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Clinical Pediatrics May 2017Mild diaper dermatitis often occurs in children before toilet training is complete, particularly from 9 to 12 months of age, and the most common presentation is an...
Mild diaper dermatitis often occurs in children before toilet training is complete, particularly from 9 to 12 months of age, and the most common presentation is an irritant contact dermatitis. Diaper dermatitis may account for up to 25% of dermatology visits to health care providers during the first year of life. Fortunately, since the introduction of hypoallergenic, superabsorbent modern disposable diapers, the incidence and severity of irritant and allergic contact dermatitis has decreased dramatically. Diaper dermatitis broadly refers to skin disorders that occur in the diaper area, such as skin eruptions triggered by diapers, rashes exacerbated by the diaper, and other events that occur in the diaper area. A number of skin conditions that can occur anywhere on the skin may present with distinctive findings in the diaper area. The following discussion will review the most common triggers of diaper dermatitis and contact irritant dermatitis, while focusing on the skin conditions that may be associated or overlap clinically with contact dermatitis.
Topics: Acute Disease; Candidiasis, Cutaneous; Dermatitis, Contact; Diagnosis, Differential; Diaper Rash; Diapers, Infant; Disposable Equipment; Female; Humans; Infant; Infant, Newborn; Keratosis, Seborrheic; Male; Staphylococcal Skin Infections
PubMed: 28420251
DOI: 10.1177/0009922817706982 -
International Journal of Women's... Sep 2021This review looks at novel combinations of topical agents (i.e., zinc gluconate, zinc oxide, dexpanthenol, and taurine) that target a combination of mechanisms in diaper... (Review)
Review
OBJECTIVE
This review looks at novel combinations of topical agents (i.e., zinc gluconate, zinc oxide, dexpanthenol, and taurine) that target a combination of mechanisms in diaper dermatitis.
METHODS
A literature search of published studies was conducted using the search terms "diaper dermatitis", "treatment of diaper dermatitis in infants", "treatment of diaper dermatitis in adults", "nonsteroidal", "nonantibiotic", "antiinflammatory", "moisturizer", and "treatment for irritation". A total of 207 related articles were screened, and those categorized as clinical trials and reviews were studied and compared. Articles with common themes were categorized, summarized, and presented herein.
RESULTS
Diaper dermatitis, also referred to as diaper rash, napkin dermatitis, and nappy rash, is the most common skin eruption in infants and toddlers. In the last several years, there have been several technologic advances in diaper design to lessen the severity of diaper dermatitis symptoms. However, due to the unique environment of the diaper area, children and adults continue to have recurring symptoms of diaper dermatitis. Both commercially available products and certain home remedies are considered effective for managing sensitive and delicate skin in the diaper area. These topical agents create a protective barrier over the skin and reduce the impact of external irritants, which cause the reddening and burning sensation often associated with diaper dermatitis.
CONCLUSION
A range of therapeutic strategies for preventing and controlling diaper dermatitis are summarized in this manuscript.
PubMed: 34621960
DOI: 10.1016/j.ijwd.2021.02.003 -
Nursing For Women's Health 2015Diaper dermatitis in infants is commonly seen by clinicians in both primary care and acute care settings. The condition can cause significant discomfort for infants and...
Diaper dermatitis in infants is commonly seen by clinicians in both primary care and acute care settings. The condition can cause significant discomfort for infants and distress for their parents and caregivers. Nursing for Women's Health convened a group of nursing clinicians who work in a variety of settings to discuss the issues and challenges related to preventing and treating diaper dermatitis in both healthy term newborns and premature newborns.
Topics: Breast Feeding; Diaper Rash; Humans; Infant, Newborn; Infant, Premature
PubMed: 26460914
DOI: 10.1111/1751-486X.12233 -
Pediatric Emergency Care Jul 2019A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which...
A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which was initially concerning for nonaccidental burn. Upon further investigation, it was found that Ex-Lax had been given to the patient for constipation. This had resulted in a bowel movement, which led to an irritant dermatitis. The patient was eventually diagnosed with senna-induced erosive diaper dermatitis. This case report highlights the importance of a thorough history and physical examination to prevent an unnecessary child abuse work-up.
Topics: Charcot-Marie-Tooth Disease; Child Abuse; Child, Preschool; Constipation; Dermatitis, Contact; Diagnosis, Differential; Diaper Rash; Female; Humans; Laxatives; Phenolphthalein
PubMed: 29746360
DOI: 10.1097/PEC.0000000000001498 -
International Journal of Dermatology Mar 2018Diaper dermatitis is the most common inflammatory skin eruption within the diaper area in infants and toddlers. Although it rarely causes problems for prolonged periods... (Review)
Review
Diaper dermatitis is the most common inflammatory skin eruption within the diaper area in infants and toddlers. Although it rarely causes problems for prolonged periods of time, it causes considerable distress for both infants and parents. Diapered skin is exposed to friction, excessive hydration, varying pH, and is in constant contact with urine and feces, both of which are highly irritant to the skin. The three most common types of diaper dermatitis include chaffing dermatitis, irritant contact dermatitis, and diaper candidiasis. However, a variety of other skin conditions may manifest in the diaper area. Candida albicans and Staphylococcus aureus are most frequently isolated from the affected area and are thought to have a predominant role in diaper dermatitis. The review includes an overview of the epidemiology, etiology, and common skin microbiota in the diaper area. State-of-the-art strategies for diagnosis, management, and prevention of diaper dermatitis are also included. Appropriate skin care can help in the prevention of diaper dermatitis and can aid the reparation of the skin. This review discusses common causes, skin microbiota within the diapered area, differential diagnosis, and finally possible prevention and treatment recommendations. Recent findings have proven that the key to efficient eradication of irritant diaper dermatitis lies in its prevention.
