Diaper Dermatitis: The Most Common Skin Problem in Infants (Video: 2:26 minutes)

Article

Diaper Dermatitis is the most common skin problem in infants. The differential includes contact and seborrheic dermatitis, psoriasis, scabies, and infection. Treatment guidelines are outlined here.

 

Diaper dermatitis is the most common skin problem among infants. Up to a third are affected.

It's important to make the correct diagnosis: not everything that occurs in the diaper area is simple dermatitis. The differential includes:
. Contact dermatitis (irritant/allergic)
. Infectious (candida, Strep, Staph)
. Seborrheic dermatitis
. Psoriasis (especially in children with a family history)
. Langerhans cell histiocytosis
. Kawasaki disease (with desquamation)
. Zinc deficiency (with peri-oral involvement)

First-line therapy for diaper dermatitis includes:
. Frequent diaper changes, barrier creams (Zinc oxide and petrolatum-based)
. Cover for candida
. Consider a weak topical steroid
. Rule out staph and Strep by culture

When the rash is refractory, think of psoriasis and metabolic conditions.

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