“Diaper rash,” a diagnostic anachronism

Abstract

T H F~ term rash is used all too frequently in a diagnostic sense, as though the diverse dermatoses that may affect the young child constituted a single, specific clinical entity. Treatment based on this meaningless, purely topographic diagnosis tends to defeat its purpose. A skin condition, no matter what its location, requires a specific differential diagnosis, so that optimal t reatment may be given. The present study proposes to illustrate this point on the basis of the response of 256 young children with candidal and noncandidal diaper dermatoses to medications containing specific anticandidal agents and to nonspecific medications. Four of the remedies used were evaluated by means of a double-blind study involving 98 patients. As a result of constant irritation and slight maceration engendered by wet diapers, the skin in that area becomes a fertile soil for a variety of dermatoses? Many of these are clinically characteristic. Ammoniacal dermatitis and candidiasis are seen with