*diagnosis:-
-إالتهاب واحمرار شائع جدا في مكان الحفاضة في الاطفال غالبا بسبب
*fungal infection + contact dermatitis due to "irritation from urine"
في أغلب الأحيان بتبقى إلتهابات فقط من البول وأحيانا بتبقى فطريات.
طب نفرق بينهم إزااااااااااااااااااي؟؟؟؟؟؟؟؟
★لو في dermatitis فقط :normal inguinal folds
★لو في fungal infection:affected inguinal folds + satellite lesions
*prevention:-"الوقاية"
1-تنظيف الطفل باستمرار وتنشيفه جيدا."cleaning"
2-تعريض الطفل للهواء 10 دقائق قبل وضع الحفاضة الجديدة."airiness"
3-وضع كريم مرطب قبل وضع الحفاضة الجديدة."soothing cream"
-Ex:-zinc olive cream contains"ZnO in olive oil"زنك اوكسيد في زيت الزيتون"
*treatment:-
1-تغيير نوع الحفاضة لو المشكلة متكررة"ممكن حساسية لنوع الحفاضه نفسه"........"chanching pads type-
2-مضاد فطريات +كورتيزون ضعيف "عشان يعالج الحالتين............topical antifungal + weak corticosteroid
Ex:-daktacort cream contains"miconazole nitrate 2%" + hydrocortisone 1%"
Ex:-momenta cream contains"momentasone 0.1%+gentamicin 0.1% +miconazole nitrate 2%
".....وده افضلهم لاحتوائه على مضاد للفطريات ومضاد للبكتيريا وكورتيزون....."
important note"معلومة مهمة"
-يفضل عدم استخدام كريم kenacomb في هذه الحالات نظرا لإحتوائه على نوع كورتيزون"triamcinolone 1%"
لا يصلح لإستخدامه في الأطفال وinguinal folds
What is napkin dermatitis?
-Napkin dermatitis and nappy rash are used to describe various skin conditions that affect the skin under a baby's napkin.
-The US term is diaper rash.
-Napkin dermatitis is most often a form of contact dermatitis.
**Who gets nappy rash?
-Nappy rash most often affects babies aged 3 to 15 months of age,
-especially those wearing traditional cloth nappies (50%).
- It is much less prevalent in babies wearing modern breathable and multilayered disposable nappies.
-Napkin dermatitis can also affect older children and adults that are incontinent.
-More images of napkin dermatitis ...
-What is the cause of napkin dermatitis?
-Napkin dermatitis follows damage to the normal skin barrier and is primarily a form of irritant contact dermatitis.
-Urine and occlusion leads to overhydration and skin maceration
-Faecal bile salts and enzymes break down stratum corneum lipids and proteins
-A mixture of urine and faeces creates ammonium hydroxide, raising pH
-The wet skin is colonised by micro-organisms, particularly candida
-Mechanical friction from limb movement may increase discomfort
*Other causes of napkin rashes include:
#Candida albicans
#Impetigo
" (Staphylococcus aureus and/or Streptococcus pyogenes): irregular blisters and pustules"
#Infantile seborrhoeic dermatitis
" cradle cap and bilateral salmon pink patches, often desquamating, in skin folds"
#Atopic eczema
"bilateral scratched, dry plaques anywhere, but uncommon in nappy area; family history common"
#Psoriasis
"persistent, well-circumscribed, symmetrical, shiny, red, scaly or macerated plaques; other sites may be involved; family history common"
#Miliaria
#Rare disorders
Napkin dermatitis is not due to:
-Allergy to the napkins
-Toxins in the napkins
-Washing powders
-Dermatophyte fungal infections (tinea)
-What are the clinical features of napkin dermatitis?
One or more forms of napkin rash may be present.
-Irritant napkin dermatitis: well-demarcated variable erythema, oedema, dryness and scaling. Affected skin is in contact with the wet napkin and tends to spare the skin folds
-Chafing: erythema and erosions where the napkin rubs, usually on waistband or thighs
-Candida albicans: erythematous papules and plaques with small satellite spots or superficial pustules
-Disseminated secondary eczema or autoeczematisation: rash in distal sites associated with severe napkin
What tests should be done?
-In most cases, no tests are necessary.
-Skin swabs may be useful to confirm yeast or bacterial infection.
What is the treatment for napkin dermatitis?
-General measures:-
-The need to keep baby dry and use barrier protection should be emphasised.
-Napkin dermatitis is much less common with modern disposable napkins compared to cloth varieties.
-Disposable nappies:
-Are available in different shapes and sizes depending on age and gender
-Keep the skin dry and clean
-Maintain optimal skin pH
-Should be changed when wet or soiled
-Contain cellulose pulp and superabsorbent polymers
-May include petrolatum-based moisturising lotion to support skin barrier
-Fasteners, backsheets and stretch reduce leakage
Are non-toxic and biologically inert
-Do not contain allergens such as natural rubber latex or disperse dyes
Lead to less household exposure to faecal matter
-If using cloth nappies, use nappy liners to keep the skin dry.
- Avoid plastic pants.
At napkin changes:
-Gently clean the baby’s skin with water and a soft cloth
-Wet wipes are convenient but expensive and can lead to contact allergy to preservatives used to stop them going mouldy
-Aqueous cream or other non-soap cleanser can be used if necessary
Pat dry gently and allow to air dry
-Apply protective emollient ointment containing petrolatum and/or zinc oxide
Other suggestions:
-Give evening fluids early to reduce wetting at night.
-Observe whether certain foods are related to the rash by increasing stool acidity (eg orange juice) or frequency.
- If this is the case, discontinue the responsible food, at least temporarily.
-إالتهاب واحمرار شائع جدا في مكان الحفاضة في الاطفال غالبا بسبب
*fungal infection + contact dermatitis due to "irritation from urine"
في أغلب الأحيان بتبقى إلتهابات فقط من البول وأحيانا بتبقى فطريات.
طب نفرق بينهم إزااااااااااااااااااي؟؟؟؟؟؟؟؟
★لو في dermatitis فقط :normal inguinal folds
★لو في fungal infection:affected inguinal folds + satellite lesions
*prevention:-"الوقاية"
1-تنظيف الطفل باستمرار وتنشيفه جيدا."cleaning"
2-تعريض الطفل للهواء 10 دقائق قبل وضع الحفاضة الجديدة."airiness"
3-وضع كريم مرطب قبل وضع الحفاضة الجديدة."soothing cream"
-Ex:-zinc olive cream contains"ZnO in olive oil"زنك اوكسيد في زيت الزيتون"
*treatment:-
1-تغيير نوع الحفاضة لو المشكلة متكررة"ممكن حساسية لنوع الحفاضه نفسه"........"chanching pads type-
2-مضاد فطريات +كورتيزون ضعيف "عشان يعالج الحالتين............topical antifungal + weak corticosteroid
Ex:-daktacort cream contains"miconazole nitrate 2%" + hydrocortisone 1%"
Ex:-momenta cream contains"momentasone 0.1%+gentamicin 0.1% +miconazole nitrate 2%
".....وده افضلهم لاحتوائه على مضاد للفطريات ومضاد للبكتيريا وكورتيزون....."
important note"معلومة مهمة"
-يفضل عدم استخدام كريم kenacomb في هذه الحالات نظرا لإحتوائه على نوع كورتيزون"triamcinolone 1%"
لا يصلح لإستخدامه في الأطفال وinguinal folds
What is napkin dermatitis?
-Napkin dermatitis and nappy rash are used to describe various skin conditions that affect the skin under a baby's napkin.
-The US term is diaper rash.
-Napkin dermatitis is most often a form of contact dermatitis.
**Who gets nappy rash?
-Nappy rash most often affects babies aged 3 to 15 months of age,
-especially those wearing traditional cloth nappies (50%).
- It is much less prevalent in babies wearing modern breathable and multilayered disposable nappies.
-Napkin dermatitis can also affect older children and adults that are incontinent.
-More images of napkin dermatitis ...
-What is the cause of napkin dermatitis?
-Napkin dermatitis follows damage to the normal skin barrier and is primarily a form of irritant contact dermatitis.
-Urine and occlusion leads to overhydration and skin maceration
-Faecal bile salts and enzymes break down stratum corneum lipids and proteins
-A mixture of urine and faeces creates ammonium hydroxide, raising pH
-The wet skin is colonised by micro-organisms, particularly candida
-Mechanical friction from limb movement may increase discomfort
*Other causes of napkin rashes include:
#Candida albicans
#Impetigo
" (Staphylococcus aureus and/or Streptococcus pyogenes): irregular blisters and pustules"
#Infantile seborrhoeic dermatitis
" cradle cap and bilateral salmon pink patches, often desquamating, in skin folds"
#Atopic eczema
"bilateral scratched, dry plaques anywhere, but uncommon in nappy area; family history common"
#Psoriasis
"persistent, well-circumscribed, symmetrical, shiny, red, scaly or macerated plaques; other sites may be involved; family history common"
#Miliaria
#Rare disorders
Napkin dermatitis is not due to:
-Allergy to the napkins
-Toxins in the napkins
-Washing powders
-Dermatophyte fungal infections (tinea)
-What are the clinical features of napkin dermatitis?
One or more forms of napkin rash may be present.
-Irritant napkin dermatitis: well-demarcated variable erythema, oedema, dryness and scaling. Affected skin is in contact with the wet napkin and tends to spare the skin folds
-Chafing: erythema and erosions where the napkin rubs, usually on waistband or thighs
-Candida albicans: erythematous papules and plaques with small satellite spots or superficial pustules
-Disseminated secondary eczema or autoeczematisation: rash in distal sites associated with severe napkin
What tests should be done?
-In most cases, no tests are necessary.
-Skin swabs may be useful to confirm yeast or bacterial infection.
What is the treatment for napkin dermatitis?
-General measures:-
-The need to keep baby dry and use barrier protection should be emphasised.
-Napkin dermatitis is much less common with modern disposable napkins compared to cloth varieties.
-Disposable nappies:
-Are available in different shapes and sizes depending on age and gender
-Keep the skin dry and clean
-Maintain optimal skin pH
-Should be changed when wet or soiled
-Contain cellulose pulp and superabsorbent polymers
-May include petrolatum-based moisturising lotion to support skin barrier
-Fasteners, backsheets and stretch reduce leakage
Are non-toxic and biologically inert
-Do not contain allergens such as natural rubber latex or disperse dyes
Lead to less household exposure to faecal matter
-If using cloth nappies, use nappy liners to keep the skin dry.
- Avoid plastic pants.
At napkin changes:
-Gently clean the baby’s skin with water and a soft cloth
-Wet wipes are convenient but expensive and can lead to contact allergy to preservatives used to stop them going mouldy
-Aqueous cream or other non-soap cleanser can be used if necessary
Pat dry gently and allow to air dry
-Apply protective emollient ointment containing petrolatum and/or zinc oxide
Other suggestions:
-Give evening fluids early to reduce wetting at night.
-Observe whether certain foods are related to the rash by increasing stool acidity (eg orange juice) or frequency.
- If this is the case, discontinue the responsible food, at least temporarily.
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