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International Journal of Dermatology Jul 2016Diaper dermatitis is a common condition that often prompts parents to seek medical attention. Irritant diaper dermatitis is by far the most common cause, but numerous... (Review)
Review
Diaper dermatitis is a common condition that often prompts parents to seek medical attention. Irritant diaper dermatitis is by far the most common cause, but numerous potentially serious diseases can present with changes of the skin in the diaper area. The differential diagnosis can include psoriasis, metabolic disorders, rare immune diseases and infection. Clinical examination can be helpful in distinguishing the underlying cause. General screening laboratory tests, as well as select testing when a specific condition is suspected, can be used to challenge or confirm the putative diagnosis.
Topics: Diagnosis, Differential; Diaper Rash; Humans; Infant; Skin Diseases; Skin Diseases, Infectious
PubMed: 27311780
DOI: 10.1111/ijd.13372 -
Advances in Neonatal Care : Official... Aug 2020Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of... (Review)
Review
BACKGROUND
Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of clinical characteristic (CC) involvement.
PURPOSE
The purpose of this literature review is to explore the descriptions of CC of infants with DD provided within infant DD literature.
SEARCH STRATEGY
PubMed and Web of Science were searched using the keywords: diaper dermatitis, diaper rash, infant, and neonate. The inclusion criteria for this project are as follows: published after 1990, English language, include skin assessment or evaluation, and infant/children < two years of age. Review and opinion articles were excluded.
RESULTS
A total of 454 studies were retrieved, 27 remained after review for duplicates and relevance. The CC described most often were: type of feeds, stool frequency, history of DD, use of antibiotics, and delivery mode.
SYNTHESIS OF EVIDENCE
The studies reported inconsistent CC and a lack of correlation between these characteristics and the condition of diapered skin. Many studies focused solely on the efficacy of interventions lacking description of possible relationships between DD and CC.
IMPLICATIONS FOR PRACTICE
Skin condition outcome variables can be improved with the acknowledgment of the impact CC have on the development of DD. The combination of assessment measures and CC may ultimately demonstrate more merit or rigor for describing DD severity and skin condition.
IMPLICATIONS FOR RESEARCH
Future research should expand this exploration to include environmental or contributing factors to continue to identify additional risk factors for DD.
Topics: Dermatitis, Irritant; Diaper Rash; Humans; Infant; Infant, Newborn; Risk Factors
PubMed: 31895136
DOI: 10.1097/ANC.0000000000000682 -
Journal of Tissue Viability Aug 2022Diaper dermatitis (DD) is a significant problem in the care of newborns, infants, and young children and good recognition of signs and symptoms optimises timely...
RATIONALE
Diaper dermatitis (DD) is a significant problem in the care of newborns, infants, and young children and good recognition of signs and symptoms optimises timely treatment. There is also a need for a standardised set of related descriptors to enable communication between health care providers about diagnosis and treatment.
OBJECTIVE
The study aimed to review the literature for descriptive words to define the clinical signs, symptoms, and characteristics, including anatomical locations and assessment scales or tools, in the newborn, infants and young children population who have been diagnosed with DD.
METHODS
A systematic review process utilising PRISMA guidelines [1] was conducted using advanced search techniques to analyse the terms from the database thesauri and keywords. Data bases including Ovid MEDLINE® and Epub Ahead of Print, in-Process & Other Non-Indexed Citations, Daily and Versions® were searched from 1946 to March 18, 2021. Cochrane Handbook Searching for and selecting studies were used as a guide and as best practice to conduct the search.
RESULTS
Of the 551 publications originally identified, 55 full text publications were examined and 21 met the inclusion criteria. The wide range of descriptors used in the literature for DD supports the need for a clearer approach to report the signs and symptoms, and the severity, of DD.
CONCLUSIONS
These findings point to gaps in the literature, both in recording signs and symptoms of DD and features such as wetness, infection, anatomical location, severity and pain in newborns, infants, and young children. There is a need to develop a robust methodological tool to bridge the gap and link a common terminology on signs and symptoms to support diagnosis of the severity of DD.
