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Japan Journal of Nursing Science : JJNS Oct 2022Prolonged diaper dermatitis may increase the risk of atopic dermatitis or infections. This prospective observational study aimed to investigate the prevalence, symptoms,... (Observational Study)
Observational Study
AIM
Prolonged diaper dermatitis may increase the risk of atopic dermatitis or infections. This prospective observational study aimed to investigate the prevalence, symptoms, areas, and recovery time of diaper dermatitis in infants aged 1 month and identify the factors related to recovery time.
METHODS
Diaper dermatitis was defined as the presence of erythema, papules, dryness, erosion, or ulceration in the diapered area. Recovery time was days between infant's 1-month medical check-up and disappearance of symptoms. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used to identify the factors related to recovery time.
RESULTS
Among 113 infants, 66 (58.4%) had diaper dermatitis, with erythema at the perianal area being the most common symptom. The median recovery time was 10 days. Four infants (6.1%) had diaper dermatitis for >5 weeks. Severity was not related to recovery time.
CONCLUSIONS
A frequency of diaper changing of ≤10 times per day was a risk factor for recovery time. Our data showed recovery in approximately 10 days, regardless of severity at study enrollment. Health care professionals could inform parents of recovery time and recommended diaper changing frequency.
Topics: Child; Diaper Rash; Erythema; Humans; Infant; Infant Care; Prospective Studies; Skin
PubMed: 35652131
DOI: 10.1111/jjns.12492 -
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 -
Drug Delivery Dec 2022Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical...
Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical delivery of this poorly water soluble and high-molecular-weight drug, however, mightily entail an adequate vehiculation. ITZ aspasomes, newer antioxidant generation of liposomes, have been designed and enclosed in a cream to ameliorate skin deposition. The proposed creams containing non-formulated ITZ or encapsulated in aspasomes (0.1% or 0.5%) were topically applied in patients with diagnosed diaper dermatitis complicated by candidiasis, tinea corporis (TC), and tinea versicolor (TVC). Placebos (void aspasomal cream and cream base) were also utilized. The obtained results for diaper rash revealed that aspasomal cream (0.5% ITZ) was eminent with respect to complete cure and negative candida culture after 10-day therapy relative to counterparts containing 0.1% ITZ aspasomes or non-formulated ITZ (0.1% and 0.5%). For tinea, the same trend was manifested in terms of 'cleared' clinical response in 90% of patients and absence of fungal elements after 4-week treatment. Relative to non-formulated ITZ, ITZ aspasomal cream was endorsed to be auspicious especially when ITZ concentration was lowered to half commercially available cream concentration (1%), pushing further exploitation in other dermal fungal infections.
Topics: Antifungal Agents; Humans; Itraconazole; Liposomes; Skin; Tinea
PubMed: 35506466
DOI: 10.1080/10717544.2022.2067601 -
MBio Jun 2022Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae...
Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae and hyphae) is tightly associated with its pathogenesis. Based on studies, the cAMP-protein kinase A (PKA) pathway is a key regulator of C. albicans morphogenesis. Using an intravital imaging approach, we investigated the role of the cAMP-PKA pathway during infection. Consistent with their roles , the downstream effectors of the cAMP-PKA pathway Efg1 and Nrg1 function, respectively, as an activator and a repressor of filamentation. Surprisingly, strains lacking the adenylyl cyclase, , showed only slightly reduced filamentation despite being completely unable to filament in RPMI + 10% serum at 37°C. Consistent with these findings, deletion of the catalytic subunits of PKA (Tpk1 and Tpk2), either singly or in combination, generated strains that also filamented but not . transcription profiling of C. albicans isolated from both ear and kidney tissue showed that the expression of a set of 184 environmentally responsive genes correlated well with filamentation (, 0.62 to 0.68) genes. This concordance suggests that the and transcriptional responses are similar but that the upstream regulatory mechanisms are distinct. As such, these data emphatically emphasize that C. albicans filamentation is a complex phenotype that occurs in different environments through an intricate network of distinct regulatory mechanisms. The fungus Candida albicans causes a wide range of disease in humans from common diaper rash to life-threatening infections in patients with compromised immune systems. As such, the mechanisms for its ability to cause disease are of wide interest. An intensely studied virulence property of C. albicans is its ability to switch from a round yeast form to filament-like forms (hyphae and pseudohyphae). Surprisingly, we have found that a key signaling pathway that regulates this transition , the protein kinase A pathway, is not required for filamentation during infection of the host. Our work not only demonstrates that the regulation of filamentation depends upon the specific environment C. albicans inhabits but also underscores the importance of studying these mechanisms during infection.
