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PubMed1987

Clinical correlates with diaper dermatitis.

Three types of clinical studies were carried out to better understand diaper dermatitis in a general infant population. In 'snapshot' clinical studies, skin condition under the diaper was evaluated at a given point in time across a large base of infants. Correlations were sought between diaper dermatitis incidence and severity and a number of factors, including sex, diet, maturity, type of diaper, history of allergy, contact with fecal matter, presence of Candida albicans, and diaper change frequency. Severe diaper rash correlated strongly with the presence of C. albicans, and the frequency of rash correlated with duration of contact with feces and inversely with diaper change frequency. Diaper rash peaked at ages 9-12 months and was lower for breast-fed than for formula-fed infants. Exclusive use of disposable diapers correlated with lower rash levels than when some or all cloth diapers were used. In a longitudinal study, infants were observed daily for 50 days in order to determine the frequency and duration of rash episodes. In this study, the tendency for some infants to be rash-prone was clearly indicated. In a third type of study, over 10,000 infant visits to physicians' offices were used to record skin condition. Results showed a three-to fourfold increase in diaper rash if the child had diarrhea during the previous 48 h.

Candida albicans↗
PubMed2000

Continuous topical administration of a petrolatum formulation by a novel disposable diaper. 2. Effect on skin condition.

BACKGROUND: Diaper dermatitis is a common childhood affliction. Aiming to help reduce the prevalence of this problem, we have developed a novel diaper to deliver to the skin dermatological formulations intended to help protect the skin from overhydration and irritation. OBJECTIVE: To determine the clinical benefits of a novel disposable diaper designed to deliver a petrolatum-based formulation continuously to the skin during use. METHODS: Two independent, blinded, randomized clinical trials were conducted, involving an aggregate total of 391 children, 8-24 months of age. All comparisons were done versus a control diaper, identical to the test product except for the absence of the petrolatum formulation. The studies determined the effects of the novel diaper on skin erythema and diaper rash. RESULTS: Use of the formulation-treated diaper was associated with significant reductions in severity of erythema and diaper rash compared to the control product. CONCLUSIONS: The results demonstrated the clinical benefits associated with continuous topical administration of a petrolatum-based formulation by this novel diaper. We anticipate that this advance in diaper design will contribute significantly to further reduce the prevalence and severity of irritant contact dermatitis in the diaper area.

Administration, Topical↗
PubMedDate not supplied

[Infantile seborrheic dermatitis and related syndromes. Diagnostic and pathogenetic problems].

Infantile seborrhoeic dermatitis is a dermatosis affecting infants characterized by little or no itching and by completely typical skin symptoms, distribution and evolution. Infantile seborrhoeic dermatitis should therefore be differentiated from atopic dermatitis and from diaper-rash although interferences be possible. In fact the high frequency of the atopic dermatitis and of diaper rash may cause these two manifestations to sometimes superimpose on infantile seborrhoeic dermatitis. This in turn causes rather complex clinical situations that may be very hard, but not impossible to diagnose if use is made of laboratory findings to support clinical features. The pathogenesis and etiology of infantile seborrhoeic dermatitis are still debated although recent results assign the dominant role to Candida albicans. This mycete also plays a relevant role in the genesis of diaper rash and particularly of Leiner's exfoliative erythrodermas, which can be interpreted as a generalized and erythrodermic expression of infantile seborrhoeic dermatitis. Systematic cultural investigations and appropriate antimycotic treatments, that would stimulate antibody response, will allow to clarify in the near future this interesting etiological problem, with important therapeutical consequences.

Age Factors↗
PubMedDate not supplied

Childhood psoriasis: a clinical review of 1262 cases.

Our aim was to describe the types of psoriasis seen in a large series of patients presenting to a tertiary referral pediatric dermatology department using a classification system combining conventional terminology and additional categories based on the site and characteristics of the rash. A total of 1262 patients seen consecutively in the dermatology department of the Royal Alexandra Hospital for Children, Sydney, Australia, between 1981 and 1995 are described and classified according to the pattern of psoriasis at the time of presentation. Additional information recorded included family history, facial involvement, and history of a psoriatic type of diaper rash in infancy. The ages of the children ranged from 1 month to 15 years. There was an equal gender distribution and a high rate of positive family history at 71%. Twenty-six percent of children had a history of a psoriatic diaper rash and facial involvement occurred in 38% of children. Plaque psoriasis was the most common type overall, affecting 430 patients (34%). Three hundred forty-five children were less than 2 years of age, and this is the largest series of children with psoriasis in this age group presented to date. An entity defined by us as psoriatic diaper rash with dissemination was the most common type of psoriasis in the less than 2-year age group, affecting 155 (45%) patients. This large series offers information on the manifestations of psoriasis in childhood, but is particularly useful in examining the previously less well-described infant age group. The classification used is proposed as a practical way to describe psoriasis in children, particularly with respect to future descriptive studies.

Adolescent↗
PubMed2001

Skin benefits from continuous topical administration of a zinc oxide/petrolatum formulation by a novel disposable diaper.