Topics: Child, Preschool; Diagnosis, Differential; Diaper Rash; Humans; Infant; Infant, Newborn; Microbiota; Skin
PubMed: 28986935
DOI: 10.1111/ijd.13748 -
Annales de Dermatologie Et de... Jan 2015
Topics: Acrodermatitis; Dermatitis, Seborrheic; Dermatomycoses; Diagnosis, Differential; Diaper Rash; Diapers, Infant; Histiocytosis, Langerhans-Cell; Humans; Infant, Newborn; Psoriasis; Skin Diseases, Bacterial; Skin Diseases, Papulosquamous; Zinc
PubMed: 25600797
DOI: 10.1016/j.annder.2014.09.611 -
Children (Basel, Switzerland) Jan 2022Diaper dermatitis is a common type of irritant contact dermatitis occurring in infants and toddlers. Its occurrence is triggered by an unfavorable environment under the... (Review)
Review
Diaper dermatitis is a common type of irritant contact dermatitis occurring in infants and toddlers. Its occurrence is triggered by an unfavorable environment under the diaper, damage to skin integrity by fecal enzyme degradation, overhydration and disruption of the lipid bilayer structure facilitating the entry of irritants and microorganisms. In diaper dermatitis development, the central proinflammatory cytokines are IL-1α, IL-8 and TNF-α. The initial release of IL-1α and TNF-α starts a further cascade of pro-inflammatory chemo- and cytokines, resulting in inflammation and erythema of the skin. A recently recognized factor in diaper dermatitis is the composition of the skin microbiome; common pathogenic strains and are associated with skin irritation. The resulting impaired microbiome composition produces a local inflammatory response and may thus worsen the initial dermatitis clinical presentation and subsequent healing. Introduction of probiotics is an attractive treatment for microbiome modulation, which has shown success in other skin conditions in adults and children. Probiotics are thought to work as a protective shield against irritants, maintain low skin pH, secrete beneficial metabolites, and block pathogen invasion. There is preliminary evidence that certain probiotics given orally or topically could be used as a gentle intervention in diaper dermatitis.
PubMed: 35053737
DOI: 10.3390/children9010112 -
Journal of Drugs in Dermatology : JDD Nov 2021The skin of neonates and infants undergoes a maturation process from birth and is susceptible to barrier disruption. The current algorithm follows a US-based consensus...
BACKGROUND
The skin of neonates and infants undergoes a maturation process from birth and is susceptible to barrier disruption. The current algorithm follows a US-based consensus paper on skincare approaches using gentle cleansers and moisturizers in neonatal and healthy infant skin. This summary provides clinical information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants.
METHODS
The project used a modified Delphi process comprising virtual discussions followed by an online follow-up replacing the use of a questionnaire. During the virtual meeting, the systematic literature review results and a draft algorithm addressing over-the-counter skincare for neonates and infants with healthy skin were discussed and adopted using evidence coupled with the expert opinion and experience of the panel.
RESULTS
The algorithm addresses three clinical signs: xerosis, erythema, and erosion/bulla. A growing body of evidence recognizes the benefits of ongoing daily use of non-alkaline cleansers and ceramides containing moisturizers to reduce inflammation and maintain a healthy skin barrier function. Diaper rash is common in infants presenting as erythema or, in more severe cases, skin erosion. Skin protection with a barrier cream and frequent diaper changes using disposable diapers resolves most cases; however, if the rash continuous despite appropriate care, rule out a candida infection.
CONCLUSION
The current algorithm focuses on neonatal and infant healthy skin that can benefit from skincare. When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier. J Drugs Dermatol. 2021;20(11):1195-1205. doi:10.36849/JDD.6219.
Topics: Algorithms; Child; Diaper Rash; Humans; Infant; Infant Care; Infant, Newborn; Skin; Skin Care
PubMed: 34784132
DOI: 10.36849/jdd.6219 -
Academic Medicine : Journal of the... Dec 2017
Topics: Arizona; Diaper Rash; Empathy; Humans; Infant, Newborn; Male; Physicians; Poverty Areas
PubMed: 29210748
DOI: 10.1097/ACM.0000000000001958 -
The Journal of Family Practice Apr 2019A 9-day-old boy was brought to the emergency department by his mother. The infant had been doing well until his most recent diaper change when his mother noticed a rash... (Review)
Review
A 9-day-old boy was brought to the emergency department by his mother. The infant had been doing well until his most recent diaper change when his mother noticed a rash around the umbilicus, genitalia, and anus. The infant was born at term via spontaneous vaginal delivery. The pregnancy was uncomplicated; the infant's mother was group B strep negative. Following a routine postpartum course, the infant underwent an elective circumcision before hospital discharge on his second day of life. There were no interval reports of irritability, poor feeding, fevers, vomiting, or changes in urine or stool output.
Topics: Anti-Bacterial Agents; Erythema; Exanthema; Humans; Infant, Newborn; Male; Rare Diseases; Risk Assessment; Staphylococcal Scalded Skin Syndrome; Staphylococcal Skin Infections; Staphylococcus aureus; Treatment Outcome
PubMed: 31039216
DOI: No ID Found