Interstitial

INTERSTITIAL (from Latin interstitium - distance, interval), or intercellular, adjective used in relation to parenchymatous organs to denote that tissue, as well as those processes, which take place between the parenchymatous, active elements of the organ. Thus in histology the word I. is applied in relation to the connective tissue located between the parenchymatous elements, calling it P., or intercellular connective tissue, or the stroma of the organ. In pathology the word I. is used to denote various processes in those cases when these processes have their development in the interstitium, i.e., the intercellular tissue of the organ; in this sense the concept of "I. process" is opposed to the concept of "parenchymatous process" occurring in the parenchyma of the organ. Examples of I. processes are primarily those inflammations that occur mainly in the intercellular connective tissue of organs; these include I. nephritis, I. myocarditis, I. pneumonia, etc. INTERTRIGO (Latin intertrigo - rubbed place), diaper rash, syn. dermatitis intertriginosa, erythema intertrigo, inflammatory redness of the skin, often with subsequent weeping, developing in places of friction of adjacent skin surfaces (around the anus, in the folds between the genital organs and thighs, in the inguinal flexures, in the axillary regions, under the mammary glands, in the interdigital spaces, in obese persons also in the folds of the neck and abdomen). The development of diaper rash in these places is favored by the delay in evaporation of sweat that occurs here, accumulation of sebum, heat, and friction. Diaper rash is more common in subjects suffering from seborrhea, excessive sweating, diabetes, gout. The clinical picture is almost always uniform; at first a limited redness accompanied by slight itching appears, then as a result of continued friction of the affected parts, maceration of the horny layer and weeping occur. The moist, intensely red, shiny, partly eroded, hot to the touch skin acquires a darker color at the edges of the lesion. In persons predisposed to eczema, as well as with very long-standing diaper rash, the latter may turn into true intertriginous eczema. Secondary infection with pyogenic cocci occurs, rarely. Fungi and microbes found sometimes in the foci of diaper rash are not given serious pathogenetic significance by all authors (except for intertriginous lesions in the interdigital spaces of the hands and feet). Subjectively - itching, burning, in advanced cases - pain; the latter is sometimes so severe that the patient has difficulty moving. In diagnosis, intertriginous eczema must be considered (in diaper rash there is no blister stage, and the process quickly heals under appropriate therapy), marginal eczema (in diaper rash, unlike eczema marginatum, there is no elevated peripheral ridge and there is no causative agent - Epidermophyton inguinale) and erythrasma. In infants, in addition to the very common ordinary diaper rash, there are also 2 clinical varieties: 1) "Erythema of the buttocks in newborns" (erythema fessierum nursorum), appearing in cachectic, weak children with poor care; due to constant contact of the buttocks with feces and urine in the intergluteal fold, redness, cracks, erosions and sometimes eczematization occur, and the process usually also spreads to adjacent parts of the body (scrotum, thighs, lower back, abdomen). 2) Erythema papulosum posteriosivum syphiloides - the skin of the buttocks, scrotum, upper parts of the thighs and lower back is covered with brownish-red, the size of a hemp seed to a lentil, erosive papules, very similar to syphilitic ones; sometimes the skin between individual eruptions is hyperemic and weeps; the diagnosis is helped by the absence of Treponema pallidum, negative Wassermann reaction, history and examination of the parents. - For prophylactic purposes, persons prone to diaper rash are advised to frequently wash the adjacent skin surfaces with thorough drying and subsequent powdering. In infants, it is necessary to regularly and carefully cleanse all skin folds from secretions and excretions with thorough drying and powdering. - Treatment: frequent washing with astringent or mild antiseptic means (1/2% solution of resorcinol, 3% boric water, etc.) followed by dusting with talc (starch cannot be used in diaper rash) and placing a cotton pad to isolate the rubbing surfaces. For infants, baths with potassium permanganate or bran can be given; instead of powders, oily liquids (melted cocoa butter, almond oil, cod liver oil, Linim. calcar. and others) are better to use; main attention should be paid to the general condition of the child (regulation of nutrition, etc.) and rational skin care (frequent changing of diapers, sterile linen, baths).