Rich clinical experiences indicate that toe web
intertrigo is a major predisposing condition for
cellulitis/acute dermatolymphango
adenitis (ADLA) and the number of lesions is the strongest predictor of frequency of ADLA in
lymphedema (LE) patients. However, there is scanty information on the risk factors for the establishment of chronic toe web
intertrigo in LE patients. We performed a case-control study recruiting 52 lower limb LE with
intertrigo and 52 lower limb LE without
intertrigo in community settings and assessed general and local potential risk factors for chronic
intertrigo. Analysis of local risk factors revealed that topical application of oil, tingling and
numbness of the extremities were associated independently with chronic
intertrigo. In multivariate analysis, LE grades III and IV were associated with chronic
intertrigo, after adjusting for tingling and
numbness, prophylactic
antibiotic, age group, and gender. From a public health perspective, LE patients of grades III and IV and patients under
antibiotic prophylaxis should be self-motivated to look for the early symptoms of toe web
intertrigo to prevent chronic stage and recurrent episodes of
cellulitis. Patients with history of tingling and
numbness of the periphery need to be monitored for pressure effects leading to poor vascularization and delayed healing of
intertrigo.