Search Our Scientific Publications & Authors

J Pediatr 2019 12 24;215:139-143.e7. Epub 2019 Sep 24.

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA. Electronic address:

Objective: To characterize the incidence of adverse events (AEs) associated with antibiotics used to treat acute otitis media in children.

Study Design: We searched MEDLINE for studies conducted between January 1, 1966, and August 25, 2018. Two authors independently assessed potential studies and extracted the data. Read More

Clin Pediatr (Phila) 2019 06 9;58(7):806-815. Epub 2019 Apr 9.

1 The Procter & Gamble Company, Cincinnati, OH, USA.

The demand for natural infant care products, including diapers, has increased. However, few disposable diapers have been able to provide the performance caregivers desire while also incorporating ingredients consistent with the "natural" category. In an examiner-blinded clinical study, the performance of a new cotton-enhanced diaper with high-performance materials was compared with an existing natural diaper offering. Read More

Pediatr Dermatol 2019 Sep 28;36(5):602-606. Epub 2018 Nov 28.

Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey.

Background/objectives: Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food-allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persistent diaper dermatitis and food allergy. Read More

J Pediatr 2019 Mar 2;206:296. Epub 2018 Nov 2.

Department of Pediatrics Postgraduate Institute of Medical Education and Research Chandigarh, India.

Dermatol Ther 2018 11 12;31(6):e12731. Epub 2018 Oct 12.

Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

This study compares the effective of of topical application of olive and calendula ointments on childrens' diaper dermatitis (DD). This triple-blind clinical trial was conducted on 73 healthy children under the age of 2 years with non-severe and not infected DD, referred to a pediatric healthcare center in Tabriz, Iran. The children were assigned to 1. Read More

Int J Dermatol 2019 Aug 23;58(8):963-965. Epub 2018 Sep 23.

Department of Dermatology, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Pediatr Emerg Care 2019 Jul;35(7):e127

From the Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which was initially concerning for nonaccidental burn. Upon further investigation, it was found that Ex-Lax had been given to the patient for constipation. This had resulted in a bowel movement, which led to an irritant dermatitis. Read More

Breastfeed Med 2018 06 30;13(5):388-394. Epub 2018 Apr 30.

1 Department of Pediatrics, University of Virginia School of Medicine , Charlottesville, Virginia.

Introduction: Serratia marcescens is an opportunistic pathogen and common cause of infectious outbreaks in pediatric units, leading to both significant morbidity and mortality in immunocompromised hosts. Environmental and some clinical strains may produce a characteristic red pigment, prodigiosin. Colonization can hence turn breast milk and fecally-soiled diapers pink, which can lead otherwise unaffected patients to present to their physicians and also interrupt breastfeeding. Read More

Pediatr Dermatol 2018 03;35 Suppl 1:s3-s4

Dermatology and Pediatrics, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA.

Pediatr Dermatol 2018 Mar 9;35(2):e121-e123. Epub 2018 Jan 9.

Division of Pediatric Endocrinology, School of Medicine, Trakya University, Edirne, Turkey.

We report an infant with exogenous Cushing syndrome after being treated for 2 months with a potent topical corticosteroid via the mother's application of topical clobetasol for diaper rash without a prescription. We emphasize that potent topical steroids should be used with great caution, especially when used under occlusion (e.g. Read More

Pediatrics 2018 02 3;141(2). Epub 2018 Jan 3.

Dermatology Department, Hospital Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; and.

Granuloma gluteale infantum is a rare nodular complication of irritant diaper dermatitis. The association of this condition with the widespread use of nondisposable cloth diapers has been increasingly recognized. We present the case of an 18-month-old girl with granuloma gluteale infantum. Read More

Hosp Pediatr 2018 01;8(1):56-58

Department of Pediatrics, Primary Children's Hospital, Salt Lake City, Utah

Am J Perinatol 2018 Apr 22;35(5):486-493. Epub 2017 Nov 22.

Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia.

Objective:  To define the incidence of perianal dermatitis (PD) and determine the usage pattern and cost efficacy of diaper products among neonates admitted to a level IV neonatal intensive care unit (NICU) including those with a diagnosis of neonatal abstinence syndrome (NAS).

