Note the sparing of the folds.
DIAPER DERMATITIS
Diaper dermatitis (DD) is an irritant dermatitis from the stool and urine and is worsened by maceration and friction.
- DD occurs most commonly in infants younger than 12 months of age.
- Exclusive breastfeeding plays a role in the prevention of DD, so mothers should be encouraged to breastfeed their babies.
- Secondary infection is common, particularly with Candida, Staphylococcus and Streptococcus.
- Within the differential diagnosis is infection with tinea, candida, allergic contact dermatitis and Langerhans cell histiocytosis..
- It is often pragmatic to try a topical antifungal first in the setting of a diaper rash and it not helful, then add/switch to a topical steroid.
Clinical
The diaper area is red and edematous although the flexures are usually spared (in contrast to seborrheic dermatitis in diaper dermatitis. The rash may sharply end at the edge of the diaper. A bout of diarrhea may bring on or exacerbate the condition. Satellite red follicular papules and pustules indicated Candida infection.
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