A look into diaper dermatoses
DOI:
https://doi.org/10.29176/2590843X.1694Keywords:
Diaper Rash, Diaper Dermatitis, Diapers, InfantAbstract
Introduction: Diaper dermatoses are one of the most common reasons for consultation in the departments of pediatric dermatology and pediatrics. Its etiology is multifactorial.
Methods: Literature review. Results: Diaper dermatosis is classified into three subgroups
according to its etiology: skin conditions caused by the presence of the diaper; rashes exacerbated using the diaper; and eruptions that appear regardless of the use of a diaper.
Therefore, diaper dermatosis could be related to inflammatory, infectious, neoplastic, or metabolic diseases, among others. Its recognition is crucial to ameliorate the discomfort it causes in the children and the anxiety it causes in their parents. Its treatment depends on its cause and is based on adequate hygiene, the proper use of emollients, wet wipes and diapers, the avoidance of potential allergenic substances, as well as the treatment of the specific cause. Conclusion: Diaper dermatosis’ etiology is multifactorial; it mainly affects children, although adults suffer from it too. Its main cause in children is irritative contact dermatitis, which can be worsened when candida is also present.
References
1. Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018;35 Suppl 1:s19-s23.
2. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32(4):477-87.
3. Carr AN, DeWitt T, Cork MJ, Eichenfield LF, Folster-Holst R, Hohl D, et al. Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior. Pediatr Dermatol. 2020;37(1):130-6.
4. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014;31(1):1-7.
5. Burdall O, Willgress L, Goad N. Neonatal skin care: Developments in care to maintain neonatal barrier function and prevention of diaper dermatitis. Pediatr Dermatol. 2019;36(1):31-5.
6. Lebsing S, Chaiyarit J, Techasatian L. Diaper rashes can indicate systemic conditions other than diaper dermatitis. BMC Dermatol. 2020;20(1):7.
7. Folster-Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018;35 Suppl 1:s10-s8.
8. Van Gysel D. Infections and skin diseases mimicking diaper dermatitis. Int J Dermatol. 2016;55 Suppl 1:10-3.
9. Buckley BS, Mantaring JB, Dofitas RB, Lapitan MC, Monteagudo A. A New Scale for Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants: Development and Validation. Pediatr Dermatol. 2016;33(6):632-9.
10. Tuzun Y, Wolf R, Baglam S, Engin B. Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clin Dermatol. 2015;33(4):477-82.
11. Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014;61(2):367-82.
12. Sikic Pogacar M, Maver U, Marcun Varda N, Micetic-Turk D. Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol. 2018;57(3):265-75.
13. Hertis Petek T, Petek M, Petek T, Marcun Varda N. Emerging Links between Microbiome Composition and Skin Immunology in Diaper Dermatitis: A Narrative Review. Children (Basel). 2022;9(1).
14. Garcia Bartels N, Massoudy L, Scheufele R, Dietz E, Proquitte H, Wauer R, et al. Standardized diaper care regimen: a prospective, randomized pilot study on skin barrier function and epidermal IL-1alpha in newborns. Pediatr Dermatol. 2012;29(3):270-6.
15. Rippke F, Berardesca E, Weber TM. pH and Microbial Infections. Curr Probl Dermatol. 2018;54:87-94.
16. Zheng Y, Wang Q, Ma L, Chen Y, Gao Y, Zhang G, et al. Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Exp Dermatol. 2019;28(11):1289-97.
17. Kayaoglu S, Kivanc-Altunay I, Sarikaya S. Diaper Dermatitis in Infants Admitted to Social Pediatrics Health Center: Role of Socio-demographic Factors and Infant Care. Indian J Pediatr. 2015;82(10):904-8.
18. Ersoy-Evans S, Akinci H, Dogan S, Atakan N. Diaper Dermatitis: A Review of 63 Children. Pediatr Dermatol. 2016;33(3):332-6.
