[How I explore ... diaper dermatitis]

Abstract

Diaper dermatitis is a frequent condition. Several clinical types are distinguished. The most frequent type results from increased fragility of the newborn buttock skin when covered by diapers. According to the mechanisms involved and the severity of the dermatitis, one can distinguish the intertrigo of the chubby baby, and the so-called "W", "Y" and "red panties" types of diaper dermatitis. When the effects of occlusion are not controlled by adequate absorption by the diapers, hyperhydration of the stratum corneum occurs and progresses to maceration. As a result, the value of the coefficient of friction of the skin increases with epidermal weakening to rubbing. In addition, fecal enzymes (urease, proteases and lipases) alter urines and skin. Judicious hygiene measures and the correct choice of diapers are mandatory. Cutaneous colonization by microorganisms, the most important of which being Candida albicans, is the main complication. Adequate preventive and curative measures can combat diaper dermatitis with confidence. A miconazole paste allows to improve the tribological properties of the interface between diapers and the skin. It also abates the impact of Candida albicans in the pathogenesis of the skin disorder.