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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. Accessed May 27, 2012.

  • Diaper rash

  • 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.

Signs and Symptoms

  • 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.

  • Based on clinical presentation.

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

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

  • 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.

  • 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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