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Diaper dermatitis. Value of vitamin A topically applied.

The role of vitamin A in preventing diaper dermatitis was evaluated in a double-blind, randomized, prospective study in which 114 newborns were enrolled over an 11-month period. Patients in Group A (58 infants) were treated with a cream that contained 1,000 IU/g of vitamin A, whereas patients in Group B (56 infants) were treated with a cream that had the same composition, but it did not contain vitamin A. Each participant returned once every 15 days for six follow-up visits.

Administration, Topical↗

A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis.

Irritant diaper dermatitis (IDD) is a form of contact dermatitis occurring in the diaper area as a consequence of disruption of the barrier function of the skin through prolonged contact with faeces and urine. Despite advances in diaper technology, it is a condition that still occurs regularly in young children. To combat this, barrier preparations can be used to protect the skin by coating the surface of the skin and/or by supplying lipids that can penetrate the intercellular spaces of the stratum corneum. In this review, the pathophysiology of IDD is outlined and its prevention and treatment are discussed, with particular reference to the role of emollients.

Dermatitis, Irritant↗

Comparing cost per use of 3M Cavilon No Sting Barrier Film with zinc oxide oil in incontinent patients.

OBJECTIVE: This study compares the total cost of treatment, skin-condition management and prevention of skin breakdown of perianal/buttock skin in incontinent patients receiving 3M Cavilon No Sting Barrier Film (Cavilon NSBF) and zinc oxide oil. METHOD: This single-centre open-label prospective randomised study involved 40 patients with at least moderate skin damage resulting from incontinence. Patients were randomised to receive either zinc oxide oil or Cavilon NSBF and were treated for 14 days. The study products and other treatment-related products used were recorded, as was the time needed to cleanse the application site and apply the product. RESULTS: Use of both products resulted in an improvement in skin condition after 14 days, but this was significantly better with Cavilon NSBF than zinc oxide oil. Cavilon NSBF was more cost-effective as fewer applications were required, less time was spent applying the skin barrier product and faster healing rates were achieved. The cost-effectiveness ratio per treatment group showed an improvement of one point in the total score of the skin-assessment scale costs: 28.36 Euro for Cavilon NSBF versus 98.06 Euro for zinc oxide oil. CONCLUSION: Both products resulted in an improvement in skin condition after 14 days, but Cavilon NSBF was found to be more cost-effective. DECLARATION OF INTEREST: This study was supported by an educational grant from 3M.

Administration, Cutaneous↗

Topical corticosteroids for skin disorders in infants and children.

Topical corticosteroids are an essential part of the treatment regimen of children with atopic eczema and a number of other inflammatory dermatoses, such as infantile seborrhoeic eczema, pompholyx and contact dermatitis. A special form of treatment, the 'wet wrap technique, has been found to be effective in treating children with acute erythrodermic eczema in an inpatient setting. Therapy usually lasts for 3 to 5 days and is useful as crisis intervention therapy. On the other hand, in some conditions, for example pityriasis alba, perioral eczema or juvenile plantar dermatosis, therapy with these agents is generally not required or may not be useful. It is important to remember that care must be taken when a topical corticosteroid is prescribed in children, since this age group is particularly at risk of developing side effects. Thus, the patient should be monitored closely, and potent agents should be avoided.

Administration, Topical↗

Atopic dermatitis in the first six months of life.

1,476/2,320 of our cases of atopic dermatitis (AD) start in the first six months of life. The diagnosis is usually easy, but at this age it is sometimes more difficult, mainly because of lack of or rare evidence of scratching, but also because of the brief clinical history that does not allow observation of the characteristic chronic and relapsing course. Moreover, the major atopic disorders-asthma, rhinitis-usually appears later in the natural history of atopic subjects. From a differential diagnosis point of view, AD is the most definite dermatological disorder at this age. Other not well defined conditions occurring in the first six months of life are usually referred to as infantile seborrheic dermatitis, a name that has been used for at least four different disorders: cradle cap, cradle cap with involvement of inguinal, axillary and retroauricular folds, napkin psoriasis and Leiner's erythroderma. From a clinical point of view, AD in the first months of life is characterized by the prevalence of exudating lesions; moreover, the lack of or the rare evidence of scratching allows us to observe isolated vesicular lesions that are found with difficulty in the further course of the disease.

Dermatitis, Atopic↗

Management of tissue excoriation in older patients with urinary or faecal incontinence.

This article discusses good skin care in relation to the management of incontinence. It outlines the structure and functions of the skin and describes how the skin changes as we age. It examines how incontinence can damage the skin and provides an overview of the current management methods that are used to prevent tissue excoriation. It also suggests an effective alternative that could be used if previous strategies have failed and the skin begins to breakdown, that is, the use of a silver regimen.

Administration, Cutaneous↗

Prevention and management of infant skin breakdown.

There are anatomic and physiologic differences in the skin of both premature and full-term infants that place them at increased risk for skin injury and breakdown. This article reviews these differences and discusses some of the infant skin care practices that can cause injury to infant skin with preventive strategies identified. Care of skin breakdown is outlined, and topical treatments reviewed in detail. Diaper dermatitis is also discussed with treatment of the underlying causes as well as the goals of treating diaper dermatitis described.

Aging↗