Diaper dermatitis

Background

• Contact dermatitis VS candidal dermatitis

Differential Diagnosis

Neonatal Rashes

• Acne
• Atopic dermatitis
• Candidiasis
• Contact dermatitis
• Diaper dermatitis
• Erythema toxicum neonatorum
• Impetigo
• Mastitis
• Milia
• Miliaria
• Mongolian spots
• Omphalitis
• Perianal streptococcal dermatitis
• Psoriasis
• Pustular melanosis
• Seborrheic dermatitis
• Sucking blisters
• Tinea capitis

Contact Dermatitis

[[File:Contact diaper dermatitis.jpg|thumb|Contact diaper dermatitis

Diagnosis

• Erythematous, macular or papular, w/ well demarcated borders

Treatment

• Good hygiene, air drying, use of barrier creams (zinc oxide)

Candidal Dermatitis

Diagnosis

• Erythematous w/ papular and pustular lesions and scaling around margins
• Classic finding is "satellite lesions"
• Must examine for oral thrush
  • If present: Oral nystatin 2mL QID infants, 4-6mL QID children
    • Administer for up to 2d after resolution of oral lesions

Treatment

• Nystatin cream 100K U/gram TID x10-14d
• If use zinc oxide must apply after nystatin
• Hydrocortisone 1-2% after nystatin, before zinc oxide, may be used for severe lesions

See Also

• Neonatal rashes