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PubMed1988

Amoxicillin and diaper dermatitis.

Multiple skin sites and the gastrointestinal tract of 57 infants with otitis media were cultured quantitatively for Candida albicans before and after antibiotic therapy. Ten days of systemic therapy with amoxicillin was associated with a twofold increase in the recovery of C. albicans from the rectum and skin. Infants who developed diaper dermatitis had a significant increase in the number of C. albicans organisms recovered from these sites. We conclude that the use of amoxicillin increases the risk for developing diaper dermatitis.

Administration, Oral↗

PubMed2001

The aetiology and management of irritant diaper dermatitis.

Irritant diaper dermatitis (IDD) is a common condition caused by the combination of wearing diapers, and incontinence of urine and faeces. The available evidence suggests that maceration of the stratum corneum by water increases susceptibility to frictional damage, and epidermal permeation of irritants. The most important irritants underlying IDD appear to be digestive enzymes persisting in faeces, particularly when these are activated by a high pH.

Administration, Topical↗

PubMedDate not supplied

Jacquet erosive diaper dermatitis after surgery for Hirschsprung disease.

We report a case of Jacquet erosive diaper dermatitis that occurred as a consequence of severe diarrhea following extensive colectomy and coloanal anastomosis for Hirschsprung disease. Perianal pseudoverrucous papules and nodules and granuloma gluteal infantum have also been seen following this kind of surgery. We propose that these three entities represent variants in a spectrum of skin lesions associated with severe diaper dermatitis.

Colectomy↗

PubMed1992

Microbiology of secondarily infected diaper dermatitis.

Specimens obtained from 67 infants with secondarily infected diaper dermatitis were cultured for aerobic and anaerobic bacteria. Bacteria growth was obtained in 58. Aerobic facultative bacteria or Candida sp. only were present in 28 patients (48%), anaerobic bacteria only in 11 (19%), and mixed anaerobic with aerobic, facultative, or yeast flora was present in 19 (33%). Ninety-one bacterial or fungal isolates were recovered (1.6 per specimen), 54 (0.9 per specimen) aerobic or facultative bacteria, 8 (0.1 per specimen) Candida sp., and 31 (0.6 per specimen) strict anaerobes. The predominant aerobic and facultative bacteria were Staphylococcus aureus (23 isolates), Streptococcus sp. (16), and Escherichia coli (6). The predominant anaerobes included Bacteroides sp. (12, including 9 Bacteroides fragilis group) and Peptostreptococcus sp. (11). Single bacterial isolates were recovered in 32 (55%) patients, 18 of which were S. aureus. Twenty-five beta-lactamase-producing bacteria were detected in 22 (51%) of the 43 tested patients. These included 16 S. aureus and 6 B. fragilis group. These data highlight the importance of anaerobic bacteria in the polymicrobial nature of secondarily infected diaper dermatitis.

Bacteria, Aerobic↗

PubMed2005

Clinical and mycological benefits of topical application of honey, olive oil and beeswax in diaper dermatitis.

Twelve infants suffering from diaper dermatitis were treated four times daily for 7 days with a mixture containing honey, olive oil and beeswax. The severity of erythema was evaluated on a five-point scale. Three infants had severe erythema and ulceration, four had moderate erythema, and five had moderate erythema with maceration. The initial mean lesion score of 2.91 +/- 0.79 declined significantly (p < 0.05) to 2.0 +/- 0.98 (day 3), 1.25 +/- 0.96 (day 5) and 0.66 +/- 0.98 (day 7). Candida albicans was isolated initially from four patients, but from only two patients after treatment. This topical treatment was safe and well-tolerated, and demonstrated clinical and mycological benefits in the treatment of diaper dermatitis.

Administration, Topical↗

PubMed1986

Etiologic factors in diaper dermatitis: the role of feces.

While the etiology of diaper dermatitis in infants is complex, it is generally believed to involve an interaction between skin and irritants in feces and urine. Proteases and lipases were identified as the major irritants in the feces of infants, and bile salts were found to potentiate the damage produced by the action of fecal enzymes on skin. Fecal enzymes also increased the permeability of skin, thereby increasing potential susceptibility to other irritants in the diaper environment.

Animals↗

PubMed2006

Comparison of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from diarrhea: a multicenter study.

