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The Journal of Investigative Dermatology Feb 1984Iodochlorhydroxyquin (I) is used in the treatment of diaper rash and other skin disorders, and is presumed to undergo little or no percutaneous absorption. The...
Iodochlorhydroxyquin (I) is used in the treatment of diaper rash and other skin disorders, and is presumed to undergo little or no percutaneous absorption. The absorption of (I) from a 3% cream was studied in 5 normal male subjects after a single application of the cream for 12 h. Plasma levels of the drug were followed for 24 h after initial application while urinary excretion was measured for 54 h. (I) was extracted from plasma and urine and assayed by high-performance liquid chromatography. The drug in the range of 0.37-0.56 micrograms/ml was detected in plasma 2 h after application and persisted throughout the treatment period. The mean excretion rate after 12 h of application was 58.4 micrograms/h and the excretion rate was 8.8 micrograms/h at 42 h posttreatment. The elimination rate constant was calculated to be 0.15 h-1. Approximately 40% of the drug was absorbed over the 12-h application period. From the above results it is apparent that significant percutaneous absorption of (I) occurs.
Topics: Absorption; Administration, Topical; Adult; Clioquinol; Half-Life; Humans; Hydroxyquinolines; Kinetics; Male; Skin
PubMed: 6229586
DOI: 10.1111/1523-1747.ep12259839 -
Cureus Jul 2022Langerhans cell histiocytosis presents most frequently in pediatric patients with cutaneous manifestations such as erythematous and scaly papules in the trunk or scalp...
Langerhans cell histiocytosis presents most frequently in pediatric patients with cutaneous manifestations such as erythematous and scaly papules in the trunk or scalp and macerated plaques in intertriginous sites. We present a case of a seven-month-old patient who was brought with complaints of persistent diaper rash. The patient presented with skin fissures in intertriginous areas and pink color papules dispersed widely in the trunk and perineum. The skin biopsy revealed infiltration of abundant histiocytes, eosinophils, lymphocytes, and plasma cells, being CD207, CD1a, and S-100 positive by immunohistochemistry. Due to the diversified presentations of Langerhans cell histiocytosis and its propensity to mimic other dermatological conditions, physicians should have a clinical suspicion of this disease and consider it as a differential diagnosis among common skin diseases in pediatric patients.
PubMed: 35936168
DOI: 10.7759/cureus.26606 -
Molecular Genetics and Metabolism Jan 2021Neonatal onset Urea cycle disorders (UCDs) can be life threatening with severe hyperammonemia and poor neurological outcomes. Glycerol phenylbutyrate (GPB) is safe and...
BACKGROUND/AIMS
Neonatal onset Urea cycle disorders (UCDs) can be life threatening with severe hyperammonemia and poor neurological outcomes. Glycerol phenylbutyrate (GPB) is safe and effective in reducing ammonia levels in patients with UCD above 2 months of age. This study assesses safety, ammonia control and pharmacokinetics (PK) of GPB in UCD patients below 2 months of age.
METHODS
This was an open-label study in UCD patients aged 0 - 2 months, consisting of an initiation/transition period (1 - 4 days) to GPB, followed by a safety extension period (6 months to 2 years). Patients presenting with a hyperammonemic crisis (HAC) did not initiate GPB until blood ammonia levels decreased to below 100 µmol/L while receiving sodium phenylacetate/sodium benzoate and/or hemodialysis. Ammonia levels, PK analytes and safety were evaluated during transition and monthly during the safety extension for 6 months and every 3 months thereafter.
RESULTS
All 16 patients with UCD (median age 0.48 months, range 0.1 to 2.0 months) successfully transitioned to GPB within 3 days. Average plasma ammonia level excluding HAC was 94.3 µmol/L at baseline and 50.4 µmol/L at the end of the transition period (p = 0.21). No patient had a HAC during the transition period. During the safety extension, the majority of patients had controlled ammonia levels, with mean plasma ammonia levels lower during GPB treatment than baseline. Mean glutamine levels remained within normal limits throughout the study. PK analyses indicate that UCD patients <2 months are able to hydrolyze GPB with subsequent absorption of phenylbutyric acid (PBA), metabolism to phenylacetic acid (PAA) and conjugation with glutamine. Plasma concentrations of PBA, PAA, and phenylacetylglutamine (PAGN) were stable during the safety extension phase and mean plasma phenylacetic acid: phenylacetylglutamine ratio remained below 2.5 suggesting no accumulation of GPB. All patients reported at least 1 treatment emergent adverse event with gastroesophageal reflux disease, vomiting, hyperammonemia, diaper dermatitis (37.5% each), diarrhea, upper respiratory tract infection and rash (31.3% each) being the most frequently reported.
CONCLUSIONS
This study supports safety and efficacy of GPB in UCD patients aged 0 -2 months who cannot be managed by dietary protein restriction and/or amino acid supplementation alone. GPB undergoes intestinal hydrolysis with no accumulation in this population.
