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At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Development of diaper rash in the newborn.

Diaper rash is a common infant malady. This study documents the earliest stages of rash in a cohort of 31 healthy term newborns over the first 28 days of life. The diaper area was evaluated using a standardized diaper rash grading scale. The anal, buttock, genital, intertriginous, waistband, and leg areas were assessed separately. At birth the average grade was 0.1 and none of the infants had specific features of advanced rash. Nineteen percent had dryness and/or slight redness. By day 7, 71% of infants had some features of skin compromise, giving rise to an overall grade of 0.6. Both the frequency and overall grade increased during postnatal weeks 2 and 3. Overall scores for days 21 and 28 were the same (1.1). The perianal area had the highest overall regional rash grade. Gender differences were present for the genital area only. These findings indicate that epidermal barrier breakdown is an uncommon finding at birth. Clinical signs of irritated skin in the diaper area develop progressively over the first postnatal month. A better understanding of the mechanisms conferring epidermal barrier protection at birth may be important for developing skin care products and practices to extend this protection later into life.

Diaper Rash↗
PubMed1986

Etiologic factors in diaper dermatitis: the role of urine.

Diaper dermatitis may result after repeated or prolonged contact of skin with urine and feces. A hairless mouse model was used to elucidate the role of urine in this process. The results of this work suggest that an important function of urine in the etiology of diaper dermatitis is to increase the pH of the diaper environment by breaking down urea in the presence of fecal urease. This rise in pH increases the activities of fecal proteases and lipases, which can damage skin. Urine can also increase the permeability of diapered skin to irritants and can directly irritate skin when exposure is prolonged.

Ammonia↗
PubMedDate not supplied

Diaper dermatitis that does not quit.

Diaper dermatitis is one of the most common skin disorders in infants. The humid, moist environment under the diaper makes the skin more susceptible to injury from exposure to irritants particularly related to urine and feces. A gentle cleansing routine, frequent diaper changes, and a thick barrier cream help control this condition. Irritant diaper dermatitis should be distinguished from other skin conditions that may develop in this sensitive area.

Administration, Topical↗
PubMed1999

Efficacy of topical application of eosin compared with zinc oxide paste and corticosteroid cream for diaper dermatitis.

BACKGROUND: Corticosteroids, zinc paste and eosin 2% are well-known topical agents for the treatment of moderate to severe diaper dermatitis. Among these treatments, the aqueous solution of eosin 2% is extensively used in several European countries, but not in the USA or Israel. OBJECTIVE: To assess the therapeutic efficacy of eosin 2% solution compared to the other treatment modalities for diaper dermatitis. METHODS: Fifty-four infants with diaper dermatitis, recruited from hospital wards and community clinics, were randomly assigned to three treatment groups: zinc oxide paste (containing allantoin 0.5%, cod liver oil 17% and zinc oxide 47epercnt;); clobetasone butyrate 0.05%, and aqueous solution of eosin 2%. The severity of the disorder was graded on a 6-point scale by observation and quantitative measurement of the lesions. The groups were compared for rates and time to heal. Due to the red color of eosin, a double-blind controlled study was impossible. RESULTS: Following 5 days of treatment, the rate of complete healing in the group treated with eosin (61%) was significantly higher (p = 0.0479) than that in the zinc oxide paste and corticosteroid groups (22 and 33%, respectively). Furthermore, in cases of partial healing, the degree of improvement was higher in the eosin group than the other two (p = 0.0205). The fastest improvement was observed in the group treated with corticosteroid cream. CONCLUSION: Considering the potential hazards of topical corticosteroids and the greater overall efficacy of eosin 2% solution, we suggest that eosin is the preferred treatment for diaper dermatitis.

Administration, Cutaneous↗
PubMed1987

Dermatophytosis of the diaper area.