Topics: Child; Child, Preschool; Diaper Rash; Humans; Infant; Infant, Newborn
PubMed: 35562302
DOI: 10.1016/j.jtv.2022.03.003 -
Journal of Cutaneous Medicine and... 2022Atopic dermatitis (AD) is a chronic, inflammatory skin condition commonly affecting infants with notable sparing of the diaper region. Though sources anecdotally... (Review)
Review
Atopic dermatitis (AD) is a chronic, inflammatory skin condition commonly affecting infants with notable sparing of the diaper region. Though sources anecdotally attribute this sparing to the physical barrier formed by the diaper and the subsequent retention of moisture, urine, sweat and feces, no studies have formally investigated the factors contributing to this sparing phenomenon. We performed a scoping literature review to investigate the factors involved in sparing of AD in the diaper region, namely humidity, scratching, urine, sweat, feces, and microbiome composition. A total of 130 papers met the inclusion criteria, and extracted data were analyzed in an iterative manner. Increased local humidity facilitates protective changes at the cellular level and offsets transepidermal water loss. Exposure to urea from both sweat and urine may contribute to improved moisturization of the skin through its natural humectant properties and ability to modulate gene expression. Introduction of flora in feces contributes to the generation of protective immune responses and outcompetes growth of pathogens such as . Finally, diapers physically prevent scratching, which directly interrupts the itch-scratch cycle classically implicated in AD. Our study reviews factors that may contribute to the sparing of AD in the diaper region in infants. A limitation to our findings is that the studies reviewed here explore the impacts of these factors on AD broadly, and not explicitly in the diaper region. Additional studies investigating this may further our understanding of AD pathogenesis and contribute to the development of effective therapeutics.
Topics: Child; Dermatitis, Atopic; Diaper Rash; Humans; Infant; Infant Care; Skin
PubMed: 35317630
DOI: 10.1177/12034754221088533 -
American Family Physician Mar 2022
Topics: Child; Diaper Rash; Exanthema; Humans; Infant; Infant Care
PubMed: 35289583
DOI: No ID Found -
Journal of Medical Internet Research Jul 2021Caregivers of patients who wear conventional diapers are required to check for voiding every hour because prolonged wearing of wet diapers causes health problems... (Observational Study)
Observational Study
A Smart Diaper System Using Bluetooth and Smartphones to Automatically Detect Urination and Volume of Voiding: Prospective Observational Pilot Study in an Acute Care Hospital.
BACKGROUND
Caregivers of patients who wear conventional diapers are required to check for voiding every hour because prolonged wearing of wet diapers causes health problems including diaper dermatitis and urinary tract infections. However, frequent checking is labor intensive and disturbs patients' and caregivers' sleep. Furthermore, assessing patients' urine output with diapers in an acute care setting is difficult. Recently, a smart diaper system with wetness detection technology was developed to solve these issues.
OBJECTIVE
We aimed to evaluate the applicability of the smart diaper system for urinary detection, its accuracy in measuring voiding volume, and its effect on incontinence-associated dermatitis (IAD) occurrence in an acute care hospital.
METHODS
This prospective, observational, single-arm pilot study was conducted at a single tertiary hospital. We recruited 35 participants aged ≥50 years who were wearing diapers due to incontinence between August and November 2020. When the smart diaper becomes wet, the smart diaper system notifies the caregiver to change the diaper and measures voiding volume automatically. Caregivers were instructed to record the weight of wet diapers on frequency volume charts (FVCs). We determined the voiding detection rate of the smart diaper system and compared the urine volume as automatically calculated by the smart diaper system with the volume recorded on FVCs. Agreement between the two measurements was estimated using a Bland-Altman plot. We also checked for the occurrence or aggravation of IAD and bed sores.
RESULTS
A total of 30 participants completed the protocol and 390 episodes of urination were recorded. There were 108 records (27.7%) on both the FVCs and the smart diaper system, 258 (66.2%) on the FVCs alone, 18 (4.6%) on the smart diaper system alone, and 6 (1.5%) on the FVCs with sensing device lost. The detection rate of the smart diaper system was 32.8% (126/384). When analyzing records concurrently listed in both the FVCs and the smart diaper system, linear regression showed a strong correlation between the two measurements (R=0.88, P<.001). The Bland-Altman assessment showed good agreement between the two measurements, with a mean difference of -4.2 mL and 95% limits of agreement of -96.7 mL and 88.3 mL. New occurrence and aggravation of IAD and bed sores were not observed. Bed sores improved in one participant.
