Exam 5 - Diaper Dermatitis + Prickly Heat Flashcards
ABCDE’s of Diaper Dermatitis: Allow diaper to air dry and for the child to have diaper free time when possible
Air (A)
ABCDE’s of Diaper Dermatitis: Use skin protectants liberally in the diaper area
Barrier (B)
ABCDE’s of Diaper Dermatitis: Use soft cloth/warm water/baby wipe when stool is present
Cleansing (C)
ABCDE’s of Diaper Dermatitis: Change diaper frequently even when not fully soiled
Diaper (D)
ABCDE’s of Diaper Dermatitis: Counsel child’s caregivers on good practices of diaper hygiene
Education (E)
How frequently should a diaper be changed if not fully soiled?
Approximately every 2 hours or 6 times per day
True or False: It is okay to use the unsoiled portion of a diaper to clean/wipe the skin
False
What should be used for cleansing?
Fragrance free, sensitive skin wipes
What is the most common dermatologic disorder in infancy?
Diaper Dermatitis
True or False: Diaper dermatitis is an infectious condition
False
What is the most effective way to prevent diaper dermatitis?
Frequently changing diapers
True or False: Diaper dermatitis can be treated with OTC hydrocortisone in children under 2 years of age.
False (hydrocortisone is not recommended in children under 2 and should not applied in the diaper area without supervision of a provider)
Non-specific term used in several disorders (generally characterized by erythema and inflammation)
Dermatitis
A group of inflammatory skin disorders (example: atopic dermatitis)
Eczema
Redness
Erythema
Edematous
Swollen with excessive fluid accumulation
Small, solid, inflammatory elevation of the skin that does NOT contain puss
Papules
Itching
Pruritis
Xerosis
Dry Skin
Continual, widespread scaling of the skin
Ichthyosis
Blocking or covering an area
Occlusion
Which condition can be caused by contact or allergic dermatitis and presents with acute inflammation of the skin?
Diaper Dermatitis
What age group experiences diaper dermatitis most frequently and how early can it occur after birth?
-Mostly 2 years and younger
-Can occur as early as 7 days after birth
Infant’s perineal region is only about how thick compared to adults?
1/2 to 1/3 of the thickness (? just now its thinner and more subject to moisture and wetness)
Newborns need a diaper change every..
2 hours
Older infants increase diaper changing intervals to every..
3-4 hours
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
Breastfed
**What is the primary difference between diaper dermatitis and allergic contact dermatitis?
Diaper dermatitis only manifests in the diaper region avoiding skin folds
What is the clinical presentation of diaper dermatitis?
-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
If diaper dermatitis is not treated properly, it can predispose the infant to…
Secondary infections
What makes diaper dermatitis difficult?
-Manifestation of other condition
-Infants born to immunocompromised mothers
-Primary infections of skin may appear like diaper dermatitis
When to refer diaper dermatitis?
-Inguinal swelling
-Fever
-Chills
-Tachycardia
-Blisters/vesicles
-Irregular borders surrounded by bumps
Non-pharmacological goals of diaper rash
-reduce occlusion
-reduce contact time with feces/urine
-reduce mechanical irritation/trauma
-protect skin from further irritation
-encourage healing
-prevent secondary infection
Pharmacologic goals of diaper rash
-protect skin from further contact with feces/urine
-soothe discomfort
-encourage healing
-prevent secondary infection
-Physical barrier between skin and irritants
-Absorbs moisture OR prevent moisture from coming into contact with skin
-Should be applied with EACH diaper change
Skin Protectants
By law, which OTC products cannot claim to treat diaper dermatitis?
-antimicrobials
-topical analgesics
-antifungals
Commonly used for diaper dermatitis, must be removed with soap
Zinc oxide (Destin) —> another option called L-2-3 Paste
What is the most commonly seen brand name of Petrolatum (used for diaper dermatitis)?
Vaseline
*** Which products are powders that are not recommended for diaper dermatitis due to risk of cancer and risk of inhalation leading to breathing problems
Cornstarch and Talc
Inhaled talc not containing asbestos
noncancerous (according to studies)
Inhaled talc containing asbestos
cancerous (according to study)
Contraindicated agents for diaper rash (DO NOT USE)
-OTC antibiotics
-OTC antifungals
-Topical analgesics and anesthetics
-HYDROCORTISONE!!!!!!!!!!!!!!!
What complementary therapies are recommended for diaper dermatitis?
None
What is prickly heat?
Transient inflammation of skin (very fine, pinpoint, raised usually, red rash)
Prickly heat occurs when..
sweat glands are partially clogged which leads to acute inflammation that feels like stinging, burning, or itching
What pharmacologic treatments should you use/avoid for prickly heat?
-AVOID ointments
-Use water-washable creams
-For burning or itching, utilize antipruritic agents or a colloidal oatmeal (Aveeno) bath
What is the first line treatment for prickly heat in children?
Colloidal oatmeal (Aveeno) bath
Exclusions for self treatment of both diaper dermatitis and prickly heat:
-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.)
