DERM - Nappy Rash

Question 1

What is Nappy Rash?

Answer 1

Contact Dermatitis in the nappy area.

Question 2

Aetiology of Nappy Rash.

Answer 2

Friction between the skin and nappy and contact with urine and faeces in a dirty nappy.

Question 3

Epidemiology of Nappy Rash.

Answer 3

Commonest between 9 and 12 months of age.

Question 4

Risk Factors of Nappy Rash (6).

Answer 4

1. Delayed Changing.
2. Irritant Soap Products and Vigorous Cleaning.
3. Poorly Absorbent Nappies.
4. Diarrhoea.
5. Oral Antibiotics that Predispose to Candida Infection.
6. Pre-Term Infants.

Question 5

Differential Diagnoses of Nappy Rashes (5).

Answer 5

1. Irritant Dermatitis (Commonest).
2. Candida Dermatitis.
3. Seborrheic Dermatitis.
4. Psoriasis.
5. Atopic Eczema.

Question 6

Clinical Presentation of Nappy Rash.

Answer 6

1. Sore Red Inflamed Skin in Nappy Area.
2. Creases are Unaffected.
3. Severe - Erosions and Ulceration.

Question 7

How can Nappy Rash be differentiated from Candial Infection in the Nappy Area? (5)

Answer 7

1. Rash extends into creases.
2. Larger red macula’s.
3. Well Demarcated Scaly Border.
4. Circular pattern - similar to Ringworm.
5. Satellite Lesions : Similar Small Patches of Rash/Pustules Near Main Rash.

Question 8

Management of Nappy Rash.

Answer 8

1. Switch Nappy.
2. Quicker Changing.
3. Water/Alcohol-Free Cleaning.
4. Dry Nappy Area before Replacing.
5. Maximise Time Not Wearing Nappy.
6. Anti-Fungal Cream or Antibiotic.

Question 9

Complications of Nappy Rash (4).

Answer 9

1. Candida Infection.
2. Cellulitis.
3. Jacquet’s Erosive Diaper Dermatitis.
4. Perianal Pseudoverrucuous Papules and Nodules.