II. Course
- Rash starts in perianal area and spreads contiguously
III. Signs
IV. Differential Diagnosis
- Irritant Diaper Dermatitis
- Perianal Streptococcal Dermatitis
- Impetigo
-
Contact Dermatitis
- Found on convex surfaces (contrast with candida which is found in skin folds)
- Apply thick layer of barrier cream (e.g. Zinc Oxide cream)
-
Pediatric Seborrheic Dermatitis
- Typically associated with Cradle Cap
-
Congenital Candidiasis (rare, age <1 week)
- Onset at birth or in the first week of life
- Contrast with typical Candida Diaper Dermatitis which has onset AFTER the first week of life
- Rare, but serious infection with risk of disseminated candidemia (8 to 40% mortality)
- Diffuse erythematous, desquamating maculopapular or papulopustular dermatitis
- Typically spares the diaper region
- Diagnosis with a Potassium Hydroxide preparation (KOH prep) showing pseudohyphae or spores
- Early systemic Antifungals prevents progression to disseminated candidemia
- Onset at birth or in the first week of life
- Rare, refractory cases
- Zinc Deficiency
- Hand-Schuller-Christian Syndrome (Histiocytosis X)
V. Management
-
General
- Keep diaper area dry
- Keep diaper off as much as possible to aerate area
- Zinc Oxide paste
- Soothing and protective after the acute phase
- Baby powder
- May help to dry area (Risk of aspiration)
-
Topical Antifungal
- Superior cure rates
- Other agents
- Ketoconazole
- Nystatin
- Amphotericin
- Oral Antifungal and Thrush agents
- Consider to treat dermatitis and GI Infection
- Consider Burow's Solution compresses before Antifungal
- For severe inflammatory reaction
- Mix Topical Corticosteroid with Antifungal 50:50 or
- Alternate applications of Antifungal and steroid
VI. Reference
- Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7
- Hoppe (1997) Pediatr Infect Dis 16:885-94 [PubMed]
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Related Studies
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 771.7 |
| ICD10 | P37.5 |
| SnomedCT | 3973009, 157121009, 206362009, 414821002 |
| English | Neonatal candida infection NOS, Neonatal monilia, neonatal candidiasis, neonatal candidiasis (diagnosis), Neonatal candida infect, Neonatal monilia infection (disorder), Neonatal monilia infection, Neonatal candida infection (disorder), Neonatal candida infection NOS (disorder), candida; infection, neonatal, candidiasis; neonatal, infection; Candida, neonatal, infection; monilia, neonatal, monilia; infection, neonatal, moniliasis; neonatal, neonatal; candidiasis, neonatal; moniliasis, Neonatal candida infection, Neonatal candidiasis, Neonatal candidosis, Neonatal candidiasis (disorder), Neonatal Candida infection, Neonatal moniliasis |
| Italian | Infezione neonatale da Candida |
| Japanese | 新生児カンジダ感染, ｼﾝｾｲｼﾞｶﾝｼﾞﾀﾞｶﾝｾﾝ |
| German | Kandidose beim Neugeborenen, Candidainfektion beim Neugeborenen |
| Czech | Novorozenecká kandidová infekce |
| Korean | 신생아 칸디다증 |
| Hungarian | újszülöttkori candida fertőzés |
| Spanish | infección candidiásica neonatal, SAI (trastorno), infección neonatal por Candida, infección neonatal por Candida (trastorno), candidosis neonatal, infección candidiásica neonatal, SAI, moniliasis neonatal, infección monilial neonatal (trastorno), infección monilial neonatal, Infección neonatal por cándida, candidiasis neonatal, candidiasis neonatal (trastorno), infección neonatal por cándida |
| Dutch | Candida; infectie, neonataal, Monilia; infectie, neonataal, candidiasis; neonataal, infectie; Candida, neonataal, infectie; Monilia, neonataal, moniliasis; neonataal, neonataal; candidiasis, neonataal; moniliasis, Neonatale candidiasis, neonatale Candida-infectie |
| Portuguese | Infecção por cândida neonatal |
| French | Candidose néonatale |
Ontology: Diaper candidiasis (C0343874)
| Definition (NCI) | An inflammatory skin condition in the diaper area superimposed with Candida infection, characterized by a bright red rash with a sharply demarcated edge and satellite lesions. Skin folds are often involved.(NICHD) |
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 240711004, 200770009, 187015004 |
| Italian | Eritema da pannolino causato da Candida, Candidosi da pannolino, Eritema moniliasico da pannolino |
| Dutch | Monilia-luieruitslag, Candida-luieruitslag |
| French | Erythème fessier du nourrisson candidosique, Erythème fessier du nourrisson à Candida, Erythème candidosique des fesses |
| German | von Candida verursachter Windelausschlag, Windelausschlag verursacht durch Moniliasis, von Moniliasis verursachter Windelausschlag, Windelausschlag durch Candida |
| Portuguese | Erupção cutânea de candida na região das fraldas, Erupção das fraldas por candida, Erupção das fraldas por monilia, Candidíase da área das fraldas |
| Spanish | Exantema del pañal por monilias, Erupción monilial del pañal, candidiasis del pañal (trastorno), candidiasis del pañal, Eritema del pañal por cándida |
| Japanese | モニリア性おむつ皮膚炎, カンジダ性おむつ皮疹, ﾓﾆﾘｱｾｲｵﾑﾂﾋﾌｴﾝ, ｶﾝｼﾞﾀﾞｾｲｵﾑﾂﾋｼﾝ |
| English | Diaper candidiasis (disorder), neonatal candidiasis of diaper region (diagnosis), neonatal candidiasis of diaper region, Candida diaper rash, Candida nappy rash, Candidal diaper rash, Nappy rash monilial, candida diaper rash, Napkin candidiasis (disorder), Nappy rash - candidal, Candida Diaper Dermatitis, Candida Nappy Rash, Candida Diaper Rash, Diaper candidosis, Candidal nappy rash, Monilial nappy rash, Napkin candidosis, Napkin candidiasis, Diaper candidiasis |
| Czech | Plenkový exantém způsobený moniliázou, Kandidový plenkový exantém |
| Hungarian | pelenkakiütés, moniliazisos, candida okozta pelenkakiütés, Candida okozta pelenkakiütés, moniliazisos pelenka kiütés, Candidás pelenka kiütés |
