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Diaper Rash

Diaper Rash is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Very common dermatologic disorder of infancy
  • Most common in 1st month of life and again at 12–24 mo
  • Incidence in adult incontinent patients is reported from 5.7% to more than 42% and appears to be strongly associated with age
  • Primary irritant/contact dermatitis:
    • Outer skin layers are broken down, leading to inflammation, impairment of normal skin microflora, and loss of protective barrier function.
    • Increased skin moisture encourages growth of microorganisms on the surface of the skin.
    • Secondary fungal or bacterial infection can cause more severe forms of diaper dermatitis.
  • Also known as irritant diaper dermatitis

Etiology

  • Irritants:
    • Moisture:
      • Prolonged overhydration owing to infrequent diaper changes, poorly absorbing diapers or cloth diapers, urinary or faecal incontinence in adults
    • Friction:
      • Diaper rubbing on skin or loose-fitting diaper
    • Chemicals:
      • Prolonged exposure to stool enzymes and urine
      • Scents or moisturizers in wipes or soap
      • Diaper material or adhesive used to hold diaper in place
  • Infection:
    • Candida albicans:
      • Isolated in up to 80% of infants
      • Overgrowth common after systemic antibiotic use
    • Bacterial
    • Often complication of other causes of dermatitis:
      • Staphylococcus aureus, Streptococcus, Escherichia coli are common; Peptostreptococcus and Bacteroides may also be encountered.
  • Seborrheic diaper dermatitis
  • Atopic diaper dermatitis (contact dermatitis)
  • Risk factors:
    • Oral thrush
    • Number of previous episodes of diaper rash
    • Duration of use of diapers
    • Diarrhea

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Citation

Rosen, Peter, et al., editors. "Diaper Rash." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash.
Diaper Rash. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash. Accessed April 26, 2019.
Diaper Rash. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash
Diaper Rash [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Diaper Rash ID - 307308 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -