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[Diaper rash in Kawasaki disease].
The authors presents 3 cases of Kawasaki disease where, in all cases, a perineal rash or rash located in the diaper area, was an initial or predominant sign. We highlight the interest of this discovery for the early and diagnostic of this disease, in both its classics and incomplete forms, and with this achieve efficiency in the preventive treatment of the cardiovascular complications.
Effect of oral zinc supplements on diaper rash in normal infants.
A total of 89 normal newborn infants received 10mg oral zinc supplements daily for 4 months and 90 others received a placebo. The zinc supplemented group had a significant reduction in the incidence of diaper rash, and they gained slightly more in height and weight, although the growth differences were not significant.
Over-the-counter drugs for skin disorders. Part 3: aids for heat and diaper rash.
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[Questions and answers on pediatric care. Prevention of diaper rash in infants].
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Primary herpes simplex virus infection of a diaper rash.
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[Experience with lacto-placental preparation as a preventive and therapeutic measure of diaper rash].
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The relationship of diapers to diaper rashes in the one-month-old infant.
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[Treatment of diaper rash with Parfenac lipid ointment (bufexamac). A study by Austrian pediatricians].
447 children between 0 and 24 months with diaper dermatitis were treated by topical application of Parfenac-Fettsalbe (Bufexamac). This panel was selected out of 844 patients which were originally in the protocol. The Parfenac-Fettsalbe was well tolerated, 7 children presented local side effects. 62.71% of treated girls showed very good results, whereas 59.89% of boys showed this outcome. Good results were obtained in 24.35% of girls and 21.93% of boys. Very good (no efflorescences remaining) and good results (some remaining efflorescences) were thus found in more than 80% of patients treated: with respect to corticosteroid advoidance this can be regarded as an effective antiphlogistic medication for diaper dermatitis. Non responders might have been superinfected with microorganisms as candida and staphylococci. In addition, epidemiological considerations are reported in that study.
Tell-tale diaper rash in Kawasaki syndrome.
We have presented three patients in whom a striking desquamating perineal rash developed within the first five days of a febrile illness. Such a rash should raise the suspicion for Kawasaki syndrome even when all criteria are not present.
[Study of the role of Candida albicans infection in different infant conditions including a diaper rash (64 cases)].
The pathogenic role of Candida albicans has been determined by performing: skin scrapings, mouth swabs, faecal specimens and serology from 64 infants and very young children affected with different conditions including a napkin dermatitis, divided into 4 groups. 1) 7 patients affected with true or presumed candidiasis, 2) 53 patients with different manifestations of diaper dermatitis, 3) 3 patients with papulo-erosive dermatitis of the diaper area, 4) 1 congenital ichthosiform erythrodermia. Candida albicans is the only responsible agent of the granulomatous candidiasis, it is constant but appeared lately in acropathia enteropathica. It is one of the major agents of the trichophytoid dermatitis (2 cases out of 4 cases). Candida albicans has been recovered from the skin of 33 infants out of 53 patients affected with all types of napkin eruption (62 p. 100) and from faecal specimens of 43 patients (81 p. 100). Though Candida albicans has often been considered as an opportunistic organism, even in infants, this percentage is greatly higher than that of the normal infant that is about 4p. 100, and consequently has a real pathogenic value. Species of yeasts different from Candida albicans have been recovered from faecal specimens of 3 infants affected with papulo-erosive dermatitis of the napkin area: parapsilosis, macedoniensis, deformans which are not generally considered as pathogenic agents. Serology is positive only in 3 infants or young children affected with a real chronical candidosis: 1 granulomatous candidosis, 1 acropathia enteropathia, 1 erythrodermia, the faecal specimen of whom contained a great nomber of Candida albicans.
Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis.
Cloth diapers, cellulose core diapers (conventional disposable diapers), and cellulose core diapers containing absorbent gelling material were examined for their effects on diaper rash and skin microbiology of normal infants and infants with atopic dermatitis in a 26-week double-blind clinical trial. Infants with atopic dermatitis wearing the diapers containing absorbent gelling material had significantly lower diaper rash grades than infants with atopic dermatitis wearing cloth diapers at five of eight grading visits. Infants with atopic dermatitis wearing conventional cellulose core diapers had statistically less rash at one of eight visits. There was no statistically significant difference between diaper types at three of the eight visits. At no time did the cloth group have less diaper rash than the conventional cellulose or absorbent gelling material disposable diaper group. A statistical correlation between the severity of general atopic dermatitis outside the diaper area and the diaper rash condition under the diaper occurred only in the atopic dermatitis group wearing cloth diapers. Isolation of microorganisms from the intact, uninvolved skin surface both inside and outside the diaper showed no biologically significant changes in the presence or numbers of selected skin organisms. Repeated isolation, at multiple grading visits of Staphylococcus aureus from uncompromised skin inside the diaper area was infrequent but correlated with the diagnosis of atopic dermatitis when observed.