Topics: Candida albicans; Cyclic AMP-Dependent Protein Kinases; Fungal Proteins; Gene Expression Regulation, Fungal; Hyphae
PubMed: 35475642
DOI: 10.1128/mbio.00851-22 -
Journal of Cosmetic Science 2021The background of this article is to develop formulations consisting of natural raw materials that are effective in diaper rash by taking advantage of the medicinal...
The background of this article is to develop formulations consisting of natural raw materials that are effective in diaper rash by taking advantage of the medicinal properties of zinc oxide, natural oils, and beeswax. The purpose of this research was to determine the appropriate amounts of the constituents of the formulation and to determine the optimum formulation by comparing the margin of safety (MoS), and microbiological and physicochemical properties of the best formulation. For this purpose, parameters such as pH, rheological behavior, hydrophilic and lipophilic balance (HLB), zeta potential, and polydispersity index were analyzed and evaluated to determine the optimum formulation. Besides, microbiological reproduction and 3-month stability studies of the developed product were carried out, and it has been proven that the developed product maintains both microbiological and stability properties throughout its shelf life. Furt hermore, whether each raw material used in the selected optimum formulation remained within MoS values was evaluated according to exposure doses in the literature. Whether it maintains the desired properties throughout the shelf life was evaluated by stability studies. In this article, eight different zinc oxide-based formulations for preventing diaper rash were developed, and their physicochemical properties were examined to optimize cream formulations. baby barrier cream (BBC)-8 was chosen as the ideal formula by comparing all the parameters obtained as a result of the analysis. As a result of the optimization studies of the BBC-8 formulation, the pH value was 7.2, the viscosity property was pseudoplastic-type flow, the particle size was 533.2 nm ± 6.93, and the zeta potential was -30.9 mV ± 0.72. The theoretical safety assessment of each constituent has been made according to the European Union Cosmetics Directives. According to the calculations made on each raw material in BBC-8 according to the directives, the MoS value was found to be more than 230. For the stability studies, no microbiological growth was observed at the end of the 3-month stability studies at 25 and 40°C. In terms of the development of future natural cosmetic product formulations and the defi nition of "natural formulation," it gives hope to prepare a safer cosmetic product for baby rash creams that do not contain preservatives, perfumes, and dyes and consists of natural oils and zinc oxide.
Topics: Cosmetics; Emollients; Humans; Infant; Particle Size; Plant Oils; Zinc Oxide
PubMed: 35361323
DOI: No ID Found -
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 -
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 -
Frontiers in Psychiatry 2021We identified the first-generation antihistamine hydroxyzine as the earliest and most frequently prescribed drug affecting the central nervous system in children under...
We identified the first-generation antihistamine hydroxyzine as the earliest and most frequently prescribed drug affecting the central nervous system in children under the age of 5 years in the province of British Columbia, Canada (1. 1% prevalence). Whereas, the antagonism of H1-receptors exerts anti-pruritic effects in atopic dermatitis and diaper rash, animal studies suggest an adverse association between reduced neurotransmission of histamine and psychomotor behavior. In order to investigate hydroxyzine safety, we characterized the longitudinal patterns of hydroxyzine use in children under the age of 5 years and determined mental- and psychomotor disorders up to the age of 10 years. We found significantly higher rates of ICD-9 and ICD-10 codes for disorders such as tics (307), anxiety (300) and disturbance of conduct (312) in frequent users of hydroxyzine. Specifically, repeat prescriptions of hydroxyzine compared to a single prescription show an increase in tic disorder, anxiety and disturbance of conduct by odds ratios of: 1.55 (95%CI: 1.23-1.96); 1.34 (95%CI: 1.05-1.70); and 1.34 (95%CI: 1.08-1.66) respectively in children up to the age of 10 years. Furthermore, a non-significant increased trend was found for ADHD (314) and disturbance of emotions (313). This is the first study reporting an association between long-term neurodevelopmental adverse effects and early use of hydroxyzine. Controlled studies are required in order to prove a causal relationship and to confirm the safety of hydroxyzine in the pediatric population. For the time being, we suggest the shortest possible duration for hydroxyzine use in preschool-age children.
PubMed: 35153845
DOI: 10.3389/fpsyt.2021.721875