Methods:  A retrospective cohort study to evaluate neonates with PD based on number of orders for Aquaphor, Bagbalm, Desitin, Flanders, or Nystatin. Various demographic and clinical parameters were recorded. Read More

Int J Dermatol 2018 Mar 6;57(3):265-275. Epub 2017 Oct 6.

Faculty of Medicine, Department of Pediatrics, University of Maribor, Maribor, Slovenia.

Diaper dermatitis is the most common inflammatory skin eruption within the diaper area in infants and toddlers. Although it rarely causes problems for prolonged periods of time, it causes considerable distress for both infants and parents. Diapered skin is exposed to friction, excessive hydration, varying pH, and is in constant contact with urine and feces, both of which are highly irritant to the skin. Read More

Pediatr Dermatol 2017 May;34(3):303-307

Department of Pediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.

Background/objectives: Diaper dermatitis (DD) is one of the most common skin conditions in infants and young children. Among the factors associated with greater frequency of DD are high skin pH and transepidermal water loss (TEWL). This study examined the prevalence of DD in healthy black children in Nigeria and evaluated the association between skin surface pH, TEWL, and DD in this population. Read More

Clin Pediatr (Phila) 2017 May;56(5_suppl):23S-27S

2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Today's disposable diapers are high-performance and well-tested products, designed to keep skin dry and healthy. They are primarily made of biologically inert polymers, commonly used in fabrics and other materials that are in contact with skin, and in foods and cosmetics. Still, product safety and ingredients in everyday products can be a source of anxiety for new parents. Read More

Clin Pediatr (Phila) 2017 May;56(5_suppl):13S-15S

1 Kenwood Dermatology, Cincinnati, OH, USA.

Over the past several years, a number of articles and online posts have circulated on the Internet associating use of disposable and cloth diapers with chemical burns on babies' skin. Because both mild chemical burns and diaper dermatitis (diaper rash) can cause skin redness and peeling, it is not surprising that some confusion has arisen regarding the association between these two conditions. However, diapers cannot cause chemical burns because they are made of inert materials. Read More

Clin Pediatr (Phila) 2017 May;56(5_suppl):16S-22S

1 Johns Hopkins Children's Center, Baltimore, MD, USA.

Mild diaper dermatitis often occurs in children before toilet training is complete, particularly from 9 to 12 months of age, and the most common presentation is an irritant contact dermatitis. Diaper dermatitis may account for up to 25% of dermatology visits to health care providers during the first year of life. Fortunately, since the introduction of hypoallergenic, superabsorbent modern disposable diapers, the incidence and severity of irritant and allergic contact dermatitis has decreased dramatically. Read More

Case Rep Dermatol 2016 Sep-Dec;8(3):369-373. Epub 2016 Dec 22.

Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, France.

Propranolol, a nonselective blocker of β-adrenergic receptors, has become the first-line treatment for complicated infantile hemangiomas. Therefore, its use in the pediatric population has expanded in recent years. In adults, β-blockers have been reported to be the most common causative agents for drug-induced psoriasis. Read More

Exp Ther Med 2016 Dec 27;12(6):3665-3669. Epub 2016 Oct 27.

Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China.

The aim of the study was to investigate the application of hydrocolloid dressings in the prevention and treatment of infant diaper rash. A total of 210 infants with diaper rash were included in the study and randomized into 3 groups of 70 infants. Infants in group A received hydrocolloid dressings and individualized nursing; infants in group B received mupirocin plaster and topical application of pearl powder as well as routine nursing; and infants in group C received zinc oxide plaster and routine nursing. Read More

J Dermatol 2017 Jun 24;44(6):e136-e137. Epub 2016 Dec 24.

Department of Dermatology, Nishi-Kobe Medical Center, Kobe, Japan.

Pediatr Dermatol 2016 Nov 22;33(6):632-639. Epub 2016 Sep 22.

Philippine General Hospital, University of the Philippines, Manila, Philippines.

