Source: Law RM, Law DTS. Dermatologic drug reactions and common skin conditions. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146079670. Accessed May 10, 2017.
Acute, inflammatory contact dermatitis of buttocks, genitalia, perineal regions, lower abdomen, or thigh folds of infant or toddler resulting from direct fecal and moisture contact with skin in occlusive environment.
Erythematous rash; vesicles and oozing erosions may be present in severe cases.
May be infected by Candida species and present with confluent red plaques, papules, and pustules.
TREATMENT: NONPHARMACOLOGIC THERAPY
TREATMENT: PHARMACOLOGIC THERAPY
May apply zinc oxide for astringent and absorbent properties and to provide effective moisture barrier.
Apply topical imidazole antifungal agents for Candida (yeast). Discontinue therapy when rash subsides and continue barrier product to prevent recurrence.
May use very low potency topical corticosteroid (hydrocortisone 0.5–1%) for short periods (1–2 weeks) in severe inflammatory cases.
Commercial diaper wipes containing fragrance or alcohol should be avoided.
Educate caregivers on causative factors, preventive measures, and useful treatments.
Evaluate patients periodically to assess efficacy of therapy and possible side effects.
Date Written: May 10, 2017
Contributor: Lauren Roller, PharmD, BCCCP
Editor: Lauren Roller, PharmD, BCCCP; Laura Baumgartner, PharmD, BCPS, BCCCP