BACKGROUND: Diaper dermatitis is a common childhood affliction. Aiming to help reduce the prevalence of this problem, we have advanced in our development of a novel diaper that delivers dermatological formulations to help protect the skin from over-hydration and irritation. OBJECTIVE: To determine the clinical benefits of a novel disposable diaper designed to deliver a zinc oxide and petrolatum-based formulation continuously to the skin during use. METHODS: All studies were independent, blinded, randomized clinical trials. Study A was conducted to confirm transfer of the zinc oxide/petrolatum (ZnO/Pet) formulation from the diaper to the child's skin during use. Children wore a single diaper for 3 h or multiple diapers for 24 h. After the use period, stratum corneum samples were taken from each child and analysed for ZnO/Pet. Study B evaluated the prevention of skin irritation and barrier damage from a standard skin irritant (SLS) in an adult arm model. Study C evaluated skin erythema and diaper rash in 268 infants over a 4-week usage period. One half of the infants used the ZnO/Pet diaper, while the other half used a control diaper that was identical except for the absence of the ZnO/Pet formulation. RESULTS: The ointment formulation and ZnO transferred effectively from the diaper to the child's skin during product use. Transfer of ZnO increased from 4.2 microg/cm2 at 3 h to > 8 microg/cm2 at 24 h. Exposure to the formulations directly on adult skin prior to an irritant challenge was associated with up to a 3.5 reduction in skin barrier damage and skin erythema. Greatest reductions were seen for the ZnO containing formulations. Wearing of the formulation treated diaper was also associated with a significant reduction in skin erythema and diaper rash compared to the control product. CONCLUSIONS: The results demonstrated the clinical benefits associated with continuous topical administration of a zinc oxide/petrolatum-based formulation by this novel diaper.

Administration, Topical↗
PubMed1996

Methemoglobinemia induced by an over-the-counter medication.

OBJECTIVE: To report a case of methemoglobinemia induced by benzocaine and resorcinol (Vagisil) cream, an over-the-counter medication that was used to treat diaper rash in a neonate. CASE REPORT: A 6-day-old, 3350-g white boy was found to be cyanotic with blue mucous membranes on presentation. He had a diaper rash that was red and irritated, which his mother had treated with Vagisil cream. Methemoglobinemia secondary to absorption of benzocaine and resorcinol (1,3-benzenediol) from the Vagisil was diagnosed, with a methemoglobin level of 35% on admission (normal 0.4-1.5). Intravenous methylene blue 3 mg (1 mg/kg) was given; the neonate's skin color returned to normal 45 minutes after the dose. DISCUSSION: Methemoglobinemia is a condition in which hemoglobin is oxidized to the ferric form. Oxidized hemoglobin, methemoglobin, is incapable of reversibly binding oxygen at the physiologic partial oxygen pressure. Main causes of methemoglobin formation are exposure to certain oxidizing agents and drugs, deficiency of one of the enzymes necessary for reduction of methemoglobin to hemoglobin, or the presence of an abnormal hemoglobin resistant to reduction. Clinical manifestations of methemoglobinemia include diffuse slate-gray cyanosis with low oxygen saturation in the absence of respiratory distress. A single intravenous dose of methylene blue 1-2 mg/kg is the treatment of choice. CONCLUSIONS: Newborn infants are at increased risk for methemoglobinemia due to diminished enzyme systems required to reduce ferrihemoglobin to ferrohemoglobin, as well as because fetal hemoglobin is more easily oxidized than is adult hemoglobin. It is important to recognize possible drug reactions and educate parents on the potential risks of treatment with over-the-counter medications, especially in neonates.

Adult↗
PubMedDate not supplied

Bad advice; bad burn: a new problem in burn prevention.

Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.

Burns↗
PubMed1981

Nappy rashes.

Explore the source record for details and available documents.

Diaper Rash↗
PubMed1992

Teaching child-care skills to mothers with developmental disabilities.

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.

Adult↗
PubMed2005

Diaper dye dermatitis.

Diaper dermatitis is a common problem in outpatient pediatric office settings. Although most diaper rashes represent a form of contact dermatitis in response to irritants in the diaper environment, other rashes may be the result of an allergen in the diaper. On the basis of clinical examination results for 5 patients and patch testing results for 2 patients, we suspect that the patients demonstrated allergic contact dermatitis in response to the various blue, pink, and green dyes in diapers. Although topically administered corticosteroids are useful in the treatment regimen, the preferred treatment for allergic contact dermatitis in the diaper area is the use of dye-free diapers for allergen avoidance. Patch testing may also be valuable in identifying the allergen, because allergen avoidance is the key to prevention of recurrent disease.

Allergens↗
PubMed2005

Reminder: radiopacities from metal-containing substances.

