5-Minute Emergency Consult
Diaper Rash
Diaper Rash is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Very common dermatologic disorder of infancy
- Most common in first month of life and again at 9–12 mo
- May account for up to 25% of dermatology visits to health care providers during the first year of life
- 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 diaper dermatitis
Etiology
Etiology
- Irritants:
- Moisture:
- Prolonged overhydration owing to infrequent diaper changes, poorly absorbing diapers or cloth diapers, urinary or fecal 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 that are corrosive such as a strong acid or alkali
- Diaper material or adhesive used to hold diaper in place
- Moisture:
- 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
- Perianal streptococcal dermatitis
- Viral (HSV and enterovirus are the most common)
- Candida albicans:
- Seborrheic diaper dermatitis
- Psoriasis
- Allergic 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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Basics
Description
Description
- Very common dermatologic disorder of infancy
- Most common in first month of life and again at 9–12 mo
- May account for up to 25% of dermatology visits to health care providers during the first year of life
- 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 diaper dermatitis
Etiology
Etiology
- Irritants:
- Moisture:
- Prolonged overhydration owing to infrequent diaper changes, poorly absorbing diapers or cloth diapers, urinary or fecal 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 that are corrosive such as a strong acid or alkali
- Diaper material or adhesive used to hold diaper in place
- Moisture:
- 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
- Perianal streptococcal dermatitis
- Viral (HSV and enterovirus are the most common)
- Candida albicans:
- Seborrheic diaper dermatitis
- Psoriasis
- Allergic 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
Schaider, Jeffrey J., 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: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash. Accessed June 29, 2022.
Diaper Rash. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash
Diaper Rash [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2022 June 29]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307308/all/Diaper_Rash.
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