Napkin rash (Diaper rash)

(Ammonical dermatitis or irritant dermatitis)

This is irritant dermatitis in infants due to prolonged contact with feces and ammonia (produced by the action of urea splinting organism urine)

Clinical features

1. Moist
2. Erythemateus rashes over the buttocks and diaper area

Treatment 

1. Topical steroids with antifungal agents 
1. miconazole topical <2 years: Safety and efficacy not established
   ≥2 years: Apply topical cream or powder BID for up to 1 month
2. tolnaftate (Rx) 

   Superficial Fungal Infections

   Apply to affected area BID
   May treat for 2-3 weeks but 4-6 weeks of therapy may be needed if skin is hyperkeratotic
3. calcipotriene/betamethasone (Rx)Indicated for plaque psoriasis of the scalp
   <12 years: Safety and efficacy not established
   Suspension (12-17 years): Apply to affected area(s) qDay for up to 8 weeks; may discontinue treatment earlier, if cleared

prevention

1. Keep in area clean and dry
2. Avoiding the use of disposable bsorbent diapers
3. Washed cotton diaper should be rinsed in dilute lemon juice

Complication

secondary fungal infection