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Erythrasma typically appears as delineated, dry, red-brown patches in intertriginous areas, such as the axilla, groin, interdigital spaces, intergluteal cleft, perianal skin, and inframammary area.
Aim was to create an asymmetrical thick flap across intergluteal cleft to make cleft shallow and away from midline.
3,4) Sitting posture in obese subjects leads to a negative pressure between the intergluteal cleft, which sucks the fallen hair from the skin of back and draws them into a pit.
The basic aim of these surgical procedures is to expediate healing and provide a flattened surface in place of the intergluteal cleft.
Flap procedures and excisions by assymetrical incisions take care of correction of the anatomically deep intergluteal cleft, which is the major factor in preventing recurrence.
Males predominantly suffer because of hormonal changes leading to increased activity of pilosebaceous glands and females due to anatomically deep intergluteal cleft.
Anatomical configuration of an individual like depth of intergluteal cleft and number of hair is genetically determined factors and thus family history plays an important role.
Secondary recurrence is due to anatomically deep intergluteal cleft and hairy back with poor hygiene.
Examination of the anogenital area (Figure 1) revealed sharply demarcated extensive blistering and sloughing involving the perianal area intergluteal cleft and part of the buttocks and vulva.
The present patient had irritant contact dermatitis from the penis-massage oil probably resulting from protracted contact (6-8 hours); the oil having remained pooled on the intergluteal cleft and below the buttocks all through the night.
A clinical tip is that anomalies above the intergluteal cleft almost always warrant imaging, whereas anomalies within the cleft generally do not, said Dr.

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