Six cases of dermatophytosis of the diaper area due to either Epidermophyton floccosum or Trichophyton rubrum are described herein. The clinical and laboratory features of these patients and those reported in the literature are highlighted. Dermatophytosis should be considered in the differential diagnosis of rashes in the diaper area. Most standard remedies for diaper rash will not be effective or may exacerbate diaper dermatophytosis. Recognition of this condition by the clinician will lead to earlier rational treatment and may avoid the delay caused by therapy.

Clotrimazole↗
PubMed1987

Common conditions and factors associated with diaper dermatitis.

In 1983, a questionnaire study was carried out to ascertain the types and principal causes of diaper dermatitis. Questionnaires were sent to 3,942 nursery personnel, and 1,773 responses were received. Diaper dermatitis was classified into six types according to distribution of skin lesions: type I was rash on the whole area in contact with the diaper; type II, eruptions on pubis, external genitalia, and intergluteal folds; type III, peridiaper rashes; type IV, psoriasis-like dermatitis; type V, perianal noduli; and type VI, partial eruptions of infantile dermatitis. According to questionnaire responses, type II dermatitis was seen most frequently (73.6%), followed by type I and type III (17.3%), type V (4.5%), type IV (1.7%), and type VI (1.5%). Erythema blastomyceticum infantile (EBI) must be differentiated from diaper dermatitis. EBI is due to Candida infection. Topical steroids are assumed to be a promoting factor of EBI.

Clothing↗
PubMed1998

Diaper dermatitis in an adult. A case of erythema papuloerosive of Sevestre and Jacquet.

BACKGROUND: Irritants, friction and occlusion favor dermatitis or inflammatory reactions in the diaper area. Diaper dermatitis is not found exclusively in children but also in adults wearing a diaper for urinary incontinence. CASE: We report a case of eroded papules on the labia majora in a woman with urinary incontinence. CONCLUSION: Erythema papuloerosive of Sevestre and Jacquet is an unusual dermatitis due to irritant agents in the diaper area that may also affect adults. As this dermatitis may resemble neoplasia and venereal disease, it can be easily misdiagnosed, especially in adults.

Aged↗
PubMed1994

Evaluation of an office- and hospital-based intervention to increase the use of cloth diapers.

To evaluate an office-based educational intervention to promote the use of cloth diapers, we randomly assigned parents of 193 infants either to the intervention group or to a control group. The intervention consisted of physician advice and written material on cloth and disposable diapers at the 2-week office visit. Midway through the study, one of the birth hospitals switched to the exclusive use of cloth diapers. The results indicate that the diapering decisions of parents can be influenced by practices in hospitals and by office-based physician and nurse counseling.

Adult↗
PubMed1986

The effects of wearing diapers on skin.

Wearing dry and wet cloth and disposable diaper materials has certain effects on the degree of skin wetness. These, in turn, affect the coefficient of skin friction, the skin's susceptibility to abrasion damage, its permeability, and its support of microbial growth. These effects were explored using an adult model wearing forearm patches. The adult model was validated by comparisons of skin wetness and friction values for infants and adults determined under similar conditions. Skin wetness was proportional to diaper wetness. With increased skin wetness, there were increased coefficients of friction and increased abrasion damage, skin permeability, and microbial growth. Cloth diaper material produced wetter skin than did disposable diaper material at equivalent loadings.

Adult↗
PubMed1987

Diaper area skin microflora of normal children and children with atopic dermatitis.

In vitro studies established that neither cloth nor disposable diapers demonstrably contributed to the growth of Escherichia coli, Proteus vulgaris, Staphylococcus aureus, or Candida albicans when urine was present as a growth medium. In a clinical study of 166 children, the microbial skin flora of children with atopic dermatitis was compared with the flora of children with normal skin to determine the influence of diaper type. No biologically significant differences were detected between groups wearing disposable or cloth diapers in terms of frequency of isolation or log mean recovery of selected skin flora. Repeated isolation of S. aureus correlated with atopic dermatitis. The log mean recovery of S. aureus was higher in the atopic groups. The effects of each diaper type on skin microflora were equivalent in the normal and atopic populations.