Topics: Age of Onset; Ammonia; Child, Preschool; Female; Glycerol; Humans; Hyperammonemia; Infant; Infant, Newborn; Male; Pediatrics; Phenylacetates; Phenylbutyrates; Renal Dialysis; Urea Cycle Disorders, Inborn
PubMed: 33388234
DOI: 10.1016/j.ymgme.2020.12.002 -
Journal of Pediatric Intensive Care Sep 2012Within hours of accidental instillation of a popular diaper rash protector spray, a 23 day old male developed severe chemical pneumonitis, acute respiratory failure and...
Within hours of accidental instillation of a popular diaper rash protector spray, a 23 day old male developed severe chemical pneumonitis, acute respiratory failure and pneumomediastinum. Despite optimal ventilatory management, the unconventional use of frequent bronchial saline lavages was necessary to maintain oxygenation and ventilation. The only listed active ingredient, 10% dimethicone was a non-toxic inhalant, but the undisclosed inactive ingredients included mineral oil and balsam of peru which may cause chemical pneumonitis and allergic reactions. This case serves as a warning on OTC product designs and formulations, and cautions us to search beyond the listed active ingredients for potential toxicity.
PubMed: 31214403
DOI: 10.3233/PIC-2012-027 -
Australian and New Zealand Journal of... Apr 2002To determine the prevalence of inappropriate professional advice advocating therapeutic sun exposure in infancy and the post-partum period.
OBJECTIVE
To determine the prevalence of inappropriate professional advice advocating therapeutic sun exposure in infancy and the post-partum period.
METHODS
Self-administered postal questionnaires were completed by doctors (n=130; 71% response) and nurses (n=285; 58.6% response) responsible for the care of post-parturient women in eight hospitals in metropolitan and regional Queensland (1999/2000).
RESULTS
Both groups reported several risky beliefs about the therapeutic benefits of sun exposure including using sunlight to treat: cracked nipples (41.1% nurses, 46.2% doctors); neonatal jaundice (49.5%, 34.9%); nappy rash (23.3%, 19.5%); and acne (12.3%, 20.2%). Approximately 10% of nurses and doctors recommended sunlight to treat sore/cracked nipples from breastfeeding, while 42% recommended sun exposure to treat neonatal jaundice. Relatively few doctors and nurses who recommended therapeutic sun exposure stipulated sunning through a window. Subtropical residence was a significant predictor of recommending sunlight to treat cracked nipples (p=0.002) and nappy rash (p=0.0005) among nursing staff. Midwives were more likely to recommend sunlight for neonatal jaundice than other nurses (p=0.004). Obstetricians (p=0.046), older doctors (p=0.049) and those who qualified earlier (p=0.031) were more likely to recommend sunlight to treat nappy rash. Paediatricians and neonatologists were less likely to recommend sunlight to treat neonatal jaundice than obstetricians and other doctors (p=0.009).
CONCLUSIONS AND IMPLICATIONS
An education program is needed to change the practices of health professionals who recommend therapeutic sun exposure and should coincide with a health promotion campaign aimed at reducing the prevalence of related risky beliefs among parents.
Topics: Adult; Breast Feeding; Clinical Competence; Cross-Sectional Studies; Diaper Rash; Female; Health Knowledge, Attitudes, Practice; Heliotherapy; Humans; Infant; Infant Care; Infant, Newborn; Jaundice, Neonatal; Medical Staff, Hospital; Nipples; Nurse-Patient Relations; Nursing Staff, Hospital; Practice Patterns, Physicians'; Queensland; Surveys and Questionnaires
PubMed: 12054327
DOI: 10.1111/j.1467-842x.2002.tb00901.x -
BioMed Research International 2018Diaper rash, also known as diaper dermatitis (DD), is a very common skin condition in infants, and use of disposable diapers with breathable materials is an effective... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of the Effectiveness of New Material Diapers versus Standard Diapers for the Prevention of Diaper Rash in Chinese Babies: A Double-Blinded, Randomized, Controlled, Cross-Over Study.
BACKGROUND
Diaper rash, also known as diaper dermatitis (DD), is a very common skin condition in infants, and use of disposable diapers with breathable materials is an effective approach for the management of diaper rash. In China, new material diapers and standard diapers are currently the two most commonly used disposable diapers. This study aimed to compare the effectiveness of new material diapers versus standard diaper for the prevention of diaper rash in Chinese babies.
METHODS
A total of 80 eligible babies admitted to Shanghai Skin Diseases Hospital during the period from June through July, 2016, were enrolled and randomized into two groups. Babies in Group A ( = 41) used the new material diapers, and babies in Group B ( = 39) used standard diapers. Two weeks after the use of the diaper, the babies used the alternate product for the next 2 weeks. Skin conditions were assessed on the front and back waist, right and left buttock, pubic region, anal region, and right and left groin using a 6-point scoring system based on four parameters in 0, 2, and 4 weeks after use of the diapers.