Clinical correlates with diaper dermatitis.
Three types of clinical studies were carried out to better understand diaper dermatitis in a general infant population. In 'snapshot' clinical studies, skin condition under the diaper was evaluated at a given point in time across a large base of infants. Correlations were sought between diaper dermatitis incidence and severity and a number of factors, including sex, diet, maturity, type of diaper, history of allergy, contact with fecal matter, presence of Candida albicans, and diaper change frequency. Severe diaper rash correlated strongly with the presence of C. albicans, and the frequency of rash correlated with duration of contact with feces and inversely with diaper change frequency. Diaper rash peaked at ages 9-12 months and was lower for breast-fed than for formula-fed infants. Exclusive use of disposable diapers correlated with lower rash levels than when some or all cloth diapers were used. In a longitudinal study, infants were observed daily for 50 days in order to determine the frequency and duration of rash episodes. In this study, the tendency for some infants to be rash-prone was clearly indicated. In a third type of study, over 10,000 infant visits to physicians' offices were used to record skin condition. Results showed a three-to fourfold increase in diaper rash if the child had diarrhea during the previous 48 h.
[Infantile seborrheic dermatitis and related syndromes. Diagnostic and pathogenetic problems].
Infantile seborrhoeic dermatitis is a dermatosis affecting infants characterized by little or no itching and by completely typical skin symptoms, distribution and evolution. Infantile seborrhoeic dermatitis should therefore be differentiated from atopic dermatitis and from diaper-rash although interferences be possible. In fact the high frequency of the atopic dermatitis and of diaper rash may cause these two manifestations to sometimes superimpose on infantile seborrhoeic dermatitis. This in turn causes rather complex clinical situations that may be very hard, but not impossible to diagnose if use is made of laboratory findings to support clinical features. The pathogenesis and etiology of infantile seborrhoeic dermatitis are still debated although recent results assign the dominant role to Candida albicans. This mycete also plays a relevant role in the genesis of diaper rash and particularly of Leiner's exfoliative erythrodermas, which can be interpreted as a generalized and erythrodermic expression of infantile seborrhoeic dermatitis. Systematic cultural investigations and appropriate antimycotic treatments, that would stimulate antibody response, will allow to clarify in the near future this interesting etiological problem, with important therapeutical consequences.
Bad advice; bad burn: a new problem in burn prevention.
Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.
Teaching child-care skills to mothers with developmental disabilities.
The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.
Comparison of disposable diapers with fluff absorbent and fluff plus absorbent polymers: effects on skin hydration, skin pH, and diaper dermatitis.
Diaper dermatitis results from the action of a number of physical and chemical factors on the skin. While its etiology is complex, there is agreement that prolonged contact between wet diapers and the skin leading to excessive hydration of the stratum corneum and reduced barrier function is a primary factor. Recent research also indicates that pH elevation resulting from ammonia production increases the probability of skin damage due to fecal enzyme activity. New diapers containing absorbent polymers blended with cellulose fluff in the absorbent core have been developed. The absorbent polymer binds fluids and controls pH in the diaper environment. To assess the effectiveness of these diapers, a clinical study was conducted with approximately 150 infants over 15 weeks, using fluff diapers and absorbent polymer diapers. The results clearly showed that the diapers with absorbent polymer provide a better skin environment than those with fluff only with respect to lower skin wetness and pH control (instrumental measurements). In addition, the clinicians' grades indicated a directional reduction in diaper rash severity.
Common skin problems in the pediatric office.
Skin diseases represent a major problem in everyday practice. This article discusses the most common dermatological entities as seen in the pediatrician's office with practical guidelines for their therapy. Acne, eczema, diaper rash, verruca vulgaris, impetigo and skin infestations are among those topics discussed.