for anxiety. Depending on the situation, a biopsy is sometimes required followed by surgical treatment. The approach is individual. The main tactic for this disease is observation by a gynecologist.

Benign tumors of the vulva

Tumors of the vulva are diverse and require surgical treatment with subsequent histological examination.

Systemic diseases

The most pronounced changes in the vulva are observed in Behçet’s disease and Crohn’s disease.