Diaper Dermatitis
James E. Rasmussen MD1
1 Professor of Dermatology and Pediatrics, Department of Dermatology, C2069 Outpatient Building, Box 031, University of Michigan Medical School, Ann Arbor, MI 48109-0010
Diaper dermatitis is not a single entity. Any rash occurring in this covered area can technically be considered a variety of diaper rash, but this review will only describe those diseases whose primary manifestation is in the diaper area. The reader should appreciate that there is often considerable controversy regarding the definition, etiology, treatment, and prognosis of many of the diseases that fall under this heading. Because there has been so little data gathered, much of therapy remains empiric and reflects personal opinions buttressed by practical experiences.
COMMON VARIETIES OF DIAPER DERMATITIS (Table)
Generic
This is the most common variety, and the only diaper dermatitis that truly deserves the title. It has a number of manifestations, all of which exhibit erythema in varying degrees and in various body parts. The earliest manifestation is usually mild perianal erytherna, which is commonly noted in neonates and infants less than 4 months of age. After that time, the most common site of involvement is the lower abdomen, anterior-medial thighs, scrotum, and labia. Here the rash usually spares the depths of the folds, presenting as mild-to-moderate poorly demarcated erythema, dryness, and fine wrinkling of the surface of the skin (Fig 1). Occasionally, the buttocks are involved in a similar fashion.