Bacteria↗
PubMed2000

Prognostic factors for long-term maintenance of urinary continence in patients with incontinence managed by diapers or indwelling catheters.

OBJECTIVE: We examined the prognostic factors for longterm maintenance of continence following nonsurgical treatments in hospitalized patients with urinary incontinence. METHODS: 313 inpatients (average age: 64 years) in whom urinary incontinence had originally been managed with diapers (n = 158) or indwelling Foley catheters (n = 155) first received nonsurgical rehabilitative treatments. The patients who became continent with these treatments were then evaluated for being either continuously continent or recurrently incontinent during the 5-year follow-up period after discharge from hospital. A multivariate logistic regression analysis was then performed to determine significant risk factors for recurrent urinary incontinence. RESULTS: By initial treatments (mean duration: 144 days), 294 of the 313 patients (94%) were continent and free from diapers or catheters. After the 5-year follow-up period, urinary continence was maintained in 103 (66%) and 62 patients (45%) initially managed with diapers (n = 157) and catheters (n = 137), respectively. Multivariate logistic analysis revealed that in both patient groups, poor posttherapeutic activities of daily living or loss of home care service lowered the maintenance rate of continence. Dementia also lowered the maintenance rate in patients with catheters, but not in those with diapers. In addition, a long history of Foley catheter drainage for over 1 year prior to the initial treatment reduced the maintenance rate (highest odds ratio). CONCLUSIONS: Physical disability and poor therapeutic assistance at home are more prominent risk factors for long-term maintenance of urinary continence in elderly patients than problems within the urinary tract.

Aged↗
PubMed2002

Exposure assessment to dioxins from the use of tampons and diapers.

Over the past several years there has been concern over exposure to dioxins through the use of tampons and other sanitary products. This article describes attempts to estimate dioxin exposures from tampons and infant diapers; we then compare exposure estimates to dietary dioxin exposures. We analyzed four brands of tampons and four brands of infant diapers obtained from commercial establishments in San Francisco, California, for dioxin concentrations. We estimated exposures to dioxins on the basis of a screening level analysis that assumed all dioxins present were completely absorbed. We also estimated exposures by using a more refined analysis that incorporates partition coefficients to estimate bioavailability. None of the products contained 2,3,7,8-tetrachlorodibenzo-p-dioxin, the most potent dioxin, although other dioxins were present at detectable concentrations in all samples. We observed minimal differences in the concentrations of dioxins between 100% cotton and cotton/pulp products. The refined exposure analysis indicates that exposures to dioxins from tampons are approximately 13,000-240,000 times less than dietary exposures. The refined exposure analysis showed that exposure to dioxins from the diet is more than 30,000-2,200,000 times the exposure through diapers in nursing infants. Although dioxins are found in trace amounts in both cotton and pulp sanitary products, exposure to dioxins through tampons and diapers does not significantly contribute to dioxin exposures in the United States.

Adult↗
PubMed1993

The effects of diaper brands, urine volume, and time on specific gravity measurement.

Nurses use urine specific gravity to assess fluid volume status in pediatric patients. Specific gravity of five leading brands of disposable diapers was measured to determine the effects of diaper brand, urine volume, time elapsed, and method of specific gravity measurement comparing the two methods of refractometry and N-Multistix SG (Ames Division, Miles Inc., Elkhart, IN). Immediately after a baby voided 20 mL of urine into any disposable diaper, the specific gravity by refractometer accurately compared with the control standard. Measurement accuracy by N-Multistix SG was only assured if Pampers (Procter & Gamble, Cincinnati, OH) were used. However, both methods were inaccurate at 4 hours with 20 mL of urine. Immediately after a baby voided 40 mL of urine into any disposable diaper, both methods were accurate when compared with the control. At 4 hours, only Pampers and Chux (Procter & Gamble, Cincinnati, OH) were accurate by refractometry, and Pampers alone was accurate by N-Multistix SG.

Humans↗
PubMed2003

Disposable diapers: a hygienic alternative.

