Exam 5 - Diaper Dermatitis + Prickly Heat

Question 1

ABCDE’s of Diaper Dermatitis: Allow diaper to air dry and for the child to have diaper free time when possible

Answer 1

Air (A)

Question 2

ABCDE’s of Diaper Dermatitis: Use skin protectants liberally in the diaper area

Answer 2

Barrier (B)

Question 3

ABCDE’s of Diaper Dermatitis: Use soft cloth/warm water/baby wipe when stool is present

Answer 3

Cleansing (C)

Question 4

ABCDE’s of Diaper Dermatitis: Change diaper frequently even when not fully soiled

Answer 4

Diaper (D)

Question 5

ABCDE’s of Diaper Dermatitis: Counsel child’s caregivers on good practices of diaper hygiene

Answer 5

Education (E)

Question 6

How frequently should a diaper be changed if not fully soiled?

Answer 6

Approximately every 2 hours or 6 times per day

Question 7

True or False: It is okay to use the unsoiled portion of a diaper to clean/wipe the skin

Answer 7

False

Question 8

What should be used for cleansing?

Answer 8

Fragrance free, sensitive skin wipes

Question 9

What is the most common dermatologic disorder in infancy?

Answer 9

Diaper Dermatitis

Question 10

True or False: Diaper dermatitis is an infectious condition

Answer 10

False

Question 11

What is the most effective way to prevent diaper dermatitis?

Answer 11

Frequently changing diapers

Question 12

True or False: Diaper dermatitis can be treated with OTC hydrocortisone in children under 2 years of age.

Answer 12

False (hydrocortisone is not recommended in children under 2 and should not applied in the diaper area without supervision of a provider)

Question 13

Non-specific term used in several disorders (generally characterized by erythema and inflammation)

Answer 13

Dermatitis

Question 14

A group of inflammatory skin disorders (example: atopic dermatitis)

Answer 14

Eczema

Question 15

Redness

Answer 15

Erythema

Question 16

Edematous

Answer 16

Swollen with excessive fluid accumulation

Question 17

Small, solid, inflammatory elevation of the skin that does NOT contain puss

Answer 17

Papules

Question 18

Itching

Answer 18

Pruritis

Question 19

Xerosis

Answer 19

Dry Skin

Question 20

Continual, widespread scaling of the skin

Answer 20

Ichthyosis

Question 21

Blocking or covering an area

Answer 21

Occlusion

Question 22

Which condition can be caused by contact or allergic dermatitis and presents with acute inflammation of the skin?

Answer 22

Diaper Dermatitis

Question 23

What age group experiences diaper dermatitis most frequently and how early can it occur after birth?

Answer 23

-Mostly 2 years and younger
-Can occur as early as 7 days after birth

Question 24

Infant’s perineal region is only about how thick compared to adults?

Answer 24

1/2 to 1/3 of the thickness (? just now its thinner and more subject to moisture and wetness)

Question 25

Newborns need a diaper change every..

Answer 25

2 hours

Question 26

Older infants increase diaper changing intervals to every..

Answer 26

3-4 hours

Question 27

Breastfed vs Formula Fed: Which group seems to have a lower incidence of diaper rash and less copious, less alkaline, and less caustic to the skin

Answer 27

Breastfed

Question 28

**What is the primary difference between diaper dermatitis and allergic contact dermatitis?

Answer 28

Diaper dermatitis only manifests in the diaper region avoiding skin folds

Question 29

What is the clinical presentation of diaper dermatitis?

Answer 29

-Erythematous (bright red) -Sometimes shiny, wet-looking patches -Mainly in the area where diaper is -May spread to other areas -Full blown rash can appear in hours, but may take days to resolve completely

Question 30

If diaper dermatitis is not treated properly, it can predispose the infant to...

Answer 30

Secondary infections

Question 31

What makes diaper dermatitis difficult?

Answer 31

-Manifestation of other condition -Infants born to immunocompromised mothers -Primary infections of skin may appear like diaper dermatitis

Question 32

When to refer diaper dermatitis?

Answer 32

-Inguinal swelling -Fever -Chills -Tachycardia -Blisters/vesicles -Irregular borders surrounded by bumps

Question 33

Non-pharmacological goals of diaper rash

Answer 33

-reduce occlusion -reduce contact time with feces/urine -reduce mechanical irritation/trauma -protect skin from further irritation -encourage healing -prevent secondary infection

Question 34

Pharmacologic goals of diaper rash

Answer 34

-protect skin from further contact with feces/urine -soothe discomfort -encourage healing -prevent secondary infection

Question 35

-Physical barrier between skin and irritants -Absorbs moisture OR prevent moisture from coming into contact with skin -Should be applied with EACH diaper change

Answer 35

Skin Protectants

Question 36

By law, which OTC products cannot claim to treat diaper dermatitis?

Answer 36

-antimicrobials -topical analgesics -antifungals

Question 37

Commonly used for diaper dermatitis, must be removed with soap

Answer 37

Zinc oxide (Destin) ---> another option called L-2-3 Paste

Question 38

What is the most commonly seen brand name of Petrolatum (used for diaper dermatitis)?

Answer 38

Vaseline

Question 39

*** Which products are powders that are not recommended for diaper dermatitis due to risk of cancer and risk of inhalation leading to breathing problems

Answer 39

Cornstarch and Talc

Question 40

Inhaled talc not containing asbestos

Answer 40

noncancerous (according to studies)

Question 41

Inhaled talc containing asbestos

Answer 41

cancerous (according to study)

Question 42

Contraindicated agents for diaper rash (DO NOT USE)

Answer 42

-OTC antibiotics -OTC antifungals -Topical analgesics and anesthetics -HYDROCORTISONE!!!!!!!!!!!!!!!

Question 43

What complementary therapies are recommended for diaper dermatitis?

Answer 43

None

Question 44

What is prickly heat?

Answer 44

Transient inflammation of skin (very fine, pinpoint, raised usually, red rash)

Question 45

Prickly heat occurs when..

Answer 45

sweat glands are partially clogged which leads to acute inflammation that feels like stinging, burning, or itching

Question 46

What pharmacologic treatments should you use/avoid for prickly heat?

Answer 46

-AVOID ointments -Use water-washable creams -For burning or itching, utilize antipruritic agents or a colloidal oatmeal (Aveeno) bath

Question 47

What is the first line treatment for prickly heat in children?

Answer 47

Colloidal oatmeal (Aveeno) bath

Question 48

Exclusions for self treatment of both diaper dermatitis and prickly heat:

Answer 48

-lesions present longer than 7 days -presence of diaper dermatitis outside of diaper region -presence of broken skin -oozing, blood, vesicles, or pus at lesion sites -constitutional symptoms (fever, diarrhea, nausea, vomiting, swollen inguinal lymph notes, etc.)