Background: One methodologic challenge in conducting research relating to diaper dermatitis (DD) is the absence of a reliable, objective, validated scale for assessing severity. The aim of this study was to develop and validate such a scale.

Methods: Scale development was based on experience of DD assessment and clinical and photographic data collected during the early stages of a randomized controlled trial of two DD treatments. Read More

Iran Red Crescent Med J 2016 May 22;18(5):e24809. Epub 2016 Feb 22.

Pediatrics Department, Qazvin Children's Hospital, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran.

Background: Diaper dermatitis (DD) is a common inflammatory disorder in infants, including newborns.

Objectives: This study aimed to compare the effects of a traditional medicine product (containing natural henna oil 25%) and hydrocortisone 1% cream on DD in infants.

Patients And Methods: In a triple-blind, randomized trial, 82 children aged two years or less were randomly divided into two groups of 41 children each to receive either hydrocortisone ointment or henna medicinal product. Read More

Int J Dermatol 2016 Jul;55 Suppl 1:10-3

Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium.

Diaper dermatitis is a common condition that often prompts parents to seek medical attention. Irritant diaper dermatitis is by far the most common cause, but numerous potentially serious diseases can present with changes of the skin in the diaper area. The differential diagnosis can include psoriasis, metabolic disorders, rare immune diseases and infection. Read More

Int J Dermatol 2016 Jul;55 Suppl 1:2-3

Department of Pediatric Dermatology, Hospital del Niño Jesús, Madrid, Spain.

Dr Antonio Torrelo, President of the 12(th) World Congress of Pediatric Dermatology, introduces the supplement as providing an opportunity for readers to access the lectures and related presentations delivered at the World Congress of Pediatric Dermatology held September 25-27, 2013, in Madrid. Read More

J Am Acad Dermatol 2016 Jul 4;75(1):69-76.e2. Epub 2016 Mar 4.

Department of Dermatology, University of California, San Diego, California; Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California. Electronic address:

Background: A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD).

Objective: We sought to systematically compare KD-associated psoriasiform eruptions with classic psoriasis and the outcomes of KD in children with and without this rash.

Methods: This was a retrospective study of 11 KD cases with a psoriasiform eruption matched 1:2 by age, gender, and ethnicity with psoriasis-only and KD-only controls. Read More

J Clin Diagn Res 2016 Jan 1;10(1):WC04-6. Epub 2016 Jan 1.

Research Expert, Department of Nursing, Research and Technology Division, Shahrekord University of Medical Sciences , Shahrekord, Iran .

Introduction: Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Read More

Indian J Pediatr 2015 Oct 2;82(10):904-8. Epub 2015 Jun 2.

Department of Dermatology, Sisli Etfal Teaching and Research Hospital, Sisli, Istanbul, Turkey.

Objective: To determine infant diaper dermatitis (DD) at pediatrics health center; its relation to socio-demographic factors and infant care.

Methods: The study included 113 infants aged 0-24 mo. Data on infants' age, sex, weight, mothers' education, nutrition, diaper change frequency, cleaning methods and prophylactic cream use were recorded. Read More

J Fam Psychol 2015 Jun 4;29(3):371-81. Epub 2015 May 4.

Department of Psychology, Emory University.

The emergence of consolidated nighttime sleep and the formation and maintenance of parent-infant relationships are 2 primary developmental achievements of the infancy period. Despite the development of a transactional model that links parenting behaviors to infant sleep, limited attention has been devoted to examining experimental manipulations of infant sleep that may impact the discrete parent-infant interactions that may form the foundation for emerging attachment relationships. In the present study, infants were randomly assigned to wear high-absorbency disposable diapers or to continue using traditional low-absorbency cloth diapers that necessitate frequent changes and associated disruptions of nighttime sleep. Read More

J Trop Pediatr 2015 Aug 31;61(4):250-4. Epub 2015 Mar 31.

Department of Neonatology, Fernandez Hospital, Hyderguda, Hyderabad 500029, Andhra Pradesh, India.

Objective: To study whether disposable diapers decrease the incidence of neonatal infections compared with cloth diapers in a level II neonatal intensive care unit (NICU).