The use of disposable diapers has offered improved health care benefits. Urine and fecal matter leakage from the cloth nappies and the hand-to-mouth behavior in infants leads to many illnesses with a feco-oral mode of transmission. Also, the tender skin of the infant is more prone to nappy rash. The modern age disposable diapers, when compared to cloth nappy, have displayed a superior ability in containment of urine and feces, thereby reducing contamination and transmission of infection. Also disposable diapers contain Super Absorbent Material (SAM) that successfully reduces the incidence of nappy rash.

Diaper Rash↗
PubMed2006

Can they or can they not? Nurses' ability to quantify stool in superabsorbent diapers.

Estimates of stool output in diapers is not an appropriate guideline to use in determining fluid loss through stool. This study was conducted to determine the accuracy of the ability of the nurses (RNs) and patient care technicians (PCTs) to quantify stool volume in diapers. Size 3 diapers, baby food (green peas), and water were used to simulate combinations of stool and urine and differing degrees of water loss in stool. The results indicated that RNs' and PCTs' assessments of stool volume became less accurate as water loss increased. There were no differences in estimation accuracy between RN and PCTs, and years of experience for RNs or PCTs did not influence accuracy of estimation. It is important to use a holistic approach for determining hydration status in patients, particularly knowledge of signs and symptoms of dehydration.

Analysis of Variance↗
PubMedDate not supplied

Comparative and non-comparative studies of the efficacy and tolerance of tioconazole cream 1% versus another imidazole and/or placebo in neonates and infants with candidal diaper rash and/or impetigo.

Eleven open multicentre studies were conducted to evaluate the efficacy of tioconazole cream 1% as a treatment for diaper rash with or without fungal (Candida) involvement, or impetigo in neonates and infants. In the dermal candidiasis/diaper rash group, 320 patients had either tioconazole (n = 220), a comparative imidazole (n = 43), or vehicle cream (n = 57) applied to the affected area twice daily. Twenty-one impetigo patients had only tioconazole cream 1% applied three times daily to lesions. The overall cure rate (patients with both clinical and mycological cure) at the end of treatment for tioconazole treated patients was 78%, for the comparative imidazole group it was 76% and for vehicle cream it was 39%. At the long-term follow-up evaluation approximately 6 weeks after treatment for patients with diaper rash, the overall cure rate was about the same in both tioconazole- and comparative imidazole-treated patients (87% and 90%, respectively), and 14% in patients using vehicle cream. Side-effects were coincident with disease symptoms and consisted primarily of erythema localized to the treatment area; they occurred in 5.4% (13/241) of the patients who received tioconazole and in 21% (9/43) of the patients who received comparative imidazole (econazole or miconazole). No side-effects were reported in this open study for the 57 patients who used vehicle cream. The results of these studies show that tioconazole cream 1% is safe and effective for the treatment of neonates and infants with dermal candidiasis, diaper rash and impetigo.

Adolescent↗
PubMed2004

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↗
PubMedDate not supplied

A multicenter, open-label study to assess the safety and efficacy of ciclopirox topical suspension 0.77% in the treatment of diaper dermatitis due to Candida albicans.

Ciclopirox is a broad-spectrum antifungal, antibacterial, and anti-inflammatory agent. This open-label study investigated the safety and efficacy of ciclopirox topical suspension 0.77% in the treatment of diaper dermatitis due to Candida albicans (C. albicans). Forty-four male and female subjects aged 6 to 29 months were included in the study. Study medication was applied topically to the affected diaper area twice daily for 1 week. Subjects were clinically evaluated at baseline and days 3, 7, and 14 (7 days post-treatment). Safety and efficacy variables included adverse events, mycological culture studies, KOH tests, Severity Scores, and Global Evaluation of Clinical Response. All adverse events were mild to moderate and considered not related to the study medication. Treatment provided statistically significant improvement (P < .05) for both the rate of mycological cure and reduction of Severity Score at each time point compared with baseline. Ciclopirox was safe and effective in the treatment of diaper dermatitis due to C. albicans.

Administration, Topical↗