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Mycosis of large folds
Last reviewed: 04.07.2025
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[ Pathogenesis of mycosis of large folds
Mycosis of large folds (inguinofemoral and intergluteal folds and skin under the mammary glands, abdominal folds, etc.) most often develops as a result of predisposing exogenous factors that favor the introduction and spread of the fungus. The main exogenous factors are maceration and friction that occur in overweight people and when wearing tight, synthetic, unseasonably warm clothing that predisposes to increased sweating. Endogenous factors for the development of fold lesions are the same as for widespread mycosis of smooth skin. Mycosis of the folds most often develops in the presence of focal fungal infection on the feet. With mycosis of the feet, the pathogenic fungus can enter the skin of the inguinal folds exogenously, less often lymphogenously or hematogenously. The disease usually recurs in the spring or autumn, it is widespread in countries with a humid, hot climate.
Symptoms of mycosis of large folds
Mycosis of the inguinal folds caused by Trichophyton rubra is characterized by polymorphic skin rashes, itching of varying intensity and chronic course. The disease manifests itself in red flaky lesions, round or oval in shape, with a tendency to peripheral growth, fusion, polycyclic outlines and an edematous, cherry-red, discontinuous ridge consisting of follicular papules, individual pustules and vesicles. The skin within the inguinal fold is weakly infiltrated, maceration and superficial cracks are possible in its depth. Over time, the lesion in the middle part acquires a yellowish tint and gradually goes beyond the fold. Manifestations of the disease can be bilateral, but are usually located in the folds and on the sides asymmetrically.
Similar clinical manifestations occur in the inguinal-femoral folds with inguinal epidermophytosis. This mycosis mainly affects the skin of the inguinal folds, rarely - the nail plates, and is characterized by a chronically recurring course. Infection occurs through contact with a sick person, as well as through toilet items used by the patient (washcloths, bedpans, underwear).
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Treatment of mycosis of large folds
External therapy with drugs with antifungal activity and a broad spectrum of action, such as azoles, allylamines, ciclopirox and amorolfine derivatives, is recommended. Adequate impact on the pathogenetic background of the disease is important.
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