bubble_chart Overview

Diaper dermatitis, also known as diaper rash, is a localized dermatitis that occurs in the diaper-covered area of infants.

bubble_chart Etiology

Disease cause: Failure to change the baby's diaper promptly or using plastic sheets, rubber sheets, or oilcloth over the diaper can cause the baby's buttock skin to remain continuously soaked in urine. Ammonia-forming bacteria in feces break down urea on the damp diaper, producing ammonia, which irritates the delicate skin. Rough diapers, residual detergent left on improperly washed diapers, or direct contact with plastic, rubber, or oilcloth can all contribute to dermatitis.

bubble_chart Clinical Manifestations

Initially, the lesion appears as a slightly edematous bright red patch with well-defined borders that blanches upon pressure. Subsequently, papules, papulovesicles, or small vesicles may develop on the erythematous base. In severe cases, erosion with exudation or superficial ulcers may occur, potentially leading to secondary bacterial or Candida infections. The affected areas correspond to the diaper region, primarily involving the buttocks, scrotum, labia, inner thighs, and even the lower abdomen and lumbosacral area. However, the gluteal cleft and inguinal folds, which do not come into contact with the diaper, usually exhibit milder inflammation or remain unaffected. This condition is most commonly seen in infants under six months of age.

bubble_chart Prognosis

Prevention and Treatment:
(1) Strengthen Protection Diapers should be changed frequently and thoroughly washed with clean water. Diapers should be made of soft, absorbent cotton fabric, and plastic sheets, rubber sheets, or oilcloth should not be used to wrap the outside of the diaper. Wash the buttocks and other areas frequently with warm water and apply talcum powder to keep the skin dry and clean.

(2) Local Treatment When the skin is inflamed, avoid washing with hot water or soap. For cases with only erythema or papules, wash with warm water first, then apply talcum powder, talc powder, or calamine lotion (with 0.5% neomycin added for antibacterial effects). For erosions, oily preparations are preferable, such as 40% zinc oxide oil or Arnebia oil. Alternatively, Arnebia oil (10%) can be added to zinc oxide oil. If there is significant exudate, use a 2% boric acid solution, a 1:5000–1:8000 potassium permanganate solution, or a 0.1% rivanol solution for wet compresses. Another option is to boil 30g of purslane herb and 10g of alum in 1000ml of water for half an hour, then cool and use for wet compresses. In cases of secondary infection, oral antibiotics or topical antibacterial medications such as Pikang cream or compound miconazole should be used.