19. Celiksoy MH, Topal E, Haziroglu Okmen Z, Alatas C, Demirtas MS. Characteristics of persistent diaper dermatitis in children with food allergy. Pediatr Dermatol. 2019;36(5):602-6.
20. Sáez-de-Ocariz M, Orozco-Covarrubias L, Greenawalt-Rodríguez S. Abordaje clínico y manejo integral de la dermatitis irritativa por pañal. Acta pediátrica de México. 2017;38(6):427-32.
21. Coughlin CC, Eichenfield LF, Frieden IJ. Diaper dermatitis: clinical characteristics and differential diagnosis. Pediatr Dermatol. 2014;31 Suppl 1:19-24.
22. Harfmann K, Chen AY, Witman P. Bullous diaper dermatitis with cloth diaper use. Pediatr Dermatol. 2017;34(6):e309-e12.
23. Pérez-Elizondo AD, García-Hernández F, Pérez-Campos E. Sifiloide posterosivo de Sevestre-Jacquet y granuloma glúteo infantil: presentaciones inusuales y graves de una dermatitis irritativa del área del pañal. A propósito de tres casos. Revista argentina de dermatología. 2013;94(2).
24. Morales-Conde M, Feito-Rodríguez M, de Lucas-Laguna R. Dermatophytosis of the diaper area: Case report and literature review. Pediatr Dermatol. 2018;35(6):e368-e70.
25. Bonifaz A, Rojas R, Tirado-Sanchez A, Chavez-Lopez D, Mena C, Calderon L, et al. Superficial Mycoses Associated with Diaper Dermatitis. Mycopathologia. 2016;181(9-10):671-9.
26. Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Curr Opin Pediatr. 2012;24(4):472-9.
27. Wannanukul S, Chiabunkana J. Comparative study of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis. J Med Assoc Thai. 2004;87 Suppl 2:S68-71.
28. Cohen B. Differential Diagnosis of Diaper Dermatitis. Clin Pediatr (Phila). 2017;56(5_suppl):16S-22S.
29. Pefaur L, Buongermini A, Di Martino Ortiz B. Lactante con placas eccematosas en el área del pañal. Diagnóstico y comentario. Piel. 2016;31(1):46-7.
30. St Claire K, Bunney R, Ashack KA, Bain M, Braniecki M, Tsoukas MM. Langerhans cell histiocytosis: A great imitator. Clin Dermatol. 2020;38(2):223-34.
31. Bayers S, Shulman ST, Paller AS. Kawasaki disease: part I. Diagnosis, clinical features, and pathogenesis. J Am Acad Dermatol. 2013;69(4):501 e1-11; quiz 11-2.
32. Hebert AA. A new therapeutic horizon in diaper dermatitis: Novel agents with novel action. Int J Womens Dermatol. 2021;7(4):466-70.
33. Merrill L. Prevention, Treatment and Parent Education for Diaper Dermatitis. Nurs Womens Health. 2015;19(4):324-36; quiz 37.
34. Ness MJ, Davis DM, Carey WA. Neonatal skin care: a concise review. Int J Dermatol. 2013;52(1):14-22.
35. Blume-Peytavi U, Hauser M, Lunnemann L, Stamatas GN, Kottner J, Garcia Bartels N. Prevention of diaper dermatitis in infants--a literature review. Pediatr Dermatol. 2014;31(4):413-29.
36. Abels C, Angelova-Fischer I. Skin Care Products: Age-Appropriate Cosmetics. Curr Probl Dermatol. 2018;54:173-82.
37. Rueda López J, Guerrero Palmero A, Segovia Gómez T, Muñoz Bueno AM, Bermejo Martínez M, Rosell Moreno C. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida. Gerokomos. 2012;23(1):35-41.
38. Holroyd S, Graham K. Prevention and management of incontinence-associated dermatitis using a barrier cream. Br J Community Nurs. 2014;Suppl Wound Care:S32-8.
