Nappy Rash

Question 1

What is it?

Answer 1

Inflammation of the skin in the nappy area
Due to overhydration from presence of urine and faeces causing maceration of the skin
Leads to irritation

Can get secondary infection

Question 2

What are the clinical features?

Answer 2

Well defined erythematous rash, oedema and dryness affecting the skin
Areas which are in contact with the nappy
May be papular changes
Typically sparing of the skin folds

Candida infection if
- well defined bright red patches
- presence of papules/pustules/satellite lesions

Question 3

What is the management?

Answer 3

Conservative
- high absorbency nappies, clean skin regularly and frequent nappy changes

Mild erythema but asymptomatic
- barrier cream at each nappy change

Evidence of inflammation or discomfort
- topical hydrocortisone 1% OD for 1 week

If evidence of candida or confirmed candida
- topical imidazole cream

Bacterial infection
- oral flucloxacillin