Diaper Dermatitis

Question 1

What are some patient factors in diaper dermatitis that warrant referral to an MD?

Answer 1

Immunocompromised

Question 2

What are some red flags for diaper dermatitis?

Answer 2

Acute onset
Moderate-severe presentation (bleeding, skin erosion, etc.)
Systemic signs/symptoms (fever, nausea, vomiting)
Frequent/recurrent
Behaviour changes (sleep disruption)
Treatment resistant (fails to improve after 7 days or resolve in 14 days)

Question 3

What are some symptoms that are characterized by irritant dermatitis?

Answer 3

Rash on convex surfaces in direct contact with feces (buttocks, genitalia, upper thighs, lower abdomen)
Skin creases/folds are spared
Dusky red (purple on darker skin), shiny patches

Question 4

What are some symptoms typical of candidal dermatitis?

Answer 4

Rash in skin creases/folds and present for more than 3 days
Bright red or beefy red patches
Satellite papules and pustules
Painful, crying when changing, during urination or defecation

Question 5

What are some treatments for irritant dermatitis?

Answer 5

Non-pharmacological

Air, Barrier (Vaseline), Cleansing, Diaper, and Education

HC 1% BID for 7-14 days if the area is inflamed and it is irritating to patient

Question 6

What are some treatments for candidal dermatitis?

Answer 6

Non-pharmacological treatment (Air, Barrier (Vaseline), Cleansing, Diaper, and Education)

OTC antifungal BID X 7-14 days

HC 1% BID X 7-14 days (if inflammation and patient is bothered)