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Deutsche Medizinische Wochenschrift... Feb 1972
Topics: Candidiasis, Cutaneous; Diagnosis, Differential; Diaper Rash; Humans; Infant; Infant, Newborn; Nystatin
PubMed: 5058439
DOI: No ID Found -
Regulatory Toxicology and Pharmacology... Nov 2017Diaper rash can adversely impact the barrier properties of skin, with potential implications for increased absorption of chemicals through the skin, and this should be...
Diaper rash can adversely impact the barrier properties of skin, with potential implications for increased absorption of chemicals through the skin, and this should be accounted for in any exposure assessment used in the safety evaluation of consumer products used in the diaper ("nappy") area. In the absence of a quantitative evaluation of the potential impact of diaper rash, a default assumption of 100% dermal penetration is often made for substances applied in the diaper area. We consider here the extent, duration and severity of diaper rash and make a recommendation for conservative assumptions to incorporate into exposure assessments. Using a time-weighted average, the potential impact of diaper rash is illustrated for substances that have varying degrees of absorption through healthy skin. Results confirm that for assessments that already assume dermal absorption of 50% or higher, there is no impact on the overall exposure assessment. For substances that have a very low degree of dermal penetration (1%) through healthy skin, the impact of rash is expected to be less-than four-fold. This can be refined with additional data as there are many examples of poorly absorbed compounds for which dermal penetration is still low even for compromised skin.
Topics: Consumer Product Safety; Diaper Rash; Diapers, Infant; Humans; Infant; Infant Care; Severity of Illness Index; Skin; Skin Absorption; Time Factors
PubMed: 28916467
DOI: 10.1016/j.yrtph.2017.09.011 -
Pediatric Dermatology 2014Diaper dermatitis (DD) is one of the most common skin conditions in neonates and infants, with a peak between the ages of 9 and 12 months. Appropriate skin care... (Review)
Review
Diaper dermatitis (DD) is one of the most common skin conditions in neonates and infants, with a peak between the ages of 9 and 12 months. Appropriate skin care practices that support skin barrier function and protect the buttocks skin from urine and feces are supposed to be effective in the prevention of DD. Despite many recommendations for parents and caregivers on proper diaper skin care, there is no up-to-date synthesis of the available evidence to develop recommendations for DD prevention practice. Therefore we performed a systematic literature review on the efficacy of nonmedical skin care practices on the diapered area of healthy, full-term infants ages 0 to 24 months. We identified 13 studies covering skin care practices such as cleansing, bathing, and application of topical products. DD prevalence and incidence and physiologic skin parameters were used as efficacy parameters. The results of this review indicate that cleansing of the diaper area using baby wipes or water and a washcloth have comparable effects on diapered skin. Bathing with a liquid baby cleanser twice weekly seems comparable with water alone. The application of ointments containing zinc oxide or petrolatum with or without vitamin A seems to have comparable effects on DD severity. There seems to be no information on whether single skin care practices such as cleansing, bathing, and application of topical preparations can prevent DD. High-quality randomized clinical trials are needed to show the effectiveness of skin care practices for controlling and preventing DD.
Topics: Administration, Topical; Child, Preschool; Diaper Rash; Humans; Infant; Infant Care; Infant, Newborn; Skin Care
PubMed: 24890321
DOI: 10.1111/pde.12348 -
Current Opinion in Pediatrics Aug 2000During the last decade, a number of technological innovations in disposable diaper designs and materials have aimed at reducing dermatological problems in the diaper... (Review)
Review
During the last decade, a number of technological innovations in disposable diaper designs and materials have aimed at reducing dermatological problems in the diaper area. The introduction of absorbent gelling materials led to a decrease in skin overhydration and made possible a more beneficial pH in the diaper area. A retrospective evaluation of clinical studies conducted before and after the introduction of absorbent gelling materials confirms that utilization of these materials has been associated with a marked reduction in the severity of diaper dermatitis. More recently, a novel diaper designed to deliver dermatological formulations to the skin also appears to improve the condition of diapered skin. Disposable wipes now are available that are nonirritating and suitable for use on damaged or broken skin. Ongoing innovative efforts in this area promise to further decrease the prevalence of diaper-associated dermatologic conditions.
Topics: Diaper Rash; Equipment Design; Humans; Infant; Infant Care; Prevalence; Severity of Illness Index
PubMed: 10943814
DOI: 10.1097/00008480-200008000-00011 -
Pediatric Dermatology 2008The skin of the diaper area has special needs for protection from the irritating effects of urine and feces and prevention of diaper dermatitis. These needs include... (Review)
Review
The skin of the diaper area has special needs for protection from the irritating effects of urine and feces and prevention of diaper dermatitis. These needs include products such as diapers that absorb the excreta, as well as products for cleansing and conditioning the skin. A number of factors play a role in development of diaper dermatitis, including prolonged exposure to excreta, alterations in skin pH or increased hydration, and changes in skin microbial flora. Recent decades have seen great improvements in our understanding of these factors and our ability to develop new and better products to protect baby skin. Better diaper designs and the development of pH-buffered baby wipes have improved the care of skin in the diaper area. Continuing research offers the promise of new products with additional benefits for caregivers and infants.
