60 - Diaper dermatitis

Abstract

Diaper (napkin) dermatitis encompasses a broad set of conditions, although the most common form is irritant contact dermatitis. Irritant diaper dermatitis usually presents as erythema and mild scaling on the convex surfaces of the inner upper thigh, lower abdomen, and buttock areas, classically sparing the inguinal folds where the skin is not in contact with irritants. It usually presents as early as a few days after birth to as late as several years of age, whereas diaper use in older disabled and geriatric patients may be identical in pathogenesis and physical findings. Many other dermatoses such as psoriasis, seborrheic dermatitis, allergic contact dermatitis, acrodermatitis enteropathica, infections (Candida, Staphylococcus, and Streptococcus), and Langerhans cell histiocytosis can affect the diaper area and may need to be excluded. Prevalence and severity of infant and toddler diaper dermatitis varies greatly internationally, influenced by age of toilet-training, regional diaper care habits, frequency of diaper changes, time spent overnight without diaper changes, and prophylactic use of topical products.