Method And Material: All neonates admitted to the NICU and having duration of stay >48 h were enrolled. Those babies with signs and symptoms of infection were screened with septic screen and/or blood culture. Read More

Nurs Midwifery Stud 2014 Jun 15;3(2):e14180. Epub 2014 Jun 15.

Department of Pediatrics, Emam Khomeini Hospital, Khomein, Markazi Province, IR Iran.

Background: Diaper rash is one of the most common skin disorders of infancy and childhood. Some studies have shown that Shampoo-clay was effective to treat chronic dermatitis. Then, it is supposed that it may be effective in diaper rash; however, no published studies were found in this regard. Read More

Arch Dis Child Educ Pract Ed 2015 Aug 3;100(4):185-6, 224-5. Epub 2014 Nov 3.

Division of Pediatric Dermatology, Department of Pediatrics, Federal University of Paraná, Hospital de Clínicas da UFPR, Curitiba, Paraná, Brazil.

Nappy (diaper) rash is a common cutaneous disorder of infancy, and diverse dermatoses may affect this region. To perform a differential diagnosis can be challenging. We present four cases to emphasise the importance of clinical diagnosis. Read More

J Pediatr Urol 2014 Dec 22;10(6):1227-31. Epub 2014 Jul 22.

Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, College of Medicine, Linkou, Taiwan. Electronic address:

Introduction: Patients with lower urinary tract anomalies or neurogenic disorders often suffer from voiding difficulties. Clean intermittent catheterization (CIC) is effective for bladder drainage; however, this is often painful. Transurethral catheterization is also impossible in patients with urethral stricture. Read More

Clin Pediatr (Phila) 2014 Aug 24;53(9 suppl):27S-28S. Epub 2014 Jun 24.

Center for Baby and Adult Hygiene Products, Washington, DC, USA.

With the needs of both pediatricians and parents in mind and the safety of babies a top priority, continual innovations in diaper technology have produced meaningful improvements in duration of use and care for the skin, all with the reassurance of extensive safety validation. Read More

J Pediatr 2014 Sep 16;165(3):634. Epub 2014 Jun 16.

Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.

Semin Cutan Med Surg 2013 Jun;32(2 Suppl 2):S30-2

Discovery Pediatrics, Inc., Valencia, CA 91355, USA.

Good skin care has two overall goals: to support and maintain healthy stratum corneum function and to help restore barrier function perturbed by disease processes or injuries. In this article, we discuss the special attention that is required in the initial skin care of newborns, and we address what measures, beyond the basic skin care principles, are required for patients with conditions such as atopic dermatitis, acne, contact and allergic dermatitis, and diaper rash. Read More

J Pediatr 2014 Jan 7;164(1):208-9. Epub 2013 Oct 7.

Departments of Dermatology and of Pediatrics, University of New Mexico, Albuquerque, New Mexico.

Pediatr Emerg Care 2013 May;29(5):617-23

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA.

Objectives: The perineal and gluteal regions are the most frequent areas of skin and soft tissue infection (SSTI) in diapered children. No studies have investigated the relationship between perineal and general hygiene practices and SSTIs in this population. This study was conducted to evaluate this relationship. Read More

J Perinatol 2013 Jul 17;33(7):529-32. Epub 2013 Jan 17.

Department of Pediatrics, Tulane University School of Medicine Pediatrics: Neonatology, New Orleans, LA 70112, USA.

Objective: We changed from ampicillin and gentamicin (AG) to piperacillin-tazobactam (PT) for routine treatment of suspected early-onset sepsis. The rationale for this change included ototoxic and renal toxic effects of gentamicin, resistance to gentamicin in late-onset infections and emergence of ampicillin resistant Escherichia coli. A before and after study was designed before the start of PT administration to monitor whether PT was associated with altered outcomes within the 501 to 1500 g birth weight (Very Low Birth Weight) population. Read More

J Matern Fetal Neonatal Med 2013 Jan 20;26(2):197-200. Epub 2012 Sep 20.

Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Erciyes University, Kayseri, Turkey.

