Diaper dermatitis
Summary/Definition
Diaper dermatitis (DD) is a variety of inflammatory skin changes in the groin and/or buttocks (“under the diaper”) area. This condition is more common in children in the first year of life. Diaper dermatitis occurs when the skin comes into contact with moisture, or when the clothing or diaper rubs against the skin. Moisture builds up under the diaper, reducing the skin’s natural defenses. External irritants are added to the mix, eventually leading to the development of DD.
Symptoms
Diaper dermatitis (DD) begins in infants between 3 and 12 weeks of age, rather than immediately after birth, and is most common between 7 and 12 months of age. It is usually localized to areas adjacent to the diaper area: the abdomen, buttocks, groin, inner thighs and, less commonly, the deep folds of the groin. In the early stages, there is redness of the skin, and as symptoms worsen, small papules may appear, the skin begins to peel, and there may be mucus production. If symptoms spread to the deep groin folds, differential diagnosis with diaper rash, psoriasis, and candidiasis is necessary.
Diagnostics
Diagnosis is based on the detection of characteristic skin changes that develop in the genital area of diaper-wearing infants. During the examination, it is necessary to differentiate from other diseases that may occur in similar areas. To differentiate diaper dermatitis from candidiasis, a test for fungal infection (direct smear using the OHKZ method) may be performed.
Treatment and course of the disease
The treatment approach for diaper dermatitis varies depending on the severity of the symptoms. In most cases, low potency topical steroids are used. However, because the skin in the area affected by diaper dermatitis is more fragile than other areas, these low potency steroids are used only for a short period of time, usually 3 to 7 days. In the acute form of diaper dermatitis, when there is mucus production on the affected areas, water compresses may be used to speed up the drying of the skin. This is done by applying the compress briefly for 10-15 minutes. If there is no improvement despite all the above methods, a secondary infection caused by a bacterial or fungal agent may be suspected, in which case professional medical attention should be sought at a medical facility. Candidiasis can be treated with antifungal medications, while secondary infections caused by bacteria can be treated with topical antibiotics.
