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Journal of Perinatology : Official... Apr 2024Quantify the evolution and severity of neonatal skin injury, specifically diaper skin compromise, by embedding a validated skin integrity evaluation into the electronic...
OBJECTIVE
Quantify the evolution and severity of neonatal skin injury, specifically diaper skin compromise, by embedding a validated skin integrity evaluation into the electronic health record (EHR).
METHODS
Retrospective longitudinal cohort analysis of 747 patients stratified by gestation: 22-27, 28-31, 32-24, and 35-37 weeks, from birth to discharge. Primary outcomes were time to first perineal erythema, duration as percent days with erythema, and severity as maximum score. Data were analyzed using generalized linear models and multiple linear regression methods.
RESULTS
Seventy percent had erythema and, of these, 34% had at least one high score with bleeding. Days with erythema ranged from 34-44% (p < 0.05). Days to first erythema were inversely correlated with gestational age. Risks for severe injury included short time to first erythema, 5 or more stools/day, infection, and Caucasian race/ethnicity.
CONCLUSIONS
The EHR-based scale can be readily implemented to mitigate diaper skin compromise in premature infants.
Topics: Infant, Newborn; Infant; Humans; Retrospective Studies; Electronic Health Records; Diaper Rash; Skin; Erythema
PubMed: 37985814
DOI: 10.1038/s41372-023-01824-z -
Heliyon Oct 2023Diaper dermatitis is one of infants and toddlers' most common skin diseases; it accounts for 10-20 % of all skin diseases and 25 % of pediatric dermatology visits....
BACKGROUND
Diaper dermatitis is one of infants and toddlers' most common skin diseases; it accounts for 10-20 % of all skin diseases and 25 % of pediatric dermatology visits. Diaper dermatitis also increases parents' mental health problems and compromises the quality of life. Despite its ill outcome, diaper dermatitis's burden and risk factors are poorly studied in Ethiopia. Therefore, this study aimed to assess the magnitude of diaper dermatitis and associated factors among 1-24 months children visiting public health facilities in Arba Minch town, southern Ethiopia.
METHODS
A facility-based cross-sectional study was conducted among 671 mother-child pairs from May 15 to June 15, 2022. A structured and pretested interviewer-administered questionnaire and observational checklist were used to collect the information. The data was collected using an open data kit tools and analyzed using Stata version 17.0. Bivariable and multivariable analyses were carried out to identify factors associated with diaper dermatitis. P-value <0.05 was considered to declare statistical significance.
RESULTS
In this study, 664 mother-child pairs, yielded a response rate of 98.96 %, were involved. Overall, 35.69 % [95 % CI: 32.04, 39.47] of children encountered diaper dermatitis. Being government-employed (AOR: 2.49, 95 % CI: 1.42, 4.35), primiparity (AOR: 1.52, 95 % CI: 1.03, 2.23), unplanned pregnancy (AOR: 1.93, 95 % CI: 1.22, 3.04), having poor knowledge about diaper dermatitis (AOR: 1.74, 95 % CI: 1.19, 2.56), using both disposable and non-disposable diapers alternatively (AOR: 3.35, 95 % CI: 1.55, 7.22), and applying ointments on diaper area (AOR: 1.93, 95 % CI: 1.26, 2.97) all increase the likelihood of diaper dermatitis.
CONCLUSION
Diaper dermatitis was high in the study hospitals; over one-third experienced it. Maternal occupation, parity, pregnancy status, maternal knowledge of diaper dermatitis, diaper type, and ointment application were significantly associated with diaper dermatitis. Improving maternal/guardian knowledge about diapering and diaper dermatitis is critical to reducing the burden and severity of the problem.
PubMed: 37860555
DOI: 10.1016/j.heliyon.2023.e20785 -
Pediatric Dermatology 2024Irritant diaper dermatitis is a common dermatologic problem among infants and young children. Severe erosive presentations, although uncommon, are diagnostically...
Irritant diaper dermatitis is a common dermatologic problem among infants and young children. Severe erosive presentations, although uncommon, are diagnostically challenging and can mimic non-accidental trauma (NAT). Diagnosing inflicted injury and NAT where it does not exist can cause parental distress, yet failing to diagnose inflicted injury and NAT can result in re-injury. We describe three cases of severe erosive diaper dermatitis in pediatric patients aged 2-6 years that were initially concerning for inflicted scald burn or neglect.
Topics: Infant; Humans; Child; Child, Preschool; Diaper Rash; Burns; Child Abuse; Diagnosis, Differential; Parents
PubMed: 37329293
DOI: 10.1111/pde.15374 -
Clinical Pediatrics Sep 2023To investigate effects of diaper-free times, elimination communication (EC) and early toilet training, a web-based survey was conducted for caregivers. The more...
To investigate effects of diaper-free times, elimination communication (EC) and early toilet training, a web-based survey was conducted for caregivers. The more diaper-free times an infant experienced during day, the earlier it was toilet trained ( < .001), which was enhanced by the usage of cloth diapers. The amount of diaper-free times significantly reduced the caregiver's continuous sleep, the occurrence of rashes and balm usage ( < .001) and lead to a more regular defecation frequency. Cloth diaper usage had no effect on rashes or balm usage, but on diaper change rate ( < .001). We could show that, although not as effective as full-time EC, part-time EC is more effective if cloth diapers are used, provided they are changed frequently. Furthermore, EC causes a more regular defecation in infants between 1 and 2 years.
Topics: Humans; Infant; Communication; Diaper Rash; Exanthema; Infant Care; Toilet Training
PubMed: 36852780
DOI: 10.1177/00099228221145268 -
Journal of Pediatric Endocrinology &... Apr 2023Betamethasone causing iatrogenic Cushing's syndrome (CS) in infants are rarely reported.
OBJECTIVES
Betamethasone causing iatrogenic Cushing's syndrome (CS) in infants are rarely reported.
CASE PRESENTATION
In this case report, there were severe signs of CS, such as considerable weight acceleration and concurrent height deceleration, hirsutism and ecchymosis of the face, and buffalo pad, which are often found in adults. Clobetasol propionate, diflucortolone valerate, and dexamethasone nasal sprays were used in the majority of previously reported cases of corticosteroid abuse, whereas this is the first case of CS in an infant as a result of the use of betamethasone cream, also known as betnesol, which is frequently used by mothers in developing countries as a treatment for rashes. In this instance, a severe medication interaction caused by systemic betamethasone cream buildup led to the creation of CS. For the professionals, these patients are a challenge because of drug use without prescription.
CONCLUSIONS
Topical corticosteroid usage puts infants at risk for CS. Because of excessive betamethasone treatment in this child with diaper dermatitis, he acquired CS. It is said to draw attention to the risks of self-medication in developing nations.
Topics: Male; Humans; Child; Cushing Syndrome; Glucocorticoids; Betamethasone; Adrenal Cortex Hormones; Diaper Rash; Exanthema
PubMed: 36788666
DOI: 10.1515/jpem-2022-0415 -
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 -
Journal of Tissue Viability May 2023
Topics: Humans; Infant; Diaper Rash; Terminology as Topic
PubMed: 36709099
DOI: 10.1016/j.jtv.2023.01.008