Irritant diaper dermatitis

Last Updated: 2021-12-20

Author(s): Anzengruber, Navarini

Diaper candidiasis, thrush nappy dermatitis, nappy thrush nappy dermatitis.

Dermatitis triggered by the occlusion effect of nappies.

  • Type I: infants (up to 35% of infants develop nappy dermatitis)
  • Type II: in elderly persons in need of care
  • Cumulative irritative factors caused by nappy use
    • are causative
  • Moisture exposure is aggravated by urinary and faecal incontinence, diarrhoea, etc
  • The weeping erosions create a good environment for colonisation for Candida albicans. If intestinal candidiasis is present, the risk of secondary mycological infection is increased
  • Surfaced, weeping, partly confluent erosions, macerations, partly scaling. Vesicles and pustules may also be seen
  • In very rare cases, ulcers (Jaquet's ulcers) may develop
  • Satellite lesions are possible
  • Bacterial swab in case of suspicion of secondary bacterial colonisation
  • Mycology swab in case of suspicion of secondary bacterial colonisation
  • In rare cases: Mycology examination of the stool to exclude systemic candidiasis

Diaper area.

Secondary infections (bacterial and mycotic).

  • If there is no erosion, lipophilic pastes (pasta zinci) are recommended for skin care
  • Alternatively: lipophilic pastes/creams with olive oil
  • No nappies (as far as possible, if necessary only by the hour) or frequent changing (avoidance of ↑ moisture)
  • If nappies are used, they should contain a gel pad
  • Cleaning should only be done with clear water paper towels with olive oil
  • Keep the region dry!
  • Dry blowing!

 

  • If necessary, apply a thin layer of nystatin-zinc paste several times a day
  • NO fluorinated glucocorticoids!
  1. Berg RW, Buckingham KW, Stewart RL. Etiologic Factors in Diaper Dermatitis: The Role of Urine. Pediatric Dermatology 1986;3:102-6.
  2. Buckingham KW, Berg RW. Etiologic Factors in Diaper Dermatitis: The Role of Feces. Pediatric Dermatology 1986;3:107-12.
  3. Smith WJ, Jacob SE. The Role of Allergic Contact Dermatitis in Diaper Dermatitis. Pediatric Dermatology 2009;26:369-70.