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

Understanding Intertrigo: The Skin Fold Menace

Intertrigo is a common skin condition that occurs when folds of skin rub against each other, creating an environment ripe for irritation and infection. This friction-induced dermatitis primarily affects areas where skin meets skin, such as the inner thighs, armpits, under the breasts, and in abdominal folds. The warm, moist environment in these areas 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 manifesting as diaper rash), older adults, and those with limited mobility. Factors such as obesity, diabetes, and a compromised immune system can increase the risk of developing this condition.

Who is most susceptible to intertrigo?

• Infants and young children
• Older adults
• Individuals with obesity
• People with diabetes
• Those with compromised immune systems
• Individuals with limited mobility

Recognizing the Symptoms: Identifying Yeast Infection Inner Thigh Rash

Intertrigo presents as a red, raw-looking rash in areas where skin folds meet. The affected skin may feel sore, itchy, and in some cases, may ooze. While the inner thighs are a common site for intertrigo, it can develop in various skin folds throughout the body.

Where does intertrigo commonly occur?

• Inner thighs
• Under the breasts
• In abdominal folds
• Groin area
• Between the buttocks
• In the webs of fingers and toes

Is the rash always caused by yeast? Not necessarily. While yeast infections are common in intertrigo cases, the initial irritation is caused by skin-on-skin friction. However, the warm, moist environment created by this friction provides an ideal habitat for yeast and bacteria to thrive, potentially leading to secondary infections.

Underlying Conditions: When Intertrigo is More Than Skin Deep

In some cases, intertrigo may be a symptom of an underlying health condition. Understanding these related disorders can help in proper diagnosis and treatment.

What conditions can contribute to intertrigo development?

1. Inverse Psoriasis: Also known as intertriginous psoriasis, this condition causes red, shiny patches in skin folds.
2. Hailey-Hailey Disease: A rare genetic disorder causing skin cells to adhere abnormally, leading to blisters and irritations in skin folds.
3. Pemphigus: An autoimmune disorder causing blisters on the skin and mucous membranes.
4. Bullous Pemphigoid: Another autoimmune condition resulting in itchy welts or blisters on flexing areas of skin.

Diagnosis: Identifying the Root Cause of Your Skin Irritation

Accurate diagnosis of intertrigo is crucial for effective treatment. Typically, a dermatologist will conduct a thorough examination of the affected areas and inquire about your symptoms and medical history.

Can intertrigo be diagnosed visually? While the characteristic appearance of intertrigo often allows for visual diagnosis, additional tests may be necessary in some cases. If a yeast or bacterial infection is suspected, the dermatologist may take a skin swab for laboratory analysis. This helps determine the specific pathogen involved and guides the choice of treatment.

Treatment Strategies: Combating Yeast Infection Inner Thigh Rash

Effective treatment of intertrigo involves a multi-faceted approach aimed at reducing moisture, minimizing friction, and addressing any secondary infections. The Journal of the Dermatology Nurses’ Association provides a comprehensive treatment regimen:

What is the recommended treatment protocol for intertrigo?

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).
4. Once cleared, continue using ketoconazole 1% shampoo as a cleanser in the affected area at least once weekly.
5. Ensure thorough drying after bathing or whenever the area becomes damp.

Are there any natural remedies for intertrigo? While medical treatments are most effective, some individuals find relief with natural remedies. These may include applying coconut oil, which has antifungal properties, or using a diluted apple cider vinegar solution to help balance skin pH. However, it’s important to consult with a healthcare provider before trying any alternative treatments, especially if you suspect a secondary infection.

Prevention: Keeping Yeast Infections at Bay

Preventing intertrigo revolves around keeping prone areas dry and reducing friction. The American Osteopathic College of Dermatology suggests several strategies to prevent intertrigo:

How can you prevent intertrigo recurrence?

• Place absorbent material, like cotton, in affected skin folds to absorb sweat
• Use antiperspirants in prone areas
• Wash daily with an antibacterial soap
• Apply an absorbent antifungal powder to clean, dry skin folds
• For those with obesity-related intertrigo, consult a doctor about weight management strategies

Is losing weight effective in preventing intertrigo? For individuals where obesity is a contributing factor, weight loss can significantly reduce the risk of intertrigo. Losing weight decreases the number and depth of skin folds, reducing areas where moisture can accumulate and friction can occur.

