Dermatitis and Diaper dermatitis

Question 1

what is dermatits

Answer 1

acute or chronic inflammation of skin correponding to the clinical patterns and history

Question 2

what is eczema?

Answer 2

boiling over - nonspecific term for many types of inflammtory skin conditions

Question 3

what are some types of dermatitus?

Answer 3

atopic, contact, diaper, seborrheic

Question 4

what are some other conditions that can resemble eczematous dermatitus?

TREAT THE CAUSE

Answer 4

immunodeficiencies

papulosquamous conditions - psoriasis, seborrhea

metabolic disease - fatty acid defincency

infections or infestations - scabies, candidiasis, herpes, tinea, staphylococcus aureus infections (impetigo)

neoplasms - cutaneous T cell lymphoa

photosensitivity

Question 5

what demogaphic is affected most by diaper dermtaitus?

Answer 5

infants more then 1 month old can happen earlier
elderly wearing diapers

Question 6

relationship between moisture and the diaper

Answer 6

it is a moist and humid environment
traps urine and feces

skin adn GI tract flora interact with skin and diaper

edma of the strtaum cornuem alters skin barrier

causes dermatitus:
- skin exposed to water for more then 24 hours is likely to have erosions following friction
- maceration promotes overgrowth of bacteria and yeast

Question 7

what are some risk factors for diaper dermatitis? (10)

Answer 7

1. moisture retention
2. friction and contact irritaion
3. urine and ammonia
   - ammoni ais a knonw skin irritant and can raise pH
   - ammonis doesn’t cause dermatituc however it can exacerbate it
4. Feces and alkaline pH
   - lipases and proteolytic enzymes present in feces
   - can cause conatct irritant dermatitis
   - can raise the skin pH (alkaline) - lose it’s barrier function
5. some food may increase the pH (high protein diets)

6.infants with atopic or seborheic dermatitis

7. incontinuenece - includes elderly
8. immobility
9. vigorous cleaning (esp with soaps or detergents)

Question 8

what drugs can induce diaper dermatitis?

Answer 8

lanolin
neomycin
parabens
penicillin
sulfonamides
topical antihistamines

Question 9

what should we avoud using in diaper region?

Answer 9

alcohol
benzocaine
camphor (seizures)
methyl salicylate

Question 10

what microorgaims are associted with Diaper rash?

Answer 10

candida albicans - fungal

staph aureus - bacterial

Question 11

talk about candida albicans infections

Answer 11

need anti-fungals to treat it

the most common cause (70-90% are due to it)

this microorganisms is presnt in 10-12% of babies that don’t have diaper rash

most commonly found in periphery of intense diaper rash

requires drug treament

Question 12

talk about staph aureas diaper rash

Answer 12

need anti-biotics to treat it

a frequent colonizer of dermatitic skin

occasionaly causes sever dermatitis inflammation with follicular pustules

requires drug treatment

Question 13

what is the clinical presenttation of diaper rash?

Answer 13

geogrpahical location - diaper area, not inginual folds unless candida

erythematous rash with shiny patches over conevx surfaces (may appear dusky purple on draker skin)

severe rashes may have vesciles and oozing widespread erosions