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Pediatric Dermatology Mar 2018Diaper dermatitis is the most common contact eczema present in early childhood. The main cause is an irritant reaction to urine and feces, which is facilitated by the... (Review)
Review
Diaper dermatitis is the most common contact eczema present in early childhood. The main cause is an irritant reaction to urine and feces, which is facilitated by the occlusive conditions under the diaper, leading to hyperhydration of the stratum corneum (diaper dermatitis). In addition, diaper pressure and friction can increase the risk of skin inflammation, which also opens the skin up to other irritant agents, allergens, and infectious agents, such as candida albicans. However, a variety of diseases are associated with inflammation of the skin in the diaper region, therefore the term "diaper dermatitis" is merely descriptive and does not reflect anything about the etiopathogenesis. The term diaper dermatitis refers only to an inflammation in the diapering area and should not be automatically equated with reactions to diapers. Making the correct diagnosis requires a thorough examination of the skin in its entirety and a detailed report of the patient's medical and family history. Once a specific pattern is identified, a precise diagnosis, and an appropriate therapy, can be determined.
Topics: Diagnosis, Differential; Diaper Rash; Female; Humans; Infant; Male; Skin
PubMed: 29596730
DOI: 10.1111/pde.13484 -
Clinical Pediatrics May 2017
Topics: Communication; Diaper Rash; Diapers, Infant; Humans; Infant
PubMed: 28420252
DOI: 10.1177/0009922817704929 -
Current Problems in Dermatology 2018Maintenance of an acidic stratum corneum pH is a major component of the skin's protective system and creates a hostile environment for colonization with pathogenic... (Review)
Review
Maintenance of an acidic stratum corneum pH is a major component of the skin's protective system and creates a hostile environment for colonization with pathogenic microorganisms. This barrier can however be overcome on healthy and in particular on compromised skin. Mycosis, diaper/incontinence dermatitis and wound healing are examples of cases where microbial infection is promoted by the altered skin conditions or environment. Fungi have a complex system that senses ambient pH that leads to metabolic responses allowing adhesion, growth and invasion, as microbial metabolites further increase skin pH resulting in a clinically manifest infection (mycosis). Diabetic patients with a higher pH in intertriginous areas are particularly vulnerable to candidiasis. In diaper and incontinence dermatitis, the increase in skin pH and damage to the skin barrier function is triggered by the contact with urine and faeces with or without occlusion and maintained by host and microbial enzymes and metabolites. This leads to the reduction of the protective resident microflora and fungal overgrowth, mostly with Candida albicans. Skin care with slightly acidic products may help to prevent and treat this kind of dermatitis. Wound healing is a complex sequence of biologic events correlated with ambient pH, which influences the different phases of the healing process. The pH determines the appropriate activity of immune cells and key enzymes as well as biofilm formation. Chronic wounds emerging from the disruption of the healing process are characterized by a neutral to slightly alkaline pH and may benefit from wound pH monitoring and therapeutic acidification.
Topics: Aged; Dermatitis; Dermatomycoses; Diaper Rash; Humans; Hydrogen-Ion Concentration; Infant; Microbiota; Skin; Skin Diseases; Wound Healing
PubMed: 30130777
DOI: 10.1159/000489522 -
Current Problems in Dermatology 2018In order to maintain skin in "good condition" one can use cosmetic products. Importantly, those skin care products should fulfil specific requirements for specific life... (Review)
Review
In order to maintain skin in "good condition" one can use cosmetic products. Importantly, those skin care products should fulfil specific requirements for specific life phases and specific skin conditions. In this review, we focused on 2 different age groups - namely, infants and the elderly - as well as on 2 specific skin conditions occurring in both age groups - very dry skin (Xerosis) and hyperhydrated skin (diaper rash). The goal in both conditions should be to maintain skin surface in its physiological acidic state, which is in turn crucial for the permeability barrier function, stratum corneum integrity/cohesion and antimicrobial defense. Skin care products formulated with an effective buffer system at a more acidic pH, for example 4, may be the best option to improve the acid mantle and skin barrier function and thus keep the skin in "good condition."
Topics: Age Factors; Aged; Cosmetics; Diaper Rash; Drug Compounding; Humans; Hydrogen-Ion Concentration; Infant; Skin; Skin Care; Skin Diseases; Soaps
PubMed: 30130785
DOI: 10.1159/000489531 -
Journal of Paediatrics and Child Health Oct 2020
PubMed: 33099825
DOI: 10.1111/jpc.2_14923 -
Acta Paediatrica (Oslo, Norway : 1992) May 2022In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However,... (Review)
Review
AIM
In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However, an atypical presentation may occasionally develop. We aimed at systematically assessing the characteristics of cases affected by atypical primary varicella rash.
METHODS
The United States National Library of Medicine, Excerpta Medica and Web of Science databases were reviewed, without date or language restrictions. Articles were eligible if reporting previously healthy and immunocompetent subjects with a primary varicella rash (i.e., a photo-localised primary varicella or skin inflammation-associated primary varicella).
RESULTS
Thirty-eight reports providing information on 59 cases of atypical primary varicella were identified. Twenty-four cases (median 8.5 years of age, 19 females) were photo-localised and 35 (median 4.8 years of age, 15 females) were associated with pre-existing skin inflammation (including cast occlusion, diaper irritation, operative sites, burns, insect bites, vaccinations or pre-existing skin disease). The skin rash was monomorphic and without a "starry sky" appearance.
CONCLUSION
Primary varicella may have a modified presentation in areas of irritation such as sun exposure or pre-existing inflammation. There is a need for a wider awareness of these modulators of varicella rash.
Topics: Adolescent; Adult; Chickenpox; Exanthema; Female; Herpesvirus 3, Human; Humans; Inflammation; Skin; Young Adult
PubMed: 35178772
DOI: 10.1111/apa.16300 -
Journal of Paediatrics and Child Health Oct 2022
Topics: Diagnosis, Differential; Diaper Rash; Humans; Infant
PubMed: 34697847
DOI: 10.1111/jpc.15794