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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