Topics: Diaper Rash; Diapers, Infant; Humans; Infant; Infant Care; Infant, Newborn; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 18789081
DOI: 10.1111/j.1525-1470.2008.00725.x -
The Journal of Pediatrics Dec 1960
Topics: Crying; Diaper Rash; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Posture; Prone Position; Skin Diseases; Supine Position
PubMed: 13752225
DOI: 10.1016/s0022-3476(60)80138-2 -
Emergency Medicine Clinics of North... Nov 1985Dermatitis, the inflammatory response of the skin to various factors, may present in a variety of forms. Atopic dermatitis, contact dermatitis, nummular eczema,... (Review)
Review
Dermatitis, the inflammatory response of the skin to various factors, may present in a variety of forms. Atopic dermatitis, contact dermatitis, nummular eczema, seborrhea, and stasis dermatitis, conditions with which the patient may present to the emergency department, either in the acute stage or with exacerbation of a chronic condition, are reviewed in this article.
Topics: Adolescent; Adult; Child; Child, Preschool; Dermatitis; Dermatitis, Contact; Dermatitis, Seborrheic; Dermatitis, Toxicodendron; Diaper Rash; Eczema; Female; Humans; Infant; Infant, Newborn; Male; Seasons; Sex Factors
PubMed: 2932326
DOI: No ID Found -
Nederlands Tijdschrift Voor Geneeskunde Feb 2023Diaper dermatitis in children is common and usually harmless. Often the cause is irritation, a secondary candida infection or eczema, for which treatment is simple and...
BACKGROUND
Diaper dermatitis in children is common and usually harmless. Often the cause is irritation, a secondary candida infection or eczema, for which treatment is simple and effective. In this paper we show that a therapy resistant diaper dermatitis can be the diagnostic clue to the rare but important diagnosis Langerhans cell histiocytosis (LCH).
CASE DESCRIPTION
We saw a 14 months old girl with therapy resistant diaper dermatitis, skin abnormalities on the hairy scalp, fever, otorrhea and extensive lymphadenopathy. After a long period of doctor visits, skin biopsies confirmed the diagnosis of LCH.
CONCLUSION
LCH is a rare condition that often manifests in the skin. LCH can manifest in different organs. Although skin involvement is sometimes considered as less relevant, cutaneous manifestations can be an important diagnostic clue. In this paper we show that diaper dermatitis is not always harmless: it can be a symptom of LCH.
Topics: Child; Female; Humans; Infant; Diaper Rash; Skin; Eczema; Scalp; Histiocytosis, Langerhans-Cell
PubMed: 36752661
DOI: No ID Found -
Advances in Dermatology 1988Common diaper dermatitis is a group of skin disorders that result from attack of the skin by physical, chemical, enzymatic, and microbial factors in the diaper... (Review)
Review
Common diaper dermatitis is a group of skin disorders that result from attack of the skin by physical, chemical, enzymatic, and microbial factors in the diaper environment. The integrity of healthy skin is compromised by the very nature of the diaper environment, and normal intact skin therefore remains an elusive goal of current diapering practices. Moist occlusion promotes miliaria, and causes an increase in the coefficient of skin friction. Skin hydration and an increase in skin pH result in impaired barrier function, and fecal enzymes begin to attack the skin, further degrading its normal ability to cope with its environment. Skin in this weakened state is susceptible to a variety of biological, chemical, and physical insults that can cause or aggravate diaper dermatitis. These include attack of the skin by fecal enzymes and other irritants in urine and feces, mechanical abrasion, and infection by C. albicans. Diapering is unquestionably an effective and convenient way of localizing an infant's excreta. Unfortunately, infant skin was not designed to operate continuously in the resulting environment, and is frequently unable to weather this assault. However, by improving the inherently adverse relationship between diapers and diapered skin, one can have a significant effect on the incidence and severity of diaper dermatitis. A diaper that keeps skin drier will result in skin that is less permeable to irritants, supports less microbial growth, is less susceptible to chafing damage, and has less contact with irritants in urine and feces. A diaper that maintains the environment closer to the normal acidic pH of skin will promote skin that is less permeable to irritants, and reduce the irritancy of fecal enzymes. Finally, a diaper that limits the mixing and spreading of urine and feces will result in less potentiation of enzyme activity and less contact of the skin with fecal irritants. Diaper dermatitis, by definition, cannot exist in the absence of diapers. Moreover, diaper dermatitis will become less troublesome for the infant population to the degree that diapered skin can be provided an environment closer to that of undiapered skin.
Topics: Diagnosis, Differential; Diaper Rash; Humans; Infant; Infant Care
PubMed: 3152829
DOI: No ID Found -
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