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diaper rash
Etiology:
1) irritation from feces/urine
2) allergic reaction to dyes on some diapers
Management:
1) barrier agents
a) flexible barrier film* coats affected area & allows vapor passage for up to 72 hours
b) ointments form an occlusive barrier & promote hydration but need to be reapplied after each episode of incontinence
- zinc oxide
- vitamin A & D ointment
- lanolin
- ointments containing petrolatum offer more protection
2) topical antifungal agents (clotrimazole, miconazole, nystatin) may help if Candida infection
3) topical steroids
- severe rash
- 1% hydrocortisone for up to 2 weeks
4) cholestyramine ointment may help in refractory cases
- 5%-10% cholestryramine/Aquaphor compounded by pharmacist
5) prevention is best
a) frequent diaper changes
b) keep area dry
c) avoid talcum or corn starch powders (they may cause respiratory problems if inhaled)
* treatment of choice in demented patient [2]
General
dermatitis
References
- Prescriber's Letter 12(9): 2005
Treatment of Diaper Rash (Dermatitis)
Detail-Document#: 211013
(subscription needed) http://www.prescribersletter.com
- Geriatric Review Syllabus, 9th edition (GRS9)
Medinal-Walpole A, Pacala JT, Porter JF (eds)
American Geriatrics Society, 2016