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skin maceration
Softening by contact with liquid, especially that of skin.
Etiology:
- constant contact of skin with moisture
- occlusive dressing
- wet diapers
Clinical manifestations:
- erythema
- excoriated skin
- blisters
- white & silvery patches
- can affect any skin in constant contact with moisture
- skin folds
- groin
- buttocks
Management:
1) eliminate cause of moisture
a) toileting program for urinary incontinence
b) urinary catheter
- condom catheter
- reserve indwellng urinary catheter for refractory cases
c) remove & clean fecal incontinence
2) protect skin from moisture
a) clean gently with mild soap & water after each episode of incontinence
b) apply a barrier cream (vaseline, zinc oxide)
c) use disposable diapers that wick moisture from the skin
d) use linen incontinence pads when disposable diapers worsen perineal dermatitis
3) low-potency to low-medium potency glucocorticoids if barrier cream not effective
- skin folds (genitals, gluteal cleft, & inguinal or axillary skin folds) are susceptible to atrophy from medium to high potency topical glucocorticoids
- Desonide 0.05% (low potency)
- Hydrocortisone butyrate 0.1% (lower-medium potency)
- Hydrocortisone valerate 0.2% (lower-medium potency)
- Fluocinolone acetonide 0.01% (low potency)
Related
inverse psoriasis
General
sign/symptom
dermatitis
References
- Geriatrics at your Fingertips, 13th edition, 2011
Reuben DB et al (eds)
American Geriatric Society
- Stedman's Medical Dictionary 26th ed, Williams &
Wilkins, Baltimore, 1995
- Aung T, Aung ST.
Selection of an effective topical corticosteroid.
Aust J Gen Pract. 2021 Sep;50(9):651-655.
PMID: 34462770 Free article.
https://www1.racgp.org.au/ajgp/2021/september/selection-of-a-corticosteroid/