Mycoses of intertriginous zones: A pathogenetically substantiated concept of external therapy

Abstract

The modern course of mycoses is determined by a complex of factors, including irrational therapy, concomitant somatic pathology, and the development of drug resistance. Intertriginous mycoses are characterized by acute inflammatory symptoms and are often complicated by bacterial infection, which can lead to chronicity and require a comprehensive approach to patient management. This article presents a series of clinical observations of patients with intertriginous mycoses, characterized by late diagnosis verification due to ineffective self-treatment. The infection was caused by various pathogens, and its progression was facilitated by concomitant metabolic disorders, hyperhidrosis, microtrauma, and the inappropriate use of topical steroids. Diagnosis was based on clinical examination, microscopic examination, and culture results. Two-stage topical therapy was used in all cases. During the first stage, a combination medication containing betamethasone, gentamicin, and clotrimazole (Akriderm GK cream) was prescribed, which quickly relieved inflammatory symptoms and eliminated itching. The duration of its use was determined by the rate of regression of acute inflammatory symptoms. This avoided the undesirable effects of the topical steroid and created conditions for a safe transition to the second stage, during which a dual-action antifungal agent, sertaconazole (Acrimicol cream), was used to completely eradicate the pathogen. Sequential administration of topical agents enabled rapid relief of inflammation and infection without the risk of iatrogenic complications, resulting in regression of clinical symptoms and mycological cure, as demonstrated by laboratory tests.