Skin Surface pH in Intertriginous Areas in NIDDM Patients: Possible Correlation to Candidal intertrigo

OBJECTIVE To compare skin surface pH and moisture in intertriginous areas in diabetic patients and healthy control subjects and to study the relationship between these parameters and candidal infection. RESEARCH DESIGN AND METHODS We measured the skin surface pH and moisture in the axillary, inframammary, inguinal, and forearm skin with a pH meter with a flat-glass electrode and skin corneometer. The subjects were 50 NIDDM patients from the diabetic outpatient clinic at Beilinson Medical Center, Petah Tiqva, Israel, and 40 healthy control subjects from hospital personnel. The main outcome measures were skin surface pH, skin moisture, and skin culture for Candida. RESULTS Skin pH in the inguinal and axillary regions was significantly higher in diabetic patients compared with healthy control subjects (P < 0.0001), whereas no difference was noted in the forearm. In the inframammary region, diabetic women had significantly higher pH than nondiabetic women (P < 0.01). No difference was noted in men in this region. Six patients (12%) had candidal infection in intertriginous areas. CONCLUSIONS Our study indicates that in intertriginous regions, skin surface pH of diabetic patients is significantly higher than in normal control subjects and implies the significance of skin pH as a possible factor promoting host susceptibility to skin candidal infection.