39. Sukhneewat C, Chaiyarit J, Techasatian L. Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months. BMC Dermatol. 2019;19(1):7.
40. Rodriguez KJ, Cunningham C, Foxenberg R, Hoffman D, Vongsa R. The science behind wet wipes for infant skin: Ingredient review, safety, and efficacy. Pediatr Dermatol. 2020;37(3):447-54.
41. Coughlin CC, Frieden IJ, Eichenfield LF. Clinical approaches to skin cleansing of the diaper area: practice and challenges. Pediatr Dermatol. 2014;31 Suppl 1:1-4.
42. Kazandjieva J, Gergovska M, Darlenski R. Contact dermatitis in a child from methlychloroisothiazolinone and methylisothiazolinone in moist wipes. Pediatr Dermatol. 2014;31(2):225-7.
43. Felter SP, Carr AN, Zhu T, Kirsch T, Niu G. Safety evaluation for ingredients used in baby care products: Consideration of diaper rash. Regul Toxicol Pharmacol. 2017;90:214-21.
44. Atherton DJ. Understanding irritant napkin dermatitis. Int J Dermatol. 2016;55 Suppl 1:7-9.
45. Odio M, Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatr Dermatol. 2014;31 Suppl 1:9-14.
46. Dey S, Kenneally D, Odio M, Hatzopoulos I. Modern diaper performance: construction, materials, and safety review. Int J Dermatol. 2016;55 Suppl 1:18-20.
47. Gustin J, Gibb R, Maltbie D, Roe D, Waimin Siu S. The impact of diaper design on mitigating known causes of diaper dermatitis. Pediatr Dermatol. 2018;35(6):792-5.
48. Gustin J, Bohman L, Ogle J, Fadayel G, Mitchell MC, Narendran V, et al. Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema. Pediatr Dermatol. 2021;38(4):768-74.
49. Gustin J, Bohman L, Ogle J, Chaudhary T, Li L, Fadayel G, et al. Use of an emollient-containing diaper and pH-buffered wipe regimen restores skin pH and reduces residual enzymatic activity. Pediatr Dermatol. 2020;37(4):626-31.
50. O'Connor RJ, Sanchez V, Wang Y, Gibb R, Nofziger DL, Bailey M, et al. Evaluation of the Impact of 2 Disposable Diapers in the "Natural" Diaper Category on Diapered Skin Condition. Clin Pediatr (Phila). 2019;58(7):806-15.
2. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32(4):477-87.
3. Carr AN, DeWitt T, Cork MJ, Eichenfield LF, Folster-Holst R, Hohl D, et al. Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior. Pediatr Dermatol. 2020;37(1):130-6.
4. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014;31(1):1-7.
5. Burdall O, Willgress L, Goad N. Neonatal skin care: Developments in care to maintain neonatal barrier function and prevention of diaper dermatitis. Pediatr Dermatol. 2019;36(1):31-5.
6. Lebsing S, Chaiyarit J, Techasatian L. Diaper rashes can indicate systemic conditions other than diaper dermatitis. BMC Dermatol. 2020;20(1):7.
7. Folster-Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018;35 Suppl 1:s10-s8.
8. Van Gysel D. Infections and skin diseases mimicking diaper dermatitis. Int J Dermatol. 2016;55 Suppl 1:10-3.
9. Buckley BS, Mantaring JB, Dofitas RB, Lapitan MC, Monteagudo A. A New Scale for Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants: Development and Validation. Pediatr Dermatol. 2016;33(6):632-9.
10. Tuzun Y, Wolf R, Baglam S, Engin B. Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clin Dermatol. 2015;33(4):477-82.
11. Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am. 2014;61(2):367-82.
12. Sikic Pogacar M, Maver U, Marcun Varda N, Micetic-Turk D. Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol. 2018;57(3):265-75.
13. Hertis Petek T, Petek M, Petek T, Marcun Varda N. Emerging Links between Microbiome Composition and Skin Immunology in Diaper Dermatitis: A Narrative Review. Children (Basel). 2022;9(1).
