Cryotherapy with liquid nitrogen for chronic and recalcitrant intertrigo of toe webspaces

Abstract

<p><strong>Background:</strong> The inflammation of the toe web spaces is known as foot intertrigo. Most commonly caused by candida. Important predisposing factors such as diabetes mellitus, obesity and immunosuppression lead to persistence and recurrence. Cryotherapy is a promising, safe, cost-effective, easily available therapeutic approach to treat recalcitrant intertrigo compared to available topical medications. Aim of the study was to observe the clinical improvement and therapeutic response of recalcitrant intertrigo and to observe treatment response based on photographs.</p><p><strong>Methods:</strong> A total of 30 patients who were clinically diagnosed with chronic candida intertrigo (CI) who fulfilled the inclusion and exclusion criteria were enrolled. Cryotherapy was administered with 3 cycles of freeze and thaw of 30 seconds each, every 2 weeks for a maximum of 3 treatment sessions. Follow-up of patients were done for 4 months.</p><p><strong>Results:</strong> Among 30 patients treated, 21 patients showed excellent clinical response, 6 patients showed good response. Only 2 patients showed poor response. Minimal side effects were observed, of which transient pain at the cryotherapy site is the most common. Diabetes was the most common comorbidity with poor response to treatment and recurrence.</p><p><strong>Conclusions:</strong> Cryotherapy can be used as a safe modality of treatment for recalcitrant CI cases unresponsive to topical therapy by providing faster therapeutic response and improving the quality of life in these patients. </p>