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Diaper irritant contact dermatitis
See also in: Anogenital
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Diaper irritant contact dermatitis

See also in: Anogenital
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Contributors: Sophia Delano MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Irritant diaper dermatitis is a term for dermatitis caused by the occlusion, moisture, and friction produced by diapers. Once the skin barrier is compromised by this environment, secondary factors such as urinary ammonia, increased urine pH, fecal proteases and lipases, Candida albicans, bacterial overgrowth, and detergent soaps exacerbate the dermatitis.

There have been several reports in the literature of laxative use in infants leading to a severe irritant dermatitis. Laxative-induced diarrhea contained and occluded by a diaper can cause bullae and erosions.

Related topics: Jacquet erosive diaper dermatitis, Diaper dermatitis candidiasis

Codes

ICD10CM:
L22 – Diaper dermatitis

SNOMEDCT:
91487003 – Diaper rash

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

There are many causes of diaper-area rashes. The most common alternative diagnosis in this region is Candida-induced diaper dermatitis. Irritant dermatitis presents with confluent redness in diaper-contact regions with relative sparing in skin folds. Candida presents with pustules and discrete red papules, often found within the folds. In Candida infections, satellite lesions – red papules slightly removed from the main cluster of papules and plaques – are clues to the diagnosis.

Alternative causes include atopic and seborrheic dermatitis (look for rash at distant sites such as the face and scalp for seborrheic dermatitis and flexural regions for atopic dermatitis).

Also consider:
Dermatoses unrelated to the presence of a diaper:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 11/20/2017
Last Updated: 11/20/2017
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Diaper irritant contact dermatitis
See also in: Anogenital
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Diaper irritant contact dermatitis : Confluent configuration, Diaper area, Erythema, Female genital, Fine scaly plaque, Male genital
Clinical image of Diaper irritant contact dermatitis
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