14. Garcia Bartels N, Massoudy L, Scheufele R, Dietz E, Proquitte H, Wauer R, et al. Standardized diaper care regimen: a prospective, randomized pilot study on skin barrier function and epidermal IL-1alpha in newborns. Pediatr Dermatol. 2012;29(3):270-6.
15. Rippke F, Berardesca E, Weber TM. pH and Microbial Infections. Curr Probl Dermatol. 2018;54:87-94.
16. Zheng Y, Wang Q, Ma L, Chen Y, Gao Y, Zhang G, et al. Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Exp Dermatol. 2019;28(11):1289-97.
17. Kayaoglu S, Kivanc-Altunay I, Sarikaya S. Diaper Dermatitis in Infants Admitted to Social Pediatrics Health Center: Role of Socio-demographic Factors and Infant Care. Indian J Pediatr. 2015;82(10):904-8.
18. Ersoy-Evans S, Akinci H, Dogan S, Atakan N. Diaper Dermatitis: A Review of 63 Children. Pediatr Dermatol. 2016;33(3):332-6.
19. Celiksoy MH, Topal E, Haziroglu Okmen Z, Alatas C, Demirtas MS. Characteristics of persistent diaper dermatitis in children with food allergy. Pediatr Dermatol. 2019;36(5):602-6.
20. Sáez-de-Ocariz M, Orozco-Covarrubias L, Greenawalt-Rodríguez S. Abordaje clínico y manejo integral de la dermatitis irritativa por pañal. Acta pediátrica de México. 2017;38(6):427-32.
21. Coughlin CC, Eichenfield LF, Frieden IJ. Diaper dermatitis: clinical characteristics and differential diagnosis. Pediatr Dermatol. 2014;31 Suppl 1:19-24.
22. Harfmann K, Chen AY, Witman P. Bullous diaper dermatitis with cloth diaper use. Pediatr Dermatol. 2017;34(6):e309-e12.
23. Pérez-Elizondo AD, García-Hernández F, Pérez-Campos E. Sifiloide posterosivo de Sevestre-Jacquet y granuloma glúteo infantil: presentaciones inusuales y graves de una dermatitis irritativa del área del pañal. A propósito de tres casos. Revista argentina de dermatología. 2013;94(2).
24. Morales-Conde M, Feito-Rodríguez M, de Lucas-Laguna R. Dermatophytosis of the diaper area: Case report and literature review. Pediatr Dermatol. 2018;35(6):e368-e70.
25. Bonifaz A, Rojas R, Tirado-Sanchez A, Chavez-Lopez D, Mena C, Calderon L, et al. Superficial Mycoses Associated with Diaper Dermatitis. Mycopathologia. 2016;181(9-10):671-9.
26. Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Curr Opin Pediatr. 2012;24(4):472-9.
27. Wannanukul S, Chiabunkana J. Comparative study of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis. J Med Assoc Thai. 2004;87 Suppl 2:S68-71.
28. Cohen B. Differential Diagnosis of Diaper Dermatitis. Clin Pediatr (Phila). 2017;56(5_suppl):16S-22S.
29. Pefaur L, Buongermini A, Di Martino Ortiz B. Lactante con placas eccematosas en el área del pañal. Diagnóstico y comentario. Piel. 2016;31(1):46-7.
30. St Claire K, Bunney R, Ashack KA, Bain M, Braniecki M, Tsoukas MM. Langerhans cell histiocytosis: A great imitator. Clin Dermatol. 2020;38(2):223-34.
31. Bayers S, Shulman ST, Paller AS. Kawasaki disease: part I. Diagnosis, clinical features, and pathogenesis. J Am Acad Dermatol. 2013;69(4):501 e1-11; quiz 11-2.
32. Hebert AA. A new therapeutic horizon in diaper dermatitis: Novel agents with novel action. Int J Womens Dermatol. 2021;7(4):466-70.
