Diaper rash

Children Upper respiratory illness, cough, irritability, nervousness, fatigue, disturbed sleep, diarrhea, loss of appetite, vomiting, otitis, diaper rash, headache, teething, malaise... 

Psoriatic diaper rash is the most common type of psoriasis in children under 2 years old. This usually affects inguinal folds and greater than 90% of psoriatic diaper rash cases may have involvement outside the diaper area. 

Although many factors contribute to the etiology of diaper rash, it is most likely the result of prolonged contact of the skin with urine and feces in the diaper. 

The primary goal in the treatment of diaper rash is prevention and is most often accomplished through frequent diaper changes. 

When a diaper rash is already present, repairing the damaged skin, relieving discomfort, and preventing infection are important factors to consider when developing an effective treatment regimen. 

Several thousand skin disorders are currently documented, and many patients will seek the assistance of a health care provider when a problem with their skin develops. Others will utilize methods of self-care to effectively treat their symptoms. Some skin problems, such as mild acne or diaper rash, may be successfully treated with over-the-counter medications and lifestyle modifications. However, if left untreated or treated inadequately, these seemingly simple disorders can worsen and require more advanced care. 

Diaper dermatitis, more commonly known as diaper rash, is a form of irritant contact dermatitis that affects the buttocks, upper thighs, lower abdomen, and genitalia of an estimated 7% to 35% of all infants.34,35 Onset of occurrence is usually between 3 weeks and 2 years of age, with the most cases reported between 9 and 12 months of age.36 More than 12 million adults who use diapers for incontinence also have an increased risk of developing diaper dermatitis.35... 

Erythema is the most common symptom presenting with diaper rash. The rash may begin as light to medium pink with poorly defined edges, but when further developed may become dark red and raised lesions with distinct edges. 

Most mild cases of diaper rash can be resolved with the use of nonpharmacologic therapies. Keeping the diaper area clean and dry by changing diapers as soon as practically possible is highly effective for treatment and prevention.34,35 Other nondrug options include 26,34... 

Protectants form an occlusive barrier between the skin and moisture from the diaper. Cream and ointment preparations are effective in providing a sufficient barrier in mild, irritant, non-infected diaper rashes. For more severe cases, a paste is the... 

Protectants are generally applied to the affected area after every diaper change and can be discontinued when the rash resolves. Other available protectants that can be used alone or in combination for the safe and effective treatment of diaper rash include white petrolatum, vitamins A and D, lanolin, and topical cornstarch. Many agents contain a combination of occlusive and protective agents such as Triple Paste and Calmoseptine . 

Diaper rashes lasting longer than 48 to 72 hours are at increased risk for the development of fungal infections. These complications are most frequently caused by Candida albicans and require treatment with a topical antifungal35,36 (Fig. 62-6). 

Nystatin, clotrimazole, and miconazole creams or ointments applied two to four times daily with diaper changes have all shown to be effective in the treatment of candidal diaper rash. Although some of these products are available over the counter, parents and caregivers should be advised to initiate... 

If conventional treatment fails, unresolved diaper rash can also lead to secondary bacterial infections. Staphylococcus aureus and streptococci are the most likely pathogens responsible for these infections and require treatment with systemic antibiotics.3 37 While topical protectants may be used as an adjunct in treatment, suspected bacterial infections should always be referred to a physician for accurate diagnosis and the selection of an appropriate antibacterial regimen.34 Figure 62-7 shows a useful algorithm for the effective treatment of diaper dermatitis. 

Most diaper rashes can be effectively treated in less than 1 week. If symptoms do not resolve or begin to worsen, advise caregivers to seek medical attention to determine the presence of secondary fungal or bacterial infections. In addition, provide educational information on proper diaper hygiene techniques in order to prevent the development of future diaper rashes. 

Identify the risk factors present that support the diagnosis of diaper rash. 

Provide patient education about diaper rash etiology, treatment, and prevention ... 

What is diaper rash and how does it develop What exacerbates diaper rash ... 

Amoxicillin- clavulanate 80-90 mg/kg per day in 2-3 doses (adult 875 mg twice daily) Nausea, vomiting, diarrhea, rash, diaper rash J) J) J)— More diarrhea than amoxicillin, Augmentin ES formulation preferred owing to lower daily clavulanate component... 

Cefdinir 14 mg/kg per day in 1-2 doses (adult 300 mg twice daily or 600 mg once daily) Diarrhea, rash, vomiting, diaper rash, yeast infections Preferred oral cephalosporin (good taste) separate from Al or Mg antacids and Fe supplements by 2 hours... 

Diaper rash products Build up moisture and chemical barrier... 

Diaper dermatitis (diaper rash) is an acute, inflammatory dermatitis of the buttocks, genitalia, and perineal region. The reaction is a type of contact dermatitis, as it results from direct fecal and moisture contact with the skin in an occlusive environment. 

Pharmaceutical powder is a mixture of finely divided drugs and/or chemicals in dry form. They are dispensed as bulk powders or divided powders. When the prescription is received for powders, first determine whether it is based upon one unit or upon a bulk formula to be subdivided into individual units. Bulk powders are provided as multiple doses in a container and the patient measures the dose as instructed at the time of administration. Some examples of bulk powders include Tolnaftate Powder USP and Nystatin Topical Powder USP as antifungals, and Desitin Powder for diaper rash. Divided powders are meant to be provided as single dose units in individually wrapped powder papers. Such single dose packets are stacked in a powder box, and the label... 

Alternative/Adjunctive treatment Psoriasis, seborrheic dermatitis, severe diaper rash, dishidrosis, nodular prurigo, chronic discoid lupus erythematosus, alopecia areata, lymphocytic infiltration of the skin, mycosis fungoides, and familial benign pemphigus of Hailey-Hailey. 

Uses Candidal diaper rash Action Combo antifungal Dose Pe >4 wk. Apply at each diaper change x 7d Caution [C, ] Contra None Disp Oint SE None EMS None OD Unlikely... 

I Contraindications Lesions of the eye, tuberculosis of skin, diaper rash, hypersensitivity to clioquinol or hydrocortisone or any other component of the formulation... 

Treatment of diaper rash in babies Desitin Zinc oxide Lanolin and petrolatum... 

Super slurper has wondrous properties, and it amazed people when it was first demonstrated. For some time no one seemed to know how to exploit its potential, then in 1968 chemists came up with the idea of incorporating polyacrylates into diapers, Here was a way to keep urine away from a baby s bottom and reduce diaper rash. The Japanese, always at the forefront of high-tech innovation, ate it up. Not literally, of course, but they could have — toxicity tests showed that the material was remarkably safe. By 1984 North Americans had also discovered the advantages of superabsorbent diapers, and the product rapidly dominated the market. Soon feminine hygiene products were also incorporating the new technology, as were adult incontinence products. 

Candida albicans, a yeast, and Trichomonas vagi-nalisis, a protozoa, can cause numerous health problems including vaginal infections, diaper rash, and thrush. The results below show that silver compositions of the present invention produced nearly a 100% kill of both organisms. The results show the utility of silver compositions of the present invention in a feminine hygiene product and in a diaper rash product. 

On further questioning, the parents stated that they thought the rash was just a diaper rash and had not noticed the redness around his eyes and mouth. They related that just a few days prior they had found hair on the child s bed but thought the hair loss was normal. 

---