Diaper Rash Flashcards
What are some characteristics of diaper rash?
irritant contact dermatitis
skin folds are typically spared
self-limiting (episodes last 2-3 days)
What are the causes or risks for diaper rash?
fecal/urine contact (viral gastroenteritis releases harsh enzymes)
chemical residue
chafing
antibiotic use (diarrhea as the side effect)
formula more problematic than breast milk
daycares
What type of stool is most caustic of diaper rash?
type 7=entirely liquid
more watery is harsher on the diaper area
When do we have to worry about chemical residue causing diaper rash?
the baby wears cloth diapers
What are some other conditions to keep in your differential diagnosis when a parent says their kid has diaper rash?
eczema (often spares groin region, multiple locations)
seborrheic dermatitis (mostly in skin folds, yellow scales)
impetigo
How can you try prevent a diaper rash?
change diapers as soon as possible
keep area clean
barrier products
Why was talcum powder banned?
it was getting in the lungs of babies
probably fine for diaper rash, ppl just didnt use it right
What is it good way to know if diaper rash is infected?
<3 days: probably just diaper rash with no infection
>3 days: probably yeast infection (C.albicans)
What are some signs of yeast infected diaper rash?
fiery red
vesicles/satellites
skin folds now involved
How do we treat uninfected diaper rash?
keep clean
barrier cream
can use a steroid, not necessary
How do we treat yeast infected diaper rash?
keep clean
antifungal
barrier cream
can use a steroid, not necessary
What is infant oral thrush?
yeast infection of the mouth
What can you assume if a child has oral thrush as well as diaper rash?
assume the diaper rash is infected with yeast
What agents are used OTC to treat yeast infected diaper rash?
clotrimazole 1% (Canesten foot or vaginal)
miconazole 2% (Monistat vaginal or Micatin foot)
If we are out of clotrimazole foot-version, and we only have the vaginal version, which one should we go for in yeast infected diaper rash?
1% (6 day treatment)
-external vag cream, not the one with applicators
How long is an OTC treatment for yeast infected diaper rash?
apply miconazole 2% or clotrimazole 1% BID for 1 week and one week after clearing
Which agents can be prescribed for yeast infected diaper rash? Is a prescription necessary?
ketoconazole or ciclopirox
no need, the OTC azoles are just as good
Which steroid should you pick for diaper rash? How long will it be used?
0.5% or 1% hydrocortisone
2-3 days (the azole is used for 14 days, thus combo products are undesirable)
When should topical antifungals be considered for diaper rash?
skin irritation present for more than 3 days
If using multiple products for diaper rash, what is the order of application?
anti-fungal>hydrocortisone>barrier product
2-3 minutes between application
How many times and for how long do you apply steroids and barriers creams to uninfected diaper rash?
steroid: BID for 1-2 days
barrier cream: 4-5x per day everyday
steroid is optional
How many times and for how long do you apply steroids, antifungal, and barriers creams for infected diaper rash?
antifungal: BID for 14 days
steroid: BID for 1-2 days
barrier cream: 4-5x per day everyday
steroid is optional
True or false: hydrocortisone 1% does not require a prescription for a child younger than 2
false
What can pharmacists prescribe for diaper rash?
hydrocortisone 1% if younger than 2
ketoconazole 2% (BID x 14 days)
When do we refer for diaper rash?
rash fails to improve after 7 days or resolve after 14 days