RESULTS
There were changes of the mean skin assessment score in each of the six regions after the use of the diapers. There were significant differences, in the mean skin assessment score of the front waist in Group A between weeks 2 and 4 ( = 0.006) and in Group B between weeks 0 and 2 ( = 0.004), and no significant differences were detected in the mean skin assessment score of the back waist and buttock in both Group A and Group B on weeks 0, 2, and 4. A higher mean skin assessment score of the pubic region was assessed in Group A on week 4 than on week 2 ( = 0.036), with a higher score seen on week 2 than on week 0 ( = 0.048), while no significant differences were found in Group B among weeks 0, 2, or 4. There was a higher mean score of the anal region assessed in Group A on week 2 than on week 0 ( = 0.01), while a higher mean score was found in Group B on week 2 than on weeks 0 ( = 0.036) and 4 ( = 0.01). In addition, a higher mean skin assessment score of the groin was detected on week 2 than on week 0 in both Group A ( = 0.00001) and Group B ( = 0.0001).
CONCLUSION
The new material diaper is superior to the standard diaper for the prevention of diaper rash in Chinese babies.
Topics: Asian People; China; Cross-Over Studies; Diaper Rash; Diapers, Infant; Female; Humans; Infant; Infant Care; Infant, Newborn; Male
PubMed: 30035123
DOI: 10.1155/2018/5874184 -
Mycopathologia Apr 2013Diaper dermatitis (DD) is an inflammatory irritating condition that is common in infants. Most cases are associated with the yeast colonization of Candida or diaper...
AIM
Diaper dermatitis (DD) is an inflammatory irritating condition that is common in infants. Most cases are associated with the yeast colonization of Candida or diaper dermatitis candidiasis (DDC), and therefore, the signs and symptoms improve with antimycotic treatment. Sertaconazole is a broad-spectrum third-generation imidazole derivative that is effective and safe for the treatment for superficial mycoses, such as tineas, candidiasis, and pityriasis versicolor. Our goal was to assess the efficacy and safety of sertaconazole cream (2 %) in DDC.
MATERIALS AND METHODS
Twenty-seven patients with clinical and mycological diagnosis of DDC were enrolled and treated with 2 daily applications for 14 days and were followed-up for 2 further weeks.
RESULTS
Three etiologic agents were isolated: Candida albicans in 88.8 %, Candida parapsilosis in 7.3 %, and Candida glabrata in 3.2 %. There was an average symptom reduction from 7.1 to 3.2 in the middle of treatment and to 1.2 and 0.4 units at the end of treatment and follow-up, respectively. The treatment evaluation at the end of the follow-up period showed a total clinical and mycological cure in 88.8 %, improvement in 3.7 %, and failure in 7.4 %. There was side effect (3.7 %) of skin irritation, but the drug was not discontinued.
CONCLUSIONS
Based on its safety and effectiveness, sertaconazole cream may be considered a new alternative for DDC treatment.
Topics: Administration, Topical; Antifungal Agents; Candida; Candidiasis; Diaper Rash; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Imidazoles; Infant; Male; Thiophenes; Treatment Outcome
PubMed: 23546772
DOI: 10.1007/s11046-013-9642-3 -
British Medical Journal Apr 1956
Topics: Candidiasis; Child; Dermatitis; Dermatitis, Contact; Diaper Rash; Humans; Infant; Skin Diseases
PubMed: 13304331
DOI: 10.1136/bmj.1.4970.782 -
British Medical Journal Nov 1957
Topics: Candida; Candidiasis; Child; Diaper Rash; Humans; Infant
PubMed: 13472099
DOI: No ID Found -
Pediatric Dermatology Nov 2018Diapers play a critical role in infant health. In addition to providing sanitary methods of disposing of urine and feces, they can also directly impact skin health....
BACKGROUND
Diapers play a critical role in infant health. In addition to providing sanitary methods of disposing of urine and feces, they can also directly impact skin health. Prolonged exposure to wetness and fecal matter has been shown to be a key driver of diaper dermatitis. This study sought to evaluate how diaper construction can affect absorption of stool.
METHODS
Methods included laboratory testing of stool absorbency as well as an at-home diaper evaluation study, which examined a diaper's ability to keep fecal matter from the skin. Breastfed infant stool was given special consideration, as its properties make it difficult to contain.
RESULTS
Laboratory results demonstrated that a meshlike aperture diaper was better able to absorb fecal matter. The at-home diaper evaluation study confirmed that a meshlike aperture diaper design resulted in fewer instances of stool being present on skin during diaper changes.
CONCLUSION
Diapers with a meshlike aperture topsheet may represent a better way to mitigate known causes of diaper dermatitis through their superior ability to absorb fecal matter.
Topics: Absorption, Physicochemical; Diaper Rash; Diapers, Infant; Feces; Humans; Infant; Infant Care; Infant, Newborn
PubMed: 30168199
DOI: 10.1111/pde.13680