secrets of managing diaper dermatitis in children.. for doctors

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and KEM HOSPITAL MUMBAI INDIA

secrets of DD are out : let me end this discushion : remember these basic points.
 unless we know the cause treatment is useless. 
There are 4 main types of rashes that occur in this area.
 fungal,
 cellulitis,
 ammoniacal dermatitis and
 allergic or contact dermatitis. 
Barring zinc deficiency, PEM etc are mainly for chronic ones. 


now there is one single point to diagnose each of them.


 fungal has satellite lesion == look for them,


 cellulitis is tender to touch= feel for it,


 ammoniacal has must involvement of tip of penis or clitoris and has ammo smell often related to urealytic organisms,


 contact can be elicited by repeated use at friction points more often than in center.


 treatment is accordingly, 


fungal… prefer antifungal cream prefer mico for dry lesions, antifungal powder for wet lesions .


 bacterial == local and systemic antibacterials are must, 


ammoniacal needs soothing emolients with zinc and some antibiotic like nitrofurantoin,


 contact responds to emolients and at times steroids.


 common treatment for all is 
avoid diapers however tempting it may be.
 keep the area open till healing, 
donot rub but mop after a motion. 
avoid moisture as much and as often,
 fan the area.. 
remember calamine is fooling and use only for very mild.. to be or not to be cases. No references …