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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. 8th ed. http://accesspharmacy.com/content.aspx?aid=7998475. Accessed May 27, 2012.

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  • Diaper rash

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  • 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.

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Signs and Symptoms

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  • 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.

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  • Based on clinical presentation.

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  • Relieve symptoms.
  • Remove precipitating factors.
  • Prevent recurrences.
  • Avoid adverse treatment effects.
  • Improve quality of life.

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  • Frequent diaper changes
  • Air drying (remove diaper for as long as practical)
  • Gentle cleansing with nonsoap cleansers and lukewarm water

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  • 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.
  • May use very low potency topical corticosteroid (hydrocortisone 0.5–1%) for short periods (1–2 weeks) in severe inflammatory cases.

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  • Educate caregivers on causative factors, preventive measures, and useful treatments.
  • Evaluate patients periodically to assess efficacy of therapy and possible side effects.

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