When to Seek Medical Attention: Recognizing Persistent Problems

While many cases of intertrigo can be managed at home, certain situations warrant professional medical attention. It’s important to recognize when your condition might require expert intervention.

When should you consult a doctor for intertrigo?

• If the rash persists despite home treatment
• If you experience frequent recurrences
• If the rash spreads or worsens
• If you develop signs of infection (increased redness, warmth, swelling, or pus)
• If you have underlying conditions like diabetes or a weakened immune system

Can intertrigo lead to serious complications? While intertrigo itself is not typically dangerous, untreated secondary infections can potentially spread and cause more serious health issues. This is particularly true for individuals with compromised immune systems or chronic health conditions.

Living with Intertrigo: Lifestyle Adaptations and Long-term Management

Managing intertrigo often requires ongoing attention and lifestyle adjustments. By incorporating certain habits into your daily routine, you can significantly reduce the likelihood of recurrence and maintain healthy skin.

What lifestyle changes can help manage intertrigo?

1. Clothing Choices: Opt for loose-fitting, breathable clothing made from natural fibers like cotton. This helps reduce friction and allows air circulation, keeping skin folds drier.
2. Regular Cleansing: Establish a routine of gentle cleansing and thorough drying of prone areas, especially after sweating or exposure to moisture.
3. Moisture Management: Use moisture-wicking products or absorbent powders in skin folds to keep them dry throughout the day.
4. Diet and Hydration: Maintain a balanced diet and stay well-hydrated to support overall skin health.
5. Exercise Adaptations: If you’re prone to intertrigo, consider low-impact exercises that minimize friction and sweating in affected areas.

How does climate affect intertrigo management? Climate plays a significant role in intertrigo management. Hot, humid environments can exacerbate the condition by increasing sweating and moisture in skin folds. If you live in such a climate, you may need to be extra vigilant about keeping prone areas dry and cool. Consider using air conditioning, fans, or dehumidifiers to reduce ambient humidity when possible.

Understanding the Microbiome: The Role of Skin Flora in Intertrigo

The human skin hosts a diverse community of microorganisms, collectively known as the skin microbiome. This delicate ecosystem plays a crucial role in maintaining skin health and protecting against pathogens. In the context of intertrigo, understanding the skin microbiome can provide insights into both the development and treatment of the condition.

How does the skin microbiome influence intertrigo?

• Balanced Microbiome: A healthy, diverse skin microbiome helps prevent overgrowth of harmful organisms.
• Disrupted Balance: Factors like moisture, friction, and pH changes in skin folds can disrupt the normal microbiome, allowing opportunistic pathogens to thrive.
• Probiotics and Skin Health: Emerging research suggests that topical probiotics may help restore balance to the skin microbiome and potentially prevent or treat intertrigo.

Can probiotics help prevent intertrigo? While more research is needed, preliminary studies suggest that certain probiotic strains, when applied topically or taken orally, may help maintain a healthy skin microbiome and reduce the risk of conditions like intertrigo. However, it’s important to consult with a healthcare provider before incorporating probiotics into your skincare routine, as their effectiveness can vary depending on individual factors and the specific probiotic strains used.

The Psychological Impact: Addressing the Emotional Aspects of Skin Conditions

Skin conditions like intertrigo can have a significant impact on an individual’s quality of life, affecting not just physical comfort but also emotional well-being and social interactions. Understanding and addressing these psychological aspects is crucial for comprehensive care.

How can intertrigo affect mental health?

1. Body Image Issues: Visible rashes in intimate areas can lead to self-consciousness and negative body image.
2. Social Anxiety: Concerns about odor or visibility of the condition may cause social withdrawal.
3. Stress and Anxiety: The discomfort and recurrent nature of intertrigo can be a source of ongoing stress.
4. Depression: Chronic skin conditions have been linked to higher rates of depression in some individuals.
5. Intimacy Concerns: Intertrigo in genital areas can affect sexual confidence and intimacy.

