Diaper rashes can indicate systemic conditions other than diaper dermatitis
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RESEARCH ARTICLE
Open Access
Diaper rashes can indicate systemic conditions other than diaper dermatitis Sirirus Lebsing1, Jitjira Chaiyarit2 and Leelawadee Techasatian1*
Abstract Background: Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but potentially serious cutaneous eruptions associated with systemic diseases that should not be discounted. Methods: This prospective descriptive study aimed to explore variation in cutaneous disease in the diaper area. It was conducted as a prospective descriptive study between October 2016 and November 2019 in the pediatric department of a tertiary-level hospital. Results: Three hundred consecutive patients with rashes in the diaper area were enrolled. The most common diagnosed was IDD (125 cases; 41.7%), followed by rashes exacerbated by the diaper (101 cases; 33.67%) and nondiaper-related rashes (74 cases; 24.67%). Conclusions: Our finding suggests that when diagnosing rashes that occur in the diaper area, general pediatricians should consider, in addition to IDD, the possibility of less-common conditions. The simultaneous presence of cutaneous lesions at other sites was linked to diagnoses of systemic diseases other than IDD, (P < 0.001). Keywords: Diaper rash, Diaper dermatitis, Differential diagnosis
Background Rashes around the diaper area are common in the pediatric population, especially among those who are diaper dependent [1–3]. The majority of rashes in the diaper area turn out to be irritant diaper dermatitis (IDD), meaning that they are caused by irritation from urine and feces, which is aggravated by wearing diapers. This type of skin inflammation is mostly found in diaper-dependent children under 24 months of age [3]. Although IDD is the most common diagnosis in cases of inflammation in the diaper area, there are some less common but sometimes serious cutaneous eruptions associated with systemic diseases that should not be discounted. Coughlin el al [4]. classified skin conditions that present in the diaper area in to three groups: 1) skin
conditions caused by the presence of the diaper, 2) rashes exacerbated by the diaper (but not directly caused by it), and 3) eruptions present regardless of the presence of the diaper. Previous reviews have indicated a variety of differential diagnoses of cutaneous eruptions in the diaper area [4–8]. However, there are no statistical data available regarding the frequencies of various types of cutaneous eruptions in the genitoanal area. We thus attempted to ascertain such data using a prospective descriptive study design. Our aim was to promote recognition of some less common diseases in the diaper area in order to prevent misdiagnosis and to identify cutaneous clues indicating systemic diseases that are likely to be misdiagnosed as IDD.
Methods * Correspondence: [email protected] 1 Pediatric Department, Dermatology Division, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand Full list of aut
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