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Irritant Diaper Dermatitis
Aka: Irritant Diaper Dermatitis, Diaper Rash, Diaper Dermatitis
- See Also
- Candida Diaper Dermatitis
- Perianal Streptococcal Dermatitis
- Etiology
- Reaction to friction and maceration
- Prolonged contact with urine and feces
- Symptoms
- Infant very uncomfortable with increased inflammation
- Signs
- Erythematous, scaly dermatitis
- Papulovesicular or Bullous lesions
- Fissures and erosions
- Patchy or confluent
- Sparing of genitocrural folds
- Differential Diagnosis
- Candida Diaper Dermatitis (satellite lesions present)
- Perianal Streptococcal Dermatitis
- Impetigo
- Complications
- Bacteria or yeast superinfection
- Irritant dermatitis superinfected by yeast in 3-5 days
- Management
- Frequent diaper changes
- If possible, let child go without bottoms (keep area dry)
- Use disposable diapers
- Thorough washing of genitalia with diaper change
- Alcohol-free, fragrance-free wipes or
- Mild Soap and warm water
- Apply occlusive topical agent after washing
- Zinc Oxide
- Petroleum jelly
- Aquaphor
- Additional topicals
- Topical Corticosteroid (with or without Zinc Oxide)
- Hydrocortisone Cream 0.5-1% (or other Level 6-7 Topical Corticosteroids such as Desowen)
- Avoid more potent Corticosteroids (Level 5 and less, including triamcinolone)
- Indicated for significant inflammation and use until healing completed
- Antifungals
- Indicated if superinfection with Candida Diaper Dermatitis suspected
- Typically occurs after 4-5 days of Irritant Diaper Dermatitis
- Preparations include Clotrimazole, Micoazole and Nystatin
- Avoid harmful or unnecessary agents
- Avoid systemic antibiotics (not indicated)
- Avoid occlusive plastic pants (promotes maceration)
- Avoid expensive topicals (e.g. Vusion: 0.25% Miconazole, Zinc Oxide, petrolatum)
- Prevention (especially during times of Diarrhea)
- Wash anal area after each stool
- Apply vaseline
- Apply after each diaper
- Apply especially at night and at naptime
- Change diaper immediately after each stool
- References
- (2018) Presc Lett 25(10): 57 [PubMed]