Diaper rash
| Diaper rash | |
|---|---|
| Synonyms | diaper dermatitis, napkin dermatitis" diaper rash, nappy rash |
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| Benign diaper rash | |
| Classification and external resources | |
| Specialty | dermatology |
| ICD-10 | L22 |
| ICD-9-CM | 691.0 |
| DiseasesDB | 23119 |
| MedlinePlus | 000964 |
| eMedicine | ped/2755 |
| MeSH | D003963 |
Irritant diaper dermatitis, is a generic term applied to skin rashes in the diaper area that are caused by various skin disorders and/or irritants.
Generic rash or irritant diaper dermatitis (IDD) is characterized by joined patches of erythema and scaling mainly seen on the surfaces, with the skin folds spared.
Diaper dermatitis with secondary bacterial or fungal involvement tends to spread to surfaces (i.e. skin folds), as well as convex surfaces, and often exhibits a central red, beefy erythema with satellite pustules around the border.
It is usually considered a form of irritant contact dermatitis. Despite the word "diaper" in the name, the dermatitis is not due to the diaper itself, but to the materials trapped by the diaper (usually feces). Allergic contact dermatitis has also been suggested, but there is little evidence for this etiology.
The term diaper candidiasis is used when a fungal origin is identified. The distinction is critical, because the treatment (antifungals) is completely different.
Irritant diaper dermatitis develops when skin is exposed to prolonged wetness, increased skin pH caused by urine and feces, and resulting breakdown of the stratum corneum, or outermost layer of the skin. This may be due to diarrhea, frequent stools, tight diapers, overexposure to ammonia, or allergic reactions. In adults, the stratum corneum is composed of 25 to 30 layers of flattened dead keratinocytes, which are continuously shed and replaced from below. These dead cells are interlaid with lipids secreted by the stratum granulosum just underneath, which help to make this layer of the skin a waterproof barrier. The stratum corneum's function is to reduce water loss, repel water, protect deeper layers of the skin from injury, and to repel microbial invasion of the skin. In infants, this layer of the skin is much thinner and more easily disrupted.
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