JACQUET'S (EROSIVE) DIAPER DERMATITIS

By Gary M. White, MD

Jacquet's diaper dermatitis Courtesy O. Dale Collins, MD


Jacquet's diaper dermatitis (JDD) seems to be a severe form of irritant dermatitis in the diaper area that results in erosions and ulcers. The patient is typically one who endures long periods of contact with a wet diaper. Nowadays cases in infants are most commonly associated with the use of reusable diapers, which are probably less absorbent than disposable diapers. Diarrhea may be a triggering factor.

Granuloma Gluteale Infantum (GGI) presents as asymptomatic cherry red nodules in the diaper area appearing in the setting of diaper dermatitis. Most patients with GGI have been on topical flourinated steroids.

A somewhat similar condition has been reported in elderly incontinent women with poor hygiene, e.g., the elderly and the mentally impaired. It has been called (perianal) pseudoverrucous papules.

Erosive papulonodular dermatosis has been used as a broad classification that encompasses granuloma gluteale, perianal pseudoverrucous papules and nodules, and Jacquet's erosive dermatitis.

Clinical

Punched out ulcers and erosions are seen in the diaper area. Some lesions may be nodular with an intact epidermal. Alternatively, the nodules may be eroded. In adults, vulvar or perianal pseudoverrucous papules and nodules may be seen.

Treatment

Keeping the area dry is key. No stool and no urine. Super absorbent diapers are key. See treatment in diaper dermatitis. Some have used the combination of hydrocortisone 1%, clotrimazole 1% and zinc oxide paste every 3 hours x 2 weeks.

In the case of GGI, stopping the topical steroid leads to slow resolution.

Additional Pictures

Courtesy O. Dale Collins, MD
Jacquet's dermatitis of the penis

References

J Family Community Med. 2010 May-Aug; 17(2): 107–109

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