CONCLUSIONS
The smart diaper system showed acceptable accuracy for measuring urine volume and it could replace conventional FVCs in acute setting hospitals. Furthermore, the smart diaper system has the potential advantage of preventing IAD development and bed sore worsening. However, the detection rate of the smart diaper system was lower than expected. Detection rate polarization among participants was observed, and improvements in the user interface and convenience are needed for older individuals who are unfamiliar with the smart diaper system.
Topics: Hospitals; Humans; Pilot Projects; Prospective Studies; Smartphone; Urination
PubMed: 34328427
DOI: 10.2196/29979 -
Clinical Pediatrics May 2017Today's disposable diapers are high-performance and well-tested products, designed to keep skin dry and healthy. They are primarily made of biologically inert polymers,...
Today's disposable diapers are high-performance and well-tested products, designed to keep skin dry and healthy. They are primarily made of biologically inert polymers, commonly used in fabrics and other materials that are in contact with skin, and in foods and cosmetics. Still, product safety and ingredients in everyday products can be a source of anxiety for new parents. This article provides the facts behind some commonly asked questions from consumers about diaper ingredients and safety, including myths and facts related to chlorine, latex, dyes, and chemical additives.
Topics: Child, Preschool; Chlorine; Coloring Agents; Diapers, Infant; Disposable Equipment; Humans; Infant; Latex; Polymers
PubMed: 28420254
DOI: 10.1177/0009922817706998 -
Journal of Tissue Viability May 2023
Topics: Humans; Infant; Diaper Rash; Terminology as Topic
PubMed: 36709099
DOI: 10.1016/j.jtv.2023.01.008 -
Pediatric Dermatology Nov 2014There are tremendous variations in diapering practices, reflecting varying cultural practices and regional difference. Around the world, more than 134 million babies are...
There are tremendous variations in diapering practices, reflecting varying cultural practices and regional difference. Around the world, more than 134 million babies are born each year, a rate of 255 births per minute or 4.3 births each second. While global population growth has been steadily declining from its peak in 1963, several regions, including the Middle East and Sub-Saharan Africa, continue to maintain high birth rates. Though the essential needs of infants are largely similar, family habits and practices during early years of life vary dramatically. This article surveys data documenting variations in diaper frequency, types, and duration of use internationally, including age of toilet training. These factors may influence diaper rash and skin health of infants and young children. Much of this data was collected as part of analysis of the international commercial diaper market, evaluated and organized as part of an international initiative on Global Infant Skin Care, and presented to a panel of experts for critique and commentary in a symposium held in December, 2013.
Topics: Child, Preschool; Culture; Diapers, Infant; Disposable Equipment; Humans; Infant; Infant Care; Infant, Newborn; Skin Care; Toilet Training
PubMed: 25403934
DOI: 10.1111/pde.12468 -
BMC Dermatology Sep 2020Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but...
BACKGROUND
Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but potentially serious cutaneous eruptions associated with systemic diseases that should not be discounted.
METHODS
This prospective descriptive study aimed to explore variation in cutaneous disease in the diaper area. It was conducted as a prospective descriptive study between October 2016 and November 2019 in the pediatric department of a tertiary-level hospital.
RESULTS
Three hundred consecutive patients with rashes in the diaper area were enrolled. The most common diagnosed was IDD (125 cases; 41.7%), followed by rashes exacerbated by the diaper (101 cases; 33.67%) and non-diaper-related rashes (74 cases; 24.67%).
CONCLUSIONS
Our finding suggests that when diagnosing rashes that occur in the diaper area, general pediatricians should consider, in addition to IDD, the possibility of less-common conditions. The simultaneous presence of cutaneous lesions at other sites was linked to diagnoses of systemic diseases other than IDD, (P < 0.001).
Topics: Adolescent; Age Factors; Candidiasis; Child; Child, Preschool; Dermatitis, Seborrheic; Diagnosis, Differential; Diaper Rash; Eczema; Exanthema; Female; Humans; Infant; Intertrigo; Male; Prospective Studies; Scabies; Skin
PubMed: 32957981
DOI: 10.1186/s12895-020-00104-z