What strategies can help cope with the psychological impact of intertrigo? Addressing the emotional aspects of intertrigo is as important as treating the physical symptoms. Consider the following strategies:

• Seek support from a mental health professional who specializes in chronic health conditions
• Join support groups or online communities for individuals with similar skin conditions
• Practice stress-reduction techniques like meditation or yoga
• Educate friends and family about your condition to build understanding and support
• Focus on overall health and well-being, not just the affected skin areas

By addressing both the physical and emotional aspects of intertrigo, individuals can develop a more holistic approach to managing the condition and improving their overall quality of life.

Emerging Treatments: Innovations in Intertrigo Management

As medical research advances, new treatments and management strategies for intertrigo continue to emerge. These innovations offer hope for more effective, targeted approaches to treating and preventing this common skin condition.

What are some promising new treatments for intertrigo?

1. Nanotechnology-based Treatments: Researchers are exploring nanoparticle-based delivery systems for antifungal and antibacterial agents, potentially improving their efficacy and reducing side effects.
2. Biofilm Disruptors: New compounds that can break down microbial biofilms may enhance the effectiveness of existing antifungal and antibacterial treatments.
3. Microbiome Modulators: Treatments that selectively target harmful microorganisms while preserving beneficial skin flora are under development.
4. Advanced Moisture-Wicking Fabrics: Innovative textiles designed to keep skin folds dry and reduce friction are being developed for both clothing and medical applications.
5. Photodynamic Therapy: This technique, which uses light-activated compounds to target microorganisms, shows promise for treating resistant fungal infections associated with intertrigo.

How might these emerging treatments change intertrigo management? These innovative approaches have the potential to offer more targeted, effective treatments with fewer side effects. They may also provide new options for individuals with recurrent or treatment-resistant intertrigo. As research progresses, we may see a shift towards more personalized treatment plans based on an individual’s specific skin microbiome and risk factors.

While these emerging treatments offer exciting possibilities, it’s important to note that many are still in the research or early clinical trial stages. Patients should work closely with their healthcare providers to stay informed about new treatment options as they become available and to determine the most appropriate management strategy for their individual case.

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 in the mouth in adults: symptoms, treatment – ROOTT

Causes Types Danger Treatment Remedial measures Drugs against thrush

Oral candidiasis (thrush) is an infectious disease of the mucous membranes. It is caused by a fungus of the genus Candida.

Mucous membranes are covered with whitish plaques resembling curd mass. Patients have unpleasant sensations in the mouth, a burning sensation. Eating, sometimes even speaking, becomes painful. Patients complain of dry mouth and bad breath.

Thrush is very common in infants but is easily tolerated and heals quickly. It often occurs in people with dentures, those taking corticosteroids, or undergoing chemotherapy.

Causes of the disease

Yeast fungi are present in the body of any person. Under the influence of certain factors, they begin to multiply uncontrollably.

Thrush in the mouth is caused by:

• Hormonal changes, e.g. during pregnancy
• Taking certain medications
• Weakening of immunity due to illness
• Inadequate oral hygiene
• Mucosal injuries
• High carbohydrate diet
• Taking contraceptives
• Smoking
• Candidiasis is contagious, it can be transmitted through shared utensils, kissing.

Classification

Symptoms of thrush manifest themselves in different ways, depending on the form of the disease. In dentistry, the following forms of candidiasis are distinguished:

1. Acute pseudomembranous
   – Mild form: the only symptom is the presence of plaque. If you scrape it off, a swollen, reddened mucous membrane is visible.
   – Moderate: plaque is difficult to remove, there are unpleasant sensations while eating. The submandibular lymph nodes are enlarged.
   – Severe form: extensive, off-white plaque. Signs of tissue infiltration. Plaques are removed with difficulty, bleeding mucous membrane is visible under them.
2. Acute atrophic
   Mucosa red, painful to touch, smooth. The plaque is dense, covers the cheeks from the inside, tongue, palate. The mouth is dry. There are teeth marks on the tongue. There may be a bitter, sour, metallic taste in the mouth. The acute course can become chronic, usually in patients with removable dentures. Therefore, its second name is prosthetic stomatitis. Under the prosthesis, the mucous membrane is dry, red. There is almost no plaque, but the pain syndrome is pronounced. On the back of the tongue papillae atrophy. This leads to a change in taste sensations.
   Sometimes atrophic candidiasis is called erythematous (“erythema” – redness).
3. Chronic hyperplastic
   It occurs only in adults, mainly in smokers. The coating is dirty gray, located in the corners of the lips, on the tongue. It scrapes off badly, has an unpleasant smell. The plaques merge, covering the mucosa almost completely. Saliva changes: it becomes viscous and foams. The most common such thrush in men.

Why is thrush dangerous? But candida is a yeast-like fungus, and, therefore, is capable of rapid reproduction, like any yeast. From the mucous membranes of the mouth, thrush can spread to the throat. This causes changes in the voice, makes it hoarse. Spreading to the esophagus, it provokes inflammation of the esophageal mucosa (esophagitis), making it painful for food to pass through it.

Untreated hyperplastic candidiasis develops into malignant neoplasms.

Most importantly, the reproduction of the fungus indicates a malfunction in the body’s defenses.

Only a doctor is able to prescribe the necessary examination and, based on its results, prescribe the appropriate treatment for a fungal infection.

How to treat thrush

Successful treatment requires an accurate diagnosis. For this, a number of laboratory tests are prescribed. Bacteriological culture is mandatory. He will not only confirm the thrush, but also determine which type of fungus caused it. This is important when prescribing drugs. After a clinical examination, the dentist may recommend blood glucose or HIV testing.

Recommended consultations with narrow specialists:

• Endocrinologist
  To make sure there are no endocrine disorders.
• Allergist
  To detect sensitivity to dentures.
• Therapist
  To clarify the nature of somatic diseases.

Treatment of thrush in adults and children should be comprehensive and include activities aimed at strengthening general immunity, teaching adequate oral hygiene, and changing the diet.

Algorithm of therapeutic measures

• For the best result, the intervention begins with the sanitation of the oral cavity. Carious teeth are treated by replacing the affected tissues with filling material. Remove hard plaque and tartar from enamel. Plaque is a hotbed of infection, it is necessary to get rid of it.
• Eliminate the factors provoking candidiasis. Replace dentures if they cause an allergic reaction or do not fit well. Stop the exacerbation of common diseases. Take steps to improve your hormone levels. Conduct activities that increase immunity.
• Administer antifungals based on culture results. Prescribed antihistamines, restorative agents, immunomodulators.
• Give recommendations on the normalization of the microflora in the oral cavity.

To prevent relapses, it is useful to establish regular hygiene, to exclude foods rich in fast carbohydrates and sugars from the diet. Restorative activities include physical activity and stress-reducing activities (hobbies). It is important not to take medicines uncontrollably, according to recommendations from the Internet or from friends.

Thrush medicines

• Candidiasis medicines come in various forms:
• Suspensions (Diflucan, Amphotericin B)
• Tablets (Nystatin, Flucanosole, Itriconazole)
• Gels (Mikanozol)

A good effect in candidiasis is brought by rinsing with antiseptic agents: Chlorhexidine, Miramistin. This is especially important if the patient wears removable dentures or, for various reasons, cannot maintain adequate hygiene.

Patients should be advised to regularly disinfect their prostheses.

Physician’s opinion: Most drugs for the treatment of thrush are prescription drugs. Their independent use can cause serious complications. Therefore, do not self-medicate, contact your dentist. The doctor will prescribe treatment only after determining the sensitivity of the fungus to certain drugs. This will increase the effectiveness of the intervention and prevent relapses.

Diseases of the vulva

The lesions and diseases of the vulva are varied. 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 hypoestrogenic state
• Contact dermatitis of the vulva
• Allergic contact dermatitis of the vulva
• Intertriginous dermatitis of the vulva
• Vulvar psoriasis
• Vulvar lichen sclerosus
• 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.