Background Severe infant eczema on the face should be treated early because it may lead to allergic diseases in the future. However, caregivers find it difficult to assess. A visual tool for caregivers is needed to easily determine infants’ facial skin condition severity based on the tool’s scores. We developed an infant facial skin assessment tool (IFSAT) and evaluated its reliability and validity. Methods The IFSAT draft was developed based on results of a previous literature review and qualitative sketch. Panels including medical professionals and a caregiver checked the draft’s content and face validity, and the IFSAT was finalized. To test the IFSAT’s reliability and validity, caregivers and one-month-old infants were recruited. Two scoring methods were additionally created based on the relation between the items and cure period. The relationships between scores and cure period, and the ability to predict whether the infant needed medical treatment were examined by each scoring method. For the predictive validity, scores for infants requiring medical treatment and those for infants who did not were also compared. For the intra-examiner reliability analysis, two pediatricians rated the scores separately twice using photographs. Inter-rater reliabilities were analyzed among pediatricians, nurses, and caregivers. Results Altogether, 113 infant-caregiver pairs participated in the testing phase. Of the two scoring methods created (versions 1 and 2), pediatricians’ and caregivers’ scores using versions 1 and 2 were related to the cure period. These scores predict whether the infant needed medical treatment. We then selected version 2 based on the medical professionals’ opinions. The scores of caregivers of infants requiring medical treatment were higher than those of caregivers of infants not requiring treatment (p < 0.001). The intraclass correlation coefficient (ICC) of intra-examiner reliability was 0.87. The ICC of inter-rater reliabilities between pediatricians’ and caregivers’ scores and between nurses’ and caregivers’ scores were 0.66, and 0.66, respectively. Conclusions The proposed IFSAT may be used to assess whether infants need medical treatment and whether to extend the cure period. The tool’s reliability and validity were confirmed.

This study aims to understand the prevalence and factors associated with diaper dermatitis in infants to contribute to disseminating to nurses the characteristics of infants predisposed to developing diaper dermatitis through a research review. Methods A search was conducted using the Ichushi Web, version 5, of the Japan Medical Abstracts Society and MEDLINE databases from search engine PubMed using the following combinations of key words: infant and diaper rash. Two authors reviewed the articles based on the inclusion and exclusion criteria. Results were limited to original articles in Japanese and English within the past 30 years up to May 27, 2019. Statistically significant factors associated with the development and prevention of diaper dermatitis were extracted from the selected articles. Results Thirteen articles were selected. The point prevalence of diaper dermatitis ranged between 11.5 and 70.6%, while its period prevalence was between 15.2 and 90.6%, both showing a wide range. The definition of diaper dermatitis included whether diaper dermatitis was present and the evaluation of its degree of severity was performed. Diaper dermatitis was identified by the evaluator when certain symptoms were present or a case of dermatitis was clear, regardless of the type of symptoms and their severity (as well as without defining symptoms). Factors associated with the development and prevention of diaper dermatitis were attributed to infants, skin condition, digestive condition, health condition, nutrition method, skin care method, and childcare environment. Many risk factors were associated with infants' digestive or skin conditions, and a few studies focused on skin care, such as apply products as preventives. Conclusion Further studies are needed to standardize the methods for evaluating diaper dermatitis because of the wide range of prevalence caused by disagreements in methods of symptom evaluation. Few studies have indicated the relationship between diaper dermatitis and skin care methods used at home, and further research is required in this regard.

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 logrank 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.