Diaper Dermatitis: A Review of 63 Children

Ersoy‐Evans, Sibel; Akıncı, Hande; Doğan, Sibel; Atakan, Nilgün

doi:10.1111/pde.12860

Cited by 24 publications

(19 citation statements)

References 13 publications

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“…Escherichia coli , β‐hemolytic Streptococcus sp, and Bacteroides sp and yeasts Candida tropicalis, C parapsilosis, and C glabrata were associated with diaper dermatitis 19 . Candida infection incidence was 80% 19,20 . Infants with Candida infections have more frequent DD episodes than those without Candida 20 …”

Section: Introductionmentioning

confidence: 99%

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Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status

Visscher

Narendran

2020

Skin Research and Technology

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Background Infant diaper dermatitis (DD) is a prevalent condition due to multiple, interactive factors including increased skin hydration, irritant exposure, and increased skin pH. We examined diaper dermatitis vs within diaper and non‐diaper controls over time and characterized the association of skin color and texture relative to skin barrier integrity, hydration, and pH. Materials and Methods The prospective study included 46 infants with DD at well‐child visits. Skin integrity was evaluated over 15 days, including visual skin condition, rate of stratum corneum transepidermal water accumulation, hydration, pH, and skin color and texture from high‐resolution digital skin surface images. Effects by site and time were evaluated with general linear models. Results Six distinct texture patterns were observed. All three sites differed significantly for texture class frequency. Normal dermatoglyphics were more frequent for non‐diaper vs both within diaper and rash sites. Dermatoglyphics with marked furrows or lines (class 3) were common within diaper vs rash but not for non‐diaper vs within diaper. Streaks were highest for DD and lowest for non‐diaper. Flat regions were more frequent DD. Barrier integrity, that is, moisture accumulation rate, was lower for normal dermatoglyphics than streaks or flat texture. DD severity decreased over 15 days. Barrier properties of within diaper and non‐diaper areas were not well‐differentiated. Conclusion The incidence of streak texture in the within diaper high magnification images was high despite being visually normal. This finding suggests that it is an “early indicator” of skin damage and may be clinically useful for early detection and treatment.

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Section: Introductionmentioning

confidence: 99%

“…Candida infection incidence was 80% 19,20 . Infants with Candida infections have more frequent DD episodes than those without Candida 20 …”

Section: Introductionmentioning

confidence: 99%

Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status

Visscher

Narendran

2020

Skin Research and Technology

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“…Although ammonia from urine was initially thought to be a primary cause of irritant diaper dermatitis, recent studies have implicated feces as the principle culprit along with contributing factors such as chemical irritants, increased pH, superhydrated skin, and inherited defects in barrier function. [1][2][3][4] Courses of oral antibiotics, episodes of viral gastroenteritis, and other conditions associated with increasing stool volume and pH (eg, cystic fibrosis and other disorders associated with malabsorption/malnutrition or hepatitis) may trigger more severe irritant dermatitis (Table 1 and Figure 2). 4 In order to effectively treat irritant contact diaper dermatitis, it is important to determine the predisposing factors.…”

Section: Irritant Contact Dermatitismentioning

confidence: 99%

“…Other compounds such as zinc pyrithione, selenium sulfide, salicylic acid, and coal tar shampoos may also be effective. [1][2][3][4] Seborrheic dermatitis may be difficult to distinguish from psoriasis, which presents in a similar distribution with persistent red scaly plaques with well-defined borders. Psoriasis should be considered in infants and children with a recalcitrant eruption that persists beyond the first year of life, particularly when there is a family history of psoriasis (Figures 4 and 5).…”

Section: Seborrheic Dermatitis and Psoriasismentioning

confidence: 99%

“…

Different Types of Diaper DermatosesDiaper dermatitis broadly refers to skin disorders that occur in the diaper area.

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Differential Diagnosis of Diaper Dermatitis

Cohen

2017

Clin Pediatr (Phila)

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Mild diaper dermatitis often occurs in children before toilet training is complete, particularly from 9 to 12 months of age, and the most common presentation is an irritant contact dermatitis. Diaper dermatitis may account for up to 25% of dermatology visits to health care providers during the first year of life. Fortunately, since the introduction of hypoallergenic, superabsorbent modern disposable diapers, the incidence and severity of irritant and allergic contact dermatitis has decreased dramatically. Diaper dermatitis broadly refers to skin disorders that occur in the diaper area, such as skin eruptions triggered by diapers, rashes exacerbated by the diaper, and other events that occur in the diaper area. A number of skin conditions that can occur anywhere on the skin may present with distinctive findings in the diaper area. The following discussion will review the most common triggers of diaper dermatitis and contact irritant dermatitis, while focusing on the skin conditions that may be associated or overlap clinically with contact dermatitis. Keywords dermatitis, diaper dermatitis, diaper rash, erythema, skin disease, contact dermatitis, irritant contact dermatitis, allergic contact dermatitis, seborrheic dermatitis, infected contact dermatitis, bullous dermatoses, diaper candidiasis, newborn skin care, diapers, methylisothiazolinone, pediatrics

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Measurement instruments to evaluate diaper dermatitis in children: Systematic review of measurement properties

et al. 2023

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In a Thai Day care Center, only 17.2% of children (2-4 years of age) have a documented DD, although 55.45% had experienced DD (Suebsarakam et al., 2020). Hospitalized infants (2-8 months) showed a prevalence in the perianal area of >89% in Germany, >66% in the United States and >65% in China (Carr et al., 2020). In a random sample of British children from paediatric wards, outpatient clinics or neonatal units, 48% never had DD (Adalat et al., 2007).

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Diaper Dermatitis: A Review of 63 Children

Abstract: Most babies with DD were 0 to 6 months of age. Breastfed babies had fewer previous episodes of DD, so mothers should be encouraged to breastfeed their babies to reduce the incidence of DD. Candida infection was common; clinicians should be aware of its association with DD.

Cited by 24 publications

References 13 publications

Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status

Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status

Differential Diagnosis of Diaper Dermatitis

Measurement instruments to evaluate diaper dermatitis in children: Systematic review of measurement properties

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