Breast Reduction as a Modality for Treatment of Recurrent Intertrigo: A Study of Ten Cases

Abstract

Introduction: Macromastia is associated with physical and psychosocial comorbidities. One such entity which presents to dermatologists is intertrigo which is the infection of intertriginous areas caused by various species of bacteria and fungi. This is the most common presentation in females with large ptotic breasts with involvement of the inframammary region. After exhausting all possible modalities including antibiotics, antifungals, and even anti-inflammatory drugs to exclude secondary eczema, these patients can be offered breast reduction surgery as a last resort. Aim: The aim was to study the efficacy of breast reduction surgery in the management of recalcitrant intertrigo. Methodology: Ten such patients who presented to us with recalcitrant intertrigo in the setting of macromastia and consented to breast reduction surgery were recruited, and after obtaining informed consent, breast reduction was performed by vertical mammoplasty and liposuction. The patients were followed up 3 months for 1 year postsurgery. The treatment outcome was measured by physician assessment by checking the presence of visible dermatitis in the intertriginous region and patient assessment with the help of a novel questionnaire to assess the quality of life with responses on a 4-point Likert scale from 0 to 3. However, due to the small sample size, the questionnaire could not be validated. Results: None of the patients in this study reported recurrence of intertrigo. Furthermore, there was a significant functional improvement with minimal complication rates. A novel questionnaire was devised to assess the quality of life of these patients which showed a significant improvement postsurgery. However, due to the relatively small sample size, the questionnaire could not be validated. Conclusion: There is evidence that reduction mammoplasty is not only effective at decreasing breast-related symptoms such as pain and discomfort but also improves functional limitations and clinical conditions like intertrigo. In our study, we conclusively demonstrate an intent to point out to dermatologists that breast reduction can be a treatment for resistant/ intractable intertrigo only as a last resort in patients with large breast size, as would help in reducing the constant predisposing factors of moisture and friction.

Keywords

• intertrigo
• macromastia
• questionnaire
• reduction mammoplasty