Neck-Fold Intertrigo in Babies: Think of Strep

Chubby babies often have deep, moist body folds. Red, macerated, crescentic patches are frequently seen in the valleys of these folds. Pediatricians and dermatologists are trained to think of candida intertrigo in such instances, as candida readily colonizes moist areas, particularly in the diaper region. Candida intertrigo usually responds promptly to topical antifungal agents coupled with drying strategies.

These authors describe three infants, a 3-month-old girl and two 5-month-old boys, with intertrigo that did not respond to topical antifungal medications. Cultures of intertrigo samples grew group A β-hemolytic streptococci (GABHS). Each of the patients had a 4- to 8-week history of a sharply demarcated, bright red, macerated patch deep…