Differential Diagnosis > Distribution > Intertriginous > Diaper

Diaper

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irritant (spares folds)
seborrheic dermatitis
Candidiasis
histiocytosis X
acrodermatitis enteropathica
granuloma gluteale infantum
Jacquets (=irritant)

 

Treatment pearl - use bag balm available at Target and CVS, originally used for cow udders, vaseline consistency, contains lanolin every diaper change (clears most irritant contact dermatitis i.e. common diaper rash)

Treatment pearl - send mom to www.CaliforniaBaby.com

Diaper dermatitis

flexures usually spared (vs. seborrheic dermatitis)
~ irritant contact dermatitis (to stool and urine)

 

treatment:

frequent diaper change
barrier cream after each diaper change
mix antifungal and hydrocortisone 1% cream BID

 

Seborrheic dermatitis, infantile

groin is red and scaly with prominent involvement of the flexures
scalp is frequently involved
nizoral cream (or treat like “diaper dermatitis” above)

 

Candidiasis

clue satellite pustules
treat with topical antifungal (and treat like “diaper dermatitis” above)

 

Granuloma Gluteale Infantum

multiple red-brown nodules
d/c topical fluorinated steroids (which are often the cause) for slow resolution

 

Jacquets Dermatitis

represents a primary irritant diaper dermatitis
well-defined, punched out ulcers or erosions with elevated borders
occur on the penis, labia or peri-anal area

 

Acrodermatitis Enteropathica

a vesicobullous or erosive dermatitis (peri-orificial or peri-ungual (acral))
diarrhea or hair loss or failure to thrive may accompany