Article Sections

Introduction

Diaper dermatitis is a common condition in infants and is caused by skin barrier breakdown from exposure to urine and stool.  Irritant contact dermatitis is most common and characterized by erythema that spares skin folds and is confined to the area in contact with the diaper and stool/urine.  Superinfection with fungus (Candida) or bacteria (Staphylococcus aureus, Streptococcus pyogenes) commonly occurs.

Pathogenesis

Irritant contact diaper dermatitis is the most common diaper dermatitis in infants.  This condition is caused predominantly by skin barrier breakdown from exposure to urine and stool trapped within the diaper.  Patients with frequent stooling (eg, diarrhea) are at increased risk because urease produced by fecal bacteria causes an increase in local skin pH, allowing the activation of proteolytic enzymes that disrupt the stratum corneum.  Areas of macerated skin are then prone to frictional damage from the diaper, further exacerbating the rash.

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