Diaper dermatitis: differential diagnosis and prevention issues
https://doi.org/10.21518/2079-701X-2021-1-14-19
Abstract
The skin of newborns and infants is characterized by structural and functional immaturity. Diaper dermatitis is one of the most common skin conditions in this age period. This condition has a complex and multifactorial etiology. The interaction of several causes, including high humidity under the diaper, skin maceration, and prolonged contact with irritants, leads to destruction of the immature epidermal barrier, microbial invasion, and inflammation. Diaper dermatitis should be differentiated from allergic contact dermatitis, candidiasis, atopic dermatitis, seborrheic dermatitis, psoriasis. Effective measures to prevent diaper dermatitis are to keep the skin dry, reduce friction, limit the time of contact with urine and feces, as well as the topical application of protective products. Today, of all the disposable diapers on the market, the high quality disposable diapers developed and produced by the Japanese company KAO Corporation are proven effective in preventing diaper dermatitis.
About the Authors
Irina N. Zakharova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Irina N. Zakharova, Dr. of Sci. (Med.), Professor, Head of the Department of Pediatrics named after Academician G.N. Speransky
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
Irina I. Pshenichnikova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Irina I. Pshenichnikova, Cand. of Sci. (Med.), Assistant Professor of the Department of Pediatrics
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
Tatiana M. Tvorogova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Tatiana M. Tvorogova, Cand. of Sci. (Med.), Associate Professor of the Department of Pediatrics
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
References
1. Blume‐Peytavi U., Kanti V. Prevention and treatment of diaper dermatitis. Pediatrc Dermatol. 2018;35(S1):19–23. doi: 10.1111/pde.13495.
2. Stamatas G.N., Nikolovski J., Luedtke M., Kollias N., Wiegand B.C. Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr Dermatol. 2010;27(2):125–131. doi: 10.1111/j.1525-1470.2009.00973.x.
3. Gorlanov I.A. (ed.). Pediatric dermatovenerology. Moscow; 2017. 512 p. (In Russ.).
4. Nikolovski J., Stamatas G.N., Kollias N., Wiegand B.C. Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life. J Invest Dermatol. 2008;128(7):1728–1736. doi: 10.1038/sj.jid.5701239.
5. Fluhr J.W., Darlenski R., Lachmann N., Baudouin C., Msika P., De Belilovsky C., Hachem J.P. Infant epidermal skin physiology: adaptation after birth. Br J Dermatol. 2012;166(3):483–490. doi: 10.1111/j.1365-2133.2011.10659.x.
6. Stamatas G.N., Nikolovski J., Mack M.C., Kollias N. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmet Sci. 2011;33(1):17–24. doi: 10.1111/j.1468-2494.2010.00611.x.
7. Chiou Y.B., Blume-Peytavi U. Stratum corneum maturation. Skin Pharmacol Physiol. 2004;17(2):57–66. doi: 10.1159/000076015.
8. Nakagawa N., Sakai S., Matsumoto M., Yamada K., Nagano M., Yuki T. et al. Relationship between NMF (lactate and potassium) content and the physical properties of the stratum corneum in healthy subjects. J Invest Dermatol. 2004;122(3):755–763. doi: 10.1111/j.0022-202X.2004.22317.x.
9. Zakharova I.N., Kasyanova A.N., Machneva E.B. Skin care in young children: innovative approaches. Meditsinskiy sovet = Medical Council. 2018;(2):42–51. (In Russ.) doi: 10.21518/2079-701X-2018-2-42-51.
10. Cork M.J., Danby S.G., Vasilopoulos Y., Hadgraft J., Lane M.E., Moustafa M. et al. Epidermal barrier dysfunction in atopic dermatitis. J Invest Dermatol. 2009;129(8):1892–1908. doi: 10.1038/jid.2009.133.
11. Hachem J.P., Crumrine D., Fluhr J., Brown B.E., Feingold K.R., Elias P.M. pH directly regulates epidermal permeability barrier homeostasis, and stratum corneum integrity/cohesion. J Invest Dermatol. 2003;121(2):345–353. doi: 10.1046/j.1523-1747.2003.12365.x.
12. Šikić Pogačar M., Maver U., Marčun Varda N., Mičetić-Turk D. Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol. 2018;57(3):265–275. doi: 10.1111/ijd.13748.
13. Stamatas G.N., Tierney N.K. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014;31(1):1–7. doi: 10.1111/pde.12245.
14. Blume Peytavi U., Hauser M., Lünnemann L., Stamatas G.N., Kottner J., Garcia Bartels N. Prevention of diaper dermatitis in infants – a literature review. Pediatr Dermatol. 2014;31(4):413–429. doi: 10.1111/pde.12348.
15. Atherton D.J. Understanding irritant napkin dermatitis. Int J Dermatol. 2016;55(1 Suppl.):7–9. doi: 10.1111/ijd.13334.
16. Kanti V., Günther M., Stroux A., Sawatzky S., Henrich W., Abou-Dakn M. et al. Influence of sunflower seed oil or baby lotion on the skin barrier function of newborns: A pilot study. J Cosmet Dermatol. 2017;16(4):500–507. doi: 10.1111/jocd.12302.
17. Carr A.N., DeWitt T., Cork M.J., Eichenfield L.F., Fölster-Holst R., Hohl D. et al. Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior. Pediatr Dermatol. 2020;37(1):130–136. doi: 10.1111/pde.14047.
18. Merrill L. Prevention, treatment and parent education for diaper dermatitis. Nurs Womens Health. 2015;19(4):324–337. doi: 10.1111/1751-486X.12218.
19. Ludriksone L., Garcia Bartels N., Kanti V., Blume-Peytavi U., Kottner J. Skin barrier function in infancy: a systematic review. Arch Dermatol Res. 2014;306(7):591–599. doi: 10.1007/s00403-014-1458-6.
20. Odio M., Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatr Dermatol. 2014;31(1 Suppl.):9–14.. doi: 10.1111/pde.12501.
21. Bonifaz A., Rojas R., Tirado-Sánchez A., Chávez-López D., Mena C., Calderón L., María P.O. Superficial mycoses associated with diaper dermatitis. Mycopatho logia. 2016;181(9–10):671–679. doi: 10.1007/s11046-016-0020-9.
22. Fölster‐Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018;35(1 Suppl.):10–18. doi: 10.1111/pde.13484.
23. Cohen B. Differential diagnosis of diaper dermatitis. Clin Pediatr (Phila). 2017;56(5S):16–22. doi: 10.1177/0009922817706982.
24. Buslaeva G.N. Clinical manifestations and treatment of Candida infection of the skin in newborns and younger-aged children. Klinicheskaya dermatologiya i venerologiya= Clinical Dermatology and Venereology.2008;(3):21–25. (In Russ.) Available at: https://medi.ru/info/5043/.
25. Zakharova N.I., Yakornova G.V., Leonova I.A. Epidermal protection. StatusPraesens. Pediatriya i neonatologiya= StatusPraesens. Pediatrics and Neonatology. 2019;(1):64–72. (In Russ.) Available at: https://elibrary.ru/item.asp?id=40629642.
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For citations:
Zakharova IN, Pshenichnikova II, Tvorogova TM. Diaper dermatitis: differential diagnosis and prevention issues. Meditsinskiy sovet = Medical Council. 2021;(1):14-19. (In Russ.) https://doi.org/10.21518/2079-701X-2021-1-14-19
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