BACKGROUND: Severity of irritant diaper dermatitis (IDD) from diarrhea varies from patient to patient depending on the nature of feces and the number of bowel movements. The purpose of the present study was to compare the effectiveness of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from acute diarrhea in children by measuring transepidermal water loss (TEWL). MATERIAL AND METHOD: Forty-six children with diarrhea were prospectively, block randomized, investigator-blinded to receive dexpanthenol and zinc oxide ointment on one side and ointment base on the other side. TEWL was measured before and on days 1, 3, and 7 of treatment together with the assessment of severity score. The efficacy of treatment was defined by complete clearance of the lesion. RESULTS: TEWL in the treated and control side was not different before the application of the topical medication. In the present study, the efficacy of 5% dexpanthenol and zinc oxide ointment on D3 was 39% (18from 46 patients) compared to 32% in the ointment base side. On D7, the efficacy of the treated side was 58.7% and the ointment base side was 56%. The patients who still had skin lesions were those who had prolonged diarrhea. On the treated side, the mean of TEWL was lower than the control side on DI (p = 0.18) and had significant improvement on D3 (p = 0. 002). At the end of the present study, TEWL on the treated side was less than TEWL of the control side but it did not have statistical significance (p = 0.07). There was no rash or sign of abnormality on the treated side at the end of D7. CONCLUSION: In the treatment of lDD from acute diarrhea, 5% dexpanthenol and zinc oxide ointment significantly decreased TEWL in the treated side more than the ointment base on day 3 but the severity score was not significantly different on days 1, 3 and 7.

Dermatologic Agents↗

PubMed1991

Cytomegalovirus diaper dermatitis.

Cytomegalovirus inclusions have been reported in perineal ulcers from immunosuppressed adults. The importance of this finding is unknown. We report the first pediatric case of cutaneous cytomegalovirus infection in an infant with congenital human immunodeficiency virus infection, presenting as a diaper dermatitis. Cytomegalovirus was cultured from the skin biopsy specimen, and characteristic inclusions were seen on hematoxylin-eosin-stained sections. Results of this biopsy specimen analysis prompted further investigation revealing disseminated cytomegalovirus infection, including retinitis. Aggressive pursuit of a pathogen in common conditions such as diaper dermatitis is strongly recommended in immunosuppressed pediatric patients.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[Treatment of diaper rash with Parfenac lipid ointment (bufexamac). A study by Austrian pediatricians].

447 children between 0 and 24 months with diaper dermatitis were treated by topical application of Parfenac-Fettsalbe (Bufexamac). This panel was selected out of 844 patients which were originally in the protocol. The Parfenac-Fettsalbe was well tolerated, 7 children presented local side effects. 62.71% of treated girls showed very good results, whereas 59.89% of boys showed this outcome. Good results were obtained in 24.35% of girls and 21.93% of boys. Very good (no efflorescences remaining) and good results (some remaining efflorescences) were thus found in more than 80% of patients treated: with respect to corticosteroid advoidance this can be regarded as an effective antiphlogistic medication for diaper dermatitis. Non responders might have been superinfected with microorganisms as candida and staphylococci. In addition, epidemiological considerations are reported in that study.

Bufexamac↗

PubMed1977

[Study of the role of Candida albicans infection in different infant conditions including a diaper rash (64 cases)].

The pathogenic role of Candida albicans has been determined by performing: skin scrapings, mouth swabs, faecal specimens and serology from 64 infants and very young children affected with different conditions including a napkin dermatitis, divided into 4 groups. 1) 7 patients affected with true or presumed candidiasis, 2) 53 patients with different manifestations of diaper dermatitis, 3) 3 patients with papulo-erosive dermatitis of the diaper area, 4) 1 congenital ichthosiform erythrodermia. Candida albicans is the only responsible agent of the granulomatous candidiasis, it is constant but appeared lately in acropathia enteropathica. It is one of the major agents of the trichophytoid dermatitis (2 cases out of 4 cases). Candida albicans has been recovered from the skin of 33 infants out of 53 patients affected with all types of napkin eruption (62 p. 100) and from faecal specimens of 43 patients (81 p. 100). Though Candida albicans has often been considered as an opportunistic organism, even in infants, this percentage is greatly higher than that of the normal infant that is about 4p. 100, and consequently has a real pathogenic value. Species of yeasts different from Candida albicans have been recovered from faecal specimens of 3 infants affected with papulo-erosive dermatitis of the napkin area: parapsilosis, macedoniensis, deformans which are not generally considered as pathogenic agents. Serology is positive only in 3 infants or young children affected with a real chronical candidosis: 1 granulomatous candidosis, 1 acropathia enteropathia, 1 erythrodermia, the faecal specimen of whom contained a great nomber of Candida albicans.

