Candida Diaper Dermatitis

Candida Diaper Dermatitis



Daniel Yawman, MD



Basic Information



Definition


Diaper dermatitis is a term used to describe an acute inflammatory skin reaction in the perineal area. It results from a reaction to friction, dampness, maceration, urine, or feces. The skin breakdown from these irritants often predisposes to infection with Candida albicans.



Synonyms



Monilia diaper rash

Napkin thrush

Skin thrush


ICD-9-CM Codes



112.1 Candidiasis of vulva/vagina

112.2 Candidiasis of other urogenital sites

691.0 Diaper dermatitis


Epidemiology & Demographics



• This is a common infection in the immunocompetent host.

• The peak incidence occurs in the second to fourth months of life.

• It is equally common in males and females.

• The use of antibiotics and skin breakdown are risk factors for Candida infection.


Clinical Presentation



• Erythematous rash in the diaper area, usually unresponsive to barrier or lubricant ointments.
image The rash spreads to involve the perineum.

image Maceration of the anal mucosa and perianal skin may be the first clinical sign.

• In severe cases, may involve the upper thighs, the lower abdomen, and the lower back.
image May be more impressive in skin folds.

• Perineal skin examination reveals pale pink to bright red papules often with peripheral scale.

• May coalesce to characteristic well-defined weeping, eroded lesions with a scalloped border.

• The rash is evident in the intertriginous folds.

• Additional satellite lesions: vesicopustules or papules with collarette of scale extend beyond the intertriginous fold.

• Darker skinned infants may exhibit hypopigmented lesions.


Etiology



• C. albicans is the predominant fungus responsible for candidal dermatitis.
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Jun 19, 2016 | Posted by in PEDIATRICS | Comments Off on Candida Diaper Dermatitis

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