33. Merrill L. Prevention, Treatment and Parent Education for Diaper Dermatitis. Nurs Womens Health. 2015;19(4):324-36; quiz 37.
34. Ness MJ, Davis DM, Carey WA. Neonatal skin care: a concise review. Int J Dermatol. 2013;52(1):14-22.
35. Blume-Peytavi U, Hauser M, Lunnemann L, Stamatas GN, Kottner J, Garcia Bartels N. Prevention of diaper dermatitis in infants--a literature review. Pediatr Dermatol. 2014;31(4):413-29.
36. Abels C, Angelova-Fischer I. Skin Care Products: Age-Appropriate Cosmetics. Curr Probl Dermatol. 2018;54:173-82.
37. Rueda López J, Guerrero Palmero A, Segovia Gómez T, Muñoz Bueno AM, Bermejo Martínez M, Rosell Moreno C. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida. Gerokomos. 2012;23(1):35-41.
38. Holroyd S, Graham K. Prevention and management of incontinence-associated dermatitis using a barrier cream. Br J Community Nurs. 2014;Suppl Wound Care:S32-8.
39. Sukhneewat C, Chaiyarit J, Techasatian L. Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months. BMC Dermatol. 2019;19(1):7.
40. Rodriguez KJ, Cunningham C, Foxenberg R, Hoffman D, Vongsa R. The science behind wet wipes for infant skin: Ingredient review, safety, and efficacy. Pediatr Dermatol. 2020;37(3):447-54.
41. Coughlin CC, Frieden IJ, Eichenfield LF. Clinical approaches to skin cleansing of the diaper area: practice and challenges. Pediatr Dermatol. 2014;31 Suppl 1:1-4.
42. Kazandjieva J, Gergovska M, Darlenski R. Contact dermatitis in a child from methlychloroisothiazolinone and methylisothiazolinone in moist wipes. Pediatr Dermatol. 2014;31(2):225-7.
43. Felter SP, Carr AN, Zhu T, Kirsch T, Niu G. Safety evaluation for ingredients used in baby care products: Consideration of diaper rash. Regul Toxicol Pharmacol. 2017;90:214-21.
44. Atherton DJ. Understanding irritant napkin dermatitis. Int J Dermatol. 2016;55 Suppl 1:7-9.
45. Odio M, Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatr Dermatol. 2014;31 Suppl 1:9-14.
46. Dey S, Kenneally D, Odio M, Hatzopoulos I. Modern diaper performance: construction, materials, and safety review. Int J Dermatol. 2016;55 Suppl 1:18-20.
47. Gustin J, Gibb R, Maltbie D, Roe D, Waimin Siu S. The impact of diaper design on mitigating known causes of diaper dermatitis. Pediatr Dermatol. 2018;35(6):792-5.
48. Gustin J, Bohman L, Ogle J, Fadayel G, Mitchell MC, Narendran V, et al. Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema. Pediatr Dermatol. 2021;38(4):768-74.
49. Gustin J, Bohman L, Ogle J, Chaudhary T, Li L, Fadayel G, et al. Use of an emollient-containing diaper and pH-buffered wipe regimen restores skin pH and reduces residual enzymatic activity. Pediatr Dermatol. 2020;37(4):626-31.
50. O'Connor RJ, Sanchez V, Wang Y, Gibb R, Nofziger DL, Bailey M, et al. Evaluation of the Impact of 2 Disposable Diapers in the "Natural" Diaper Category on Diapered Skin Condition. Clin Pediatr (Phila). 2019;58(7):806-15.
How to Cite
1.
Guiot N, Verjel Diaz MF, Novoa M. A look into diaper dermatoses. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2022 Jun. 27 [cited 2024 Jul. 22];30(2):108-1. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1694
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How to Cite
1.
Guiot N, Verjel Diaz MF, Novoa M. A look into diaper dermatoses. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2022 Jun. 27 [cited 2024 Jul. 22];30(2):108-1. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1694
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