Candida albicans↗

PubMed1985

Hair zinc, scalp hair quantity, and diaper rash in normal infants.

Hair zinc concentration was determined by atomic absorption spectrophotometry in 308 normal newborn infants and 199 normal infants aged one to twelve months. Hair zinc concentration declined from 204 micrograms/gm at birth to 112 micrograms/gm at age eight months, and then rose to 144 micrograms/gm at age twelve months. Diaper rash was significantly associated with reduced hair zinc, and infants with the least hair had lower zinc levels than infants with the most hair. The data indicate that hair loss and diaper rash found in normal infants is significantly associated with a reduction in hair zinc concentration.

Diaper Rash↗

PubMed1978

Clinical and antimicrobial effects of haloprogin cream in diaper dermatitis.

Haloprogin cream was applied four times a day for one week over the diaper area of eight infants affected by diaper dermatitis. All patients experienced complete clearing. Candida albicans was isolated from seven patients prior to treatment but failed to grow in cultures obtained after completion of the treatment.

Candidiasis, Cutaneous↗

PubMed1978

Diaper area granuloma of the aged.

Nine women, aged 77 to 89 years, suffered from diaper dermatitis, and many granulomas were seen in the genital or gluteal region restricted to the lesion of dermatitis. Because these granulomas resembled granuloma gluteale infantum of Tappeiner and Pfleger, we propose to call this condition diaper area granuloma of the aged.

Aged↗

PubMed1984

[Caustic diaper dermatitis and encephalitis secondary to the application of talcum contaminated with hexachlorophene].

Five observations of infants with transcutaneous intoxication by 6,3 p. 100 hexachlorophene contaminated talcum powder are reported. The diaper dermatitis is particular because of its topography (red pants shape), of its sudden occurring, of its papyraceous aspect evoking caustic origin, and of its association with severe encephalopathy. The neurological signs start with epileptic fits leading rapidly to coma. Prognosis is serious leading either to death or to paraplegia. Enquiry on that epidemic shows that mortality raised up to 18 p. 100. The neurological signs with oedematous degeneration of myelin are characteristic of hexachlorophene toxicity. Plasma levels of toxics range up to 15,94 mg/ml i.e. 30 times more than the rates observed by Curley in a premature washed with a commercial solution containing 3 p. 100 hexachlorophene. During a toxic neurological syndrome, the existence of diaper dermatitis with red plants shape must lead to an aetiological diagnosis of the possibility of transcutaneous intoxication even if the product seems as harmless as talcum powder.

Animals↗

PubMedDate not supplied

[Dermatitis of the diaper area].

Diaper area dermatitis is one of the most frequent dermatosis in infants. Knowledge of clinics, but specially of the management of this entity is important, since references to this respect are not up-to-date in spite of the importance of this disease. Newborns adn infants present this condition, due to the fact that vesical and anal sphincters are still beyond control and because the diaper is one of the most important clothing articles in babies and often in preschool or schoolage children complaining of some related pathological condition.

Bacterial Infections↗

PubMed2001

Use of cyanoacrylate tissue adhesive under a diaper.

OBJECTIVE: To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet-trained) undergoing inguinal surgery. PATIENTS AND METHODS: A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet-trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive. RESULTS: The chart review identified 45 boys (mean age 15.3 months, range 1-26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow-up. CONCLUSION: Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.

Child↗

PubMedDate not supplied

Survival of cytomegalovirus in paper diapers and saliva.

We studied the survival of human cytomegalovirus inoculated experimentally into saliva and urine-soaked paper diapers. Infectious virus could be recovered from saliva maintained at room temperature or 37 degrees C for up to 2 hours after inoculation. Cytomegalovirus survived in paper diapers for periods as long as 48 hours, with the quantity of virus in urine remaining relatively constant for the initial 12 hours. These observations provide further support for the concept that fomites may have a role in the transmission of cytomegalovirus infections.

Adult↗

PubMed1992

Diaper area granuloma of incontinence.

Granulomas in the diaper area developed in four patients; two male infants following surgery for Hirschsprung's disease and two female children with urinary (and/or fecal) incontinence. The use of the term 'Diaper area granuloma of incontinence' is suggested to describe these lesions seen in the elderly, as well as in incontinent infants and children.

Buttocks↗