Diaper dermatitis - Revision history

Rossdonaldson1 at 16:22, 11 December 2024

2024-12-11T16:22:17Z

← Older revision		Revision as of 16:22, 11 December 2024
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	==Background==		==Background==
	{{Skin anatomy background images}}		{{Skin anatomy background images}}
	~~[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]~~
	*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>		*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>
	*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier		*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier
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	==Clinical Features==		==Clinical Features==
			[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]
	*Erythematous, macular and/or papular [[rash]] with well demarcated borders		*Erythematous, macular and/or papular [[rash]] with well demarcated borders
	*More severe disease will also have skin maceration and erosions		*More severe disease will also have skin maceration and erosions

Rossdonaldson1: /* Background */

2024-12-11T16:21:13Z

Background

← Older revision		Revision as of 16:21, 11 December 2024
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	==Background==		==Background==
			{{Skin anatomy background images}}
	[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]		[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]
	*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>		*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>

Zbuchwald: /* Management */

2024-05-29T02:13:26Z

Management

← Older revision		Revision as of 02:13, 29 May 2024
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	**Powders (but caution due to risk of aspiration)		**Powders (but caution due to risk of aspiration)
	*[[Topical corticosteroids]] (if resistant to hygiene measures)<ref name="Shin" />		*[[Topical corticosteroids]] (if resistant to hygiene measures)<ref name="Shin" />
	**[[Hydrocortisone]] ~~cream~~ BID (for ~~no longer than~~ 2 weeks)		**[[Hydrocortisone]] 2.5% ointment BID over 2 weeks for mild cases
			**[[Triamcinolone]] 0.025% ointment BID over 2 weeks for moderate to severe cases <ref name="chop"> https://www.chop.edu/clinical-pathway/atopic-dermatitis-topical-steroid-treatment-recommendations</ref>
	**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)		**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)
	*Topical [[sucralfate]] may also be used<ref>Markham T, Kennedy F, Collins P. Topical sucralfate for erosive irritant diaper dermatitis. Arch Dermatol. 2000;136(10):1199-1200. doi:10.1001/archderm.136.10.1199</ref>		*Topical [[sucralfate]] may also be used<ref>Markham T, Kennedy F, Collins P. Topical sucralfate for erosive irritant diaper dermatitis. Arch Dermatol. 2000;136(10):1199-1200. doi:10.1001/archderm.136.10.1199</ref>

Elcatracho: /* Management */

2021-07-08T18:54:50Z

Management

← Older revision		Revision as of 18:54, 8 July 2021
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	*Hygiene		*Hygiene
	**Air drying		**Air drying
	**Cleansing regimen (gentle cleaning with water or soap)		**Cleansing regimen (gentle cleaning with water; avoid soap)
	**Superabsorbent gel diapers		**Superabsorbent gel diapers
	**Frequent changing		**Frequent changing

Elcatracho: /* Management */

2021-02-15T14:44:25Z

Management

← Older revision		Revision as of 14:44, 15 February 2021
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	**[[Hydrocortisone]] cream BID (for no longer than 2 weeks)		**[[Hydrocortisone]] cream BID (for no longer than 2 weeks)
	**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)		**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)
			*Topical [[sucralfate]] may also be used<ref>Markham T, Kennedy F, Collins P. Topical sucralfate for erosive irritant diaper dermatitis. Arch Dermatol. 2000;136(10):1199-1200. doi:10.1001/archderm.136.10.1199</ref>
	*[[Antifungal]] cream (if suspect candida dermatitis)<ref name="Shin" />		*[[Antifungal]] cream (if suspect candida dermatitis)<ref name="Shin" />
	**[[Nystatin]] cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)		**[[Nystatin]] cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)

Rossdonaldson1: /* Background */

2020-09-10T22:45:21Z

Background

← Older revision		Revision as of 22:45, 10 September 2020
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	==Background==		==Background==
			[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]
	*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>		*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>
	*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier		*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier
	*Breast-feeding associated with lower rates of severe diaper dermatitis<ref name="Shin" />		*Breast-feeding associated with lower rates of severe diaper dermatitis<ref name="Shin" />

	~~[[File:Contact diaper dermatitis.jpg\|thumb\|Contact [[diaper dermatitis]]]]~~		{{Dermatitis types}}

	==Clinical Features==		==Clinical Features==

ClaireLewis at 20:54, 27 September 2019

2019-09-27T20:54:54Z

← Older revision		Revision as of 20:54, 27 September 2019
Line 1:		Line 1:
	==Background==		==Background==
	*Irritant contact dermatitis - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>		*Irritant [[contact dermatitis]] - the most common skin disorder in infants<ref name="Shin">Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014 Apr;61(2):367-82.</ref>
	*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier		*Caused by presence of urine, feces, moisture, friction → breakdown of skin barrier
	*Breast-feeding associated with lower rates of severe diaper dermatitis<ref name="Shin" />		*Breast-feeding associated with lower rates of severe diaper dermatitis<ref name="Shin" />
Line 7:		Line 7:

	==Clinical Features==		==Clinical Features==
	*Erythematous, macular and/or papular rash with well demarcated borders		*Erythematous, macular and/or papular [[rash]] with well demarcated borders
	*More severe disease will also have skin maceration and erosions		*More severe disease will also have skin maceration and erosions
	*Candidal rash will include scaling around margins		*[[candida dermatitis\|Candidal rash]] will include scaling around margins
	**Classic finding is "satellite lesions" in other locations		**Classic finding is "satellite lesions" in other locations
	**Also examine for oral thrush		**Also examine for [[oral thrush]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Barrier creams (zinc oxide)		**Barrier creams (zinc oxide)
	**Powders (but caution due to risk of aspiration)		**Powders (but caution due to risk of aspiration)
	*Topical corticosteroids (if resistant to hygiene measures)<ref name="Shin" />		*[[Topical corticosteroids]] (if resistant to hygiene measures)<ref name="Shin" />
	**[[Hydrocortisone]] cream BID (for no longer than 2 weeks)		**[[Hydrocortisone]] cream BID (for no longer than 2 weeks)
	**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)		**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)
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	***Econazole 1% cream to affected area BID, continue for 3 days after resolution		***Econazole 1% cream to affected area BID, continue for 3 days after resolution
	*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />		*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />
	**Mupirocin, [[bacitracin]], polysporin, retapamulin		**[[Mupirocin]], [[bacitracin]], polysporin, retapamulin

	==Disposition==		==Disposition==

Jonwarren: /* Management */ Updated links

2018-12-31T20:12:53Z

Management: Updated links

← Older revision		Revision as of 20:12, 31 December 2018
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	*[[Antifungal]] cream (if suspect candida dermatitis)<ref name="Shin" />		*[[Antifungal]] cream (if suspect candida dermatitis)<ref name="Shin" />
	**[[Nystatin]] cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)		**[[Nystatin]] cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)
	**Other options include: clotrimazole, ketoconazole, miconazole, oxiconazole, econazole, sertaconazole		**Other options include: [[clotrimazole]], ketoconazole, [[miconazole]], oxiconazole, econazole, sertaconazole
	***Miconazole 0.25% cream to affected area with each diaper change x 7 days		***[[Miconazole]] 0.25% cream to affected area with each diaper change x 7 days
	***Econazole 1% cream to affected area BID, continue for 3 days after resolution		***Econazole 1% cream to affected area BID, continue for 3 days after resolution
	*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />		*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />

Rossdonaldson1: /* Management */

2016-09-19T04:00:25Z

Management

← Older revision		Revision as of 04:00, 19 September 2016
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	**Powders (but caution due to risk of aspiration)		**Powders (but caution due to risk of aspiration)
	*Topical corticosteroids (if resistant to hygiene measures)<ref name="Shin" />		*Topical corticosteroids (if resistant to hygiene measures)<ref name="Shin" />
	**Hydrocortisone cream BID (for no longer than 2 weeks)		**[[Hydrocortisone]] cream BID (for no longer than 2 weeks)
	**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)		**Absorption increased due to moisture and diaper (Cushing syndrome has been reported with overuse)
	*Antifungal cream (if suspect candida dermatitis)<ref name="Shin" />		*[[Antifungal]] cream (if suspect candida dermatitis)<ref name="Shin" />
	**Nystatin cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)		**[[Nystatin]] cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)
	**Other options include: clotrimazole, ketoconazole, miconazole, oxiconazole, econazole, sertaconazole		**Other options include: clotrimazole, ketoconazole, miconazole, oxiconazole, econazole, sertaconazole
	***Miconazole 0.25% cream to affected area with each diaper change x 7 days		***Miconazole 0.25% cream to affected area with each diaper change x 7 days

Bklee: /* Management */

2016-09-09T23:07:46Z

Management

← Older revision		Revision as of 23:07, 9 September 2016
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	**Nystatin cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)		**Nystatin cream 100,000 U/gram TID x10-14d (If using zinc oxide cream, apply after nystatin)
	**Other options include: clotrimazole, ketoconazole, miconazole, oxiconazole, econazole, sertaconazole		**Other options include: clotrimazole, ketoconazole, miconazole, oxiconazole, econazole, sertaconazole
			***Miconazole 0.25% cream to affected area with each diaper change x 7 days
			***Econazole 1% cream to affected area BID, continue for 3 days after resolution
	*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />		*Antibacterial therapy (if suspect bacterial infection)<ref name="Shin" />
	**Mupirocin, [[bacitracin]], polysporin, retapamulin		**Mupirocin, [[bacitracin]], polysporin, retapamulin