A 17-month-old boy with a toed-out left lower extremity was presented for evaluation. Before coming to the doctor, the mother had applied a zinc oxide lotion to treat a simple diaper rash in the groin. The radiologist did not remove the boy's diaper for the radiographic examination and so did not notice the lotion. The first radiograph showed what looked like multiple soft-tissue calcifications in the groin, but the radiopacities had been produced by the zinc oxide. This case serves as a reminder to be aware that metal-containing substances both on and in the body can produce radiopacities.

Administration, Cutaneous↗
PubMed1962

Ammoniacal dermatitis. Clinical observations on an efficacious, economical and neglected treatment.

Several pediatricians in one community began instructing mothers of infants with ammoniacal diaper rash to use o-benzyl-p-chlorophenol (OBPC) in laundering diapers. This simple, previously reported item of management was prescribed in 87 cases of ammoniacal rash. In almost all uncomplicated cases the rash cleared in an average of four days; when complicated by Staphylococcus aureus or Monilia albicans infection, clearing took a few days longer. The few cases of less than satisfactory results were attributable to improper use of the chemical. Several of the mothers had mild irritation of the hands from use of OBPC.

Candidiasis↗
PubMed1989

Comparison of disposable diapers with fluff absorbent and fluff plus absorbent polymers: effects on skin hydration, skin pH, and diaper dermatitis.

Diaper dermatitis results from the action of a number of physical and chemical factors on the skin. While its etiology is complex, there is agreement that prolonged contact between wet diapers and the skin leading to excessive hydration of the stratum corneum and reduced barrier function is a primary factor. Recent research also indicates that pH elevation resulting from ammonia production increases the probability of skin damage due to fecal enzyme activity. New diapers containing absorbent polymers blended with cellulose fluff in the absorbent core have been developed. The absorbent polymer binds fluids and controls pH in the diaper environment. To assess the effectiveness of these diapers, a clinical study was conducted with approximately 150 infants over 15 weeks, using fluff diapers and absorbent polymer diapers. The results clearly showed that the diapers with absorbent polymer provide a better skin environment than those with fluff only with respect to lower skin wetness and pH control (instrumental measurements). In addition, the clinicians' grades indicated a directional reduction in diaper rash severity.

Body Water↗
PubMedDate not supplied

Henna-induced hemolytic anemia and acute renal failure.

Henna is a traditional cosmetic agent and is used worldwide, especially in the Middle East. Its active agent is lawsone (2-hydroxy-1,4-naphthoquinone). Henna is not only applied to hands or hair as a cosmetic agent in traditional ceremonies, but is also applied to the body on lesions in the treatment of seborrheic dermatitis or fungal infections. However, its application over the body or in newborns is rare. Here we report a 27-day-old boy who developed hemolytic anemia and acute renal failure following topical application of henna to his abdomen, intertriginous region and legs to treat diaper rash.

Acute Kidney Injury↗
PubMed1978

Common skin problems in the pediatric office.

Skin diseases represent a major problem in everyday practice. This article discusses the most common dermatological entities as seen in the pediatrician's office with practical guidelines for their therapy. Acne, eczema, diaper rash, verruca vulgaris, impetigo and skin infestations are among those topics discussed.

Acne Vulgaris↗
PubMed1977

Urinary ammonia and ammonia-producing microorganisms in infants with and without diaper dermatitis.

Free ammonia was determined in diaper squeezings from 26 infants with "ammoniacal dermatitis" and in 82 controls. No significant difference was found (402 ppm in diaper dermatitis compared to 465 in controls). The groups did not differ with regard to the incidence of organisms capable of splitting ammonia from urea. Experimental application of highly ammoniacal urine on intact infant and adult skin failed to provoke a dermatitis. Erythema could be induced only when ammoniacal urine was applied occlusively to scarified skin. These findings do not support the notion that ammonia is a primary factor in common diaper rash, but do not exclude a possible role for further irritation in an already existent condition.

Ammonia↗
PubMed1954

The use of silicones in dermatology.

A cosmetically acceptable lotion containing a silicone protectant, a keratolytic, a bacteriocidal agent and antipruritic substances, was clinically tested in 208 persons with various dermatoses.Twenty-four-hour closed patch tests on humans and intradermal tests in laboratory animals indicate the lotion not to be a sensitizer. Subacute and chronic housewives' eczema and contact dermatitis of the hands, uncomplicated "diaper rash," periaural dermatitis due to excessive moisture, and certain hyperkeratotic dermatoses responded satisfactorily to the use of the lotion.

Animals↗
PubMed1978

Fournier's syndrome. Report of three cases and review of the literature.

Three children, aged 9 days, 3 weeks, and 9 1/2 months, were treated for Fournier's syndrome. The portals of entry for a miscellaneous group of pathogens included a circumcision in the first, a circumcision and a diaper rash in the second, and a hot water burn in the third. The development of the condition after a circumcision is noteworthy because it is an extremely common surgical procedure. Medical and minor surgical treatment of the gangrenous areas during the period of rapid healing was successful. This approach contrasts with those researchers who recommend grafts. All three children survived, although one died three years later of complications from the original burn, and in another, one testicle could not be palpated after healing.

Burns↗