Irritant diaper dermatitis
Last Updated: 2022-02-25
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
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!
- Berg RW, Buckingham KW, Stewart RL. Etiologic Factors in Diaper Dermatitis: The Role of Urine. Pediatric Dermatology 1986;3:102-6.
- Buckingham KW, Berg RW. Etiologic Factors in Diaper Dermatitis: The Role of Feces. Pediatric Dermatology 1986;3:107-12.
- Smith WJ, Jacob SE. The Role of Allergic Contact Dermatitis in Diaper Dermatitis. Pediatric Dermatology 2009;26:369-70.