Summary
Definition
History and exam
Key diagnostic factors
- acute onset of rash in diaper area
- erythema of convex surfaces in diaper area
- sparing of skin folds
Other diagnostic factors
- features of candidiasis
- features of Staphylococcus aureus infection
- features of group A Streptococcus infection
- fussiness
Risk factors
- young age (<2 years)
- diarrhea
- underlying dermatologic disorder
- oral antibiotics
- infrequent diaper changes
- excess use of baby care products
- excess detergent
- excess wiping
- plastic underpants
- no diaper-free time
- underlying skin infections
Diagnostic tests
Tests to consider
- potassium hydroxide test of skin scraping
- bacterial culture of skin
- fungal culture of skin
- CBC
- serum zinc level
Treatment algorithm
all patients
Contributors
Authors
Linda S. Nield, MD, FAAP
Associate Dean for Admission
Professor of Medical Education and Pediatrics
West Virginia University School of Medicine
Morgantown
WV
Disclosures
LSN is an author of references cited in this topic.
Deepak Kamat, MD, PhD, FAAP
Professor of Pediatrics
Vice Chair for Academic Affairs
Department of Pediatrics
UT Health San Antonio
San Antonio
TX
Disclosures
DK is an author of references cited in this topic.
Peer reviewers
Jonette E. Keri, MD, PhD
Assistant Professor of Dermatology and Cutaneous Surgery
University of Miami
Miller School of Medicine
Miami
FL
Disclosures
JEK declares that she has no competing interests.
Martin E. Weisse, MD
Professor of Pediatric Infectious Disease
Walter Reed Army Medical Center
Washington
DC
Disclosures
MEW declares that he has no competing interests.
Kam Lun Ellis Hon, MBBS, DCH, FAAP, FCCM
Associate Professor
Department of Paediatrics
The Chinese University of Hong Kong
Hong Kong
China
Disclosures
KLEH declares that he has no competing interests.
Differentials
- Allergic contact dermatitis
- Seborrheic dermatitis
- Psoriasis
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