Inguinal epidermophytia

Inguinal epidermophytia
Inguinal epidermophytia is a lesion of the epidermis that occurs in the inguinal, axillary areas and gluteal folds, belongs to the group of fungal diseases. In rare cases, the inflammation passes to the spaces between the toes, as well as to the nail plates of the 1st and 5th toes. In medicine, this disease is also called Hebra eczema or bordered eczema.

The content of the article:
Causes of inguinal epidermophytosis
Symptoms of inguinal epidermophytosis
Diagnosis of inguinal epidermophytia
Treatment of inguinal epidermophytosis
Prevention of inguinal epidermophytosis
Inguinal epidermophytia
Inguinal epidermophytia occurs only in humans. Men are infected three times more often than women. In children and adolescents, Hebra eczema is extremely rare. The inflammatory process in men is localized not only in the groin area, but also spreads to the scrotum and anus, in women — in the breast folds.

Causes of inguinal epidermophytosis
The causative agent of the disease are the parasitic fungi Trichophyton rubrum and Trichophyton mentagrophytes. They reproduce in conditions of high temperature and humidity. Infection occurs through fungus-infected personal items, underwear, shoes, etc. Often Trichophyton rubrum fungus is infected in showers and baths, while the feet are affected.

The risk of infection increases with the following factors:

Violation of carbohydrate metabolism;
Diseases of the endocrine system (diabetes mellitus);
Fungal lesion of feet and nails (mycosis and onychomycosis);
The presence of wounds on the surface layer of the skin;
Fatness;
Increased sweating;
Diaper rash of the skin;
Increased ambient temperature and humidity;
Non-compliance with the rules of personal hygiene.
Symptoms of inguinal epidermophytosis
The disease begins with the appearance of small (up to 1 cm) pink spots. They have a round shape and a scaly surface. The circumference of the spots is characterized by a crust with the appearance of bubbles on it. Gradually infected areas increase in size, reaching a diameter of up to 10 cm. Often the spots coalesce, spreading to adjacent areas: the inner part of the thighs, perineum, anus, scrotum, between the buttocks and in the folds under them, under the mammary glands. At the same time, the foci of inflammation have a reddish-brown or scarlet color, clearly defined borders and swelling along the periphery. Sometimes bordered eczema is complicated by the appearance of pustules, bubbles, a wet erosive crust. Subjectively, the patient feels itching.

Inguinal epidermophytosis of the feet is characterized by three stages (squamous, dyshydrotic, intertriginous), each of which has its own clinical picture:

In the squamous form, the skin of the arch of the feet becomes infected. At the initial stage, symptoms may be absent, so the patient is a carrier of the infection, without even suspecting it. Then there is peeling and itching.

The clinical picture of the dyshydrotic stage is characterized by pronounced inflammation, appearing dense bubbles that burst, form erosive and ulcerative foci. The skin at the edges of the epidermis is exfoliated. As a rule, dyshidrotic epidermophytosis extends to the back of the foot and the lateral surfaces. In the advanced form, the disease can be complicated by bacterial infection, which leads to the following secondary diseases: lymphangitis, thrombophlebitis, inflammation of regional lymph nodes and erysipelas of the shins. Treatment of inguinal epidermophytia of the foot at this stage takes much longer.

In cases of skin lesions, intertriginous epidermophytia develops in the spaces between the fingers. Cracks form on the inflamed areas, the skin peels off at the edges and the patient is worried about burning and severe itching. Interdigital fungal infection can be chronic, worsening in the cold season.

In case of inguinal epidermophytosis of the feet, a parasitic fungus can be transmitted to the nails, affecting most often the 1st and 5th nail plates. They turn yellow, thicken, deform, collapse and crumble, which is called hypertrophic epidermophytia of nails. In another variant of this disease, onycholysis may occur — thinning of the nail plate and its rejection from the soft tissues of the finger.

It is necessary to know that without timely diagnosis, the disease can last for many years, developing into a chronic form, alternating between periods of exacerbation and remission.

Diagnosis of inguinal epidermophytia
If the above symptoms are detected, the patient should contact a dermatologist who will differentiate with such diseases:

Rubrophytia;
Erythrazrm;
Psoriasis;
The superficial form of candidiasis;
Eczema.
The final diagnosis of inguinal epidermophytosis is made only after microscopic bacteriological examination of the scraping of skin scales from the affected areas. With the laboratory detection of parasitic organisms Trichophyton rubrum, we can talk about this type of disease.

Treatment of inguinal epidermophytosis
Therapy depends on the form and stage of the disease. As a rule, at the initial and moderate severity of the course, the patient is prescribed local treatment in the form of antifungal drugs:

Sulfur ointment:
Econozol;
Mycoseptin;
Clotrimazole;
Mycofungin;
Cyclopyrox et al .
In addition, antihistamines are prescribed to relieve debilitating itching:

Loratadine;
Tavegil;
Suprastin , etc .
In the acute stage of inguinal epidermophytia, treatment at the first stage involves drying the inflamed areas with lotions of 1% resarcin solution or 0.25% silver nitrate solution. Ointments are also used for this purpose:

Triderm;
Mycozolone.
Only after the removal of acute inflammation, antifungal agents are attributed. If the disease is complicated by bacteria and purulent growths are observed, then the doctor prescribes antibiotics without fail.

Local preparations are applied to inflamed foci 2 times a day. The course of treatment is at least one month.

When the inguinal epidermophytosis of the nail plates is affected, they are removed, and the nail bed is treated with fucarcin or zelenka, then the above antifungal drugs are used.

It must be remembered that during the healing process, thorough disinfection of the patient’s belongings is mandatory.

In order to avoid relapses, the course of therapy should include not only medication, but also a number of preventive procedures.

Prevention of inguinal epidermophytosis
To prevent the resumption of the disease and its development into a chronic form, such measures will help:

Daily showering in the hot season;
Wiping the body dry after water treatments;
Fight against sweating;
Timely laundry;
Use of personal shoes in the pool and bath;
Disinfection of objects and underwear used by the patient;
After recovery, lubricate the problem areas with 2% iodine solution daily for three weeks.
The prognosis in the treatment of inguinal epidermophytosis is favorable, provided that the doctor’s instructions are strictly followed and preventive measures are taken.

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