Diaper dermatitis

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Diaper dermatitis

  1. 1. Dr. Chandan N. Intern (2007 Regular batch), MIMS, Mandya
  2. 2.  Diaper dermatitis is a chemical irritant dermatitis secondary to urine and feces.
  3. 3.  Increased wetness of the diaper area.  Infrequent change of diaper.  Common after change of baby’s diet from breast milk to solid.
  4. 4.  Increased wetness by urine and faeces makes the skin more susceptible to damage by physical, chemical and enzymatic mechanisms.  Low pH of urine causes irritation of skin.  Enzymes like lipases and proteases in faeces get reactivated at low pH and causes irritation.  Furthermore they cause breach in stratum corneum and predisposes to secondary infections.
  5. 5.  Candida albicans infections is seen in most of the cases after 48-72 hours of chemical dermatitis.  Staphylococcus aureus, Escherichia coli, Proteus mirabilis etc., can also cause secondary infections.
  6. 6.  Commonly seen in the age group of 9-15 months, but can be seen as early as 2 months of age.  Buttocks, genitalia and upper thighs are involved which are in contact with wet diaper.  The depths of skin folds are spared.  Erythema in mild cases and vesicles, small erosions, papules, large ulcers in moderate to severe cases.
  7. 7.  KOH mount  VDRL  Skin biopsy
  8. 8.  Primary candidal infection  Bullous impetigo  Psoriasis  Congenital syphilis  Irritant contact dermatitis  Scabies  Intertrigo  Atopic dermatitis
  9. 9.  Using of cotton or super absorbable diapers  Frequent changing of diaper
  10. 10.  Mild topical corticosteroid with an antifungal.

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