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Jacquet erosive diaper dermatitis - Skin
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Jacquet erosive diaper dermatitis - Skin

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Contributors: Amy Fox MD, David Dasher MD, Jeffrey D. Bernhard MD, Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH, Nancy Esterly MD
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Synopsis

Jacquet erosive diaper dermatitis is a rare condition involving the genital region. It is thought to be an irritant dermatitis. Patients often have bowel or bladder incontinence in conjunction with an occlusive environment, often found with diapers. Patients typically present with pruritic papules/nodules and erosions. The condition has been described in children older than 6 months of age into adulthood, all with common environmental exposure to absorbent garments and a history of incontinence. This condition has also been reported in post-gastrointestinal or -genitourinary surgery where incontinence has developed.

The clinical presentation includes papules or nodules with overlying superficial erosions as well as erosions or ulcers with elevated borders in the genital or perirectal region. Some reports of pseudo-verrucous lesions can be found. Patients often experience pruritus and burning.

Treatment can be difficult; the most effective treatment reported is normalization of the local integumental environment and of bowel/bladder habits.

Codes

ICD10CM:
L22 – Diaper dermatitis

SNOMEDCT:
91487003 – Jacquet's dermatitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Infectious (bacterial / fungal / herpes simplex virus) – it is important to rule these out as potential agents as they can appear clinically similar. PCR and culture will be negative in Jacquet.
  • Langerhans cell histiocytosis – petechiae and nonhealing erosions in the diaper area often require histology for definitive diagnosis. Biopsy will show proliferation of histiocytes.
  • Acrodermatitis enteropathica – rash commonly described as resembling "peeling paint;" found in the perineal region of infants around 6 months of age. It is caused by zinc deficiency. Look for similar lesions around the mouth, a recent history of weaning, and low serum alkaline phosphatase to make this diagnosis.
  • Granuloma gluteale infantum – purple nodules in the diaper region of varying size; also thought to be caused by diaper irritation.
  • Pseudoverrucous papules and nodules – this may represent a spectrum of the same disease, but lesions appear more verrucous. Treatment is similar to that for Jacquet.
  • Bullous pemphigoid

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Last Updated: 05/07/2019
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Jacquet erosive diaper dermatitis - Skin
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Jacquet erosive diaper dermatitis : Burning skin sensation, Buttocks, Diaper area, Erythema, Perineum, Skin erosion, Urinary incontinence, Pruritus, Smooth papules
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