Aim: Based on a maternal observation, we aimed to evaluate the treatment effectiveness of guaiazulene (GA) containing local pomade in the high-risk neonates with recalcitrant diaper dermatitis (RDD).

Methods: We included 30 NICU patients of RDD, with level II-III aged between 22 and 67 days. Study group patients (n = 20) were treated with GA containing local pomade (0. Read More

Endocrine 2010 Dec 23;38(3):328-34. Epub 2010 Oct 23.

Division of Dermatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

Prolonged use of topical corticosteroids causes systemic adverse effects including Cushing's syndrome and hypothalamic-pituitary-adrenal (HPA) axis suppression, which is less common than that of the oral or parenteral route. At least 43 cases with iatrogenic Cushing syndrome from very potent topical steroid usage (Clobetasol) in children and adult have been published over the last 35 years particularly in developing countries. In children group (n = 22), most are infants with diaper dermatitis and two cases who had started topical application at a very early age and died from severe disseminated CMV infection. Read More

J Med Assoc Thai 2006 Oct;89(10):1654-8

Department of Pediatrics, Division of Pediatric Dermatology, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok 10330, Thailand.

Background: Severity of irritant diaper dermatitis (IDD) from diarrhea varies from patient to patient depending on the nature of feces and the number of bowel movements. The purpose of the present study was to compare the effectiveness of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from acute diarrhea in children by measuring transepidermal water loss (TEWL).

Material And Method: Forty-six children with diarrhea were prospectively, block randomized, investigator-blinded to receive dexpanthenol and zinc oxide ointment on one side and ointment base on the other side. Read More

Pediatr Ann 2006 Feb;35(2):79, 82-3

Department of Pediatrics, Children's Memorial Medical Center, Chicago, IL, USA.

Pediatr Dermatol 2006 Jan-Feb;23(1):43-8

Department of Medicine and Pediatrics (Dermatology), Dartmouth-Hitchcock Clinic, Dartmouth Medical School, Lebanon, New Hampshire, USA.

Cutaneous erosions and ulcerations in the diaper area are common in infancy and usually result from local irritation. We describe an infant with chronic diarrhea and failure to thrive who developed extensive ulcerations in the inguinal folds and perineum that were initially thought to be exclusively caused by local irritation. A cutaneous examination found signs consistent with those of pyoderma gangrenosum, leading to a diagnosis of infantile Crohn disease. Read More

Pediatrics 2005 Sep;116(3):e450-2

Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA.

Diaper dermatitis is a common problem in outpatient pediatric office settings. Although most diaper rashes represent a form of contact dermatitis in response to irritants in the diaper environment, other rashes may be the result of an allergen in the diaper. On the basis of clinical examination results for 5 patients and patch testing results for 2 patients, we suspect that the patients demonstrated allergic contact dermatitis in response to the various blue, pink, and green dyes in diapers. Read More

Pediatr Dermatol 2004 Sep-Oct;21(5):561-3

Department of Pediatrics, Ankara Hospital, Ankara, Turkey.

Chronic low-dose exogenous steroid therapy in children can result in hypothalamic-pituitary-adrenal axis dysfunction. However, the development of Cushing syndrome from topical steroid therapy is unusual. A 9-month-old girl with a diagnosis of Cushing syndrome caused by long-term topical clobetasol propionate application was evaluated. Read More

Semin Perinatol 2003 Oct;27(5):406-13

Division of Infectious Diseases, Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, TX 77555-0371, USA.

Mucocutaneous infection with Candida in neonates ranges from such common conditions as thrush and diaper dermatitis to serious diseases with potential for systemic involvement, including congenital candidiasis and invasive fungal dermatitis. In premature infants, seemingly benign mucocutaneous involvement may precede systemic infection and thus warrants thoughtful attention. Skin involvement also may be seen as an expression of systemic disease. Read More

Indian J Pediatr 2003 Sep;70(9):721-2

Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India.

Nappy rash is a common problem in infants due to their thinner skin, wetness, heat and friction under cloth nappy, fecal enzymes and alkaline urine. The disposable diapers containing Super Absorbent Material (SAM) reduce the incidence of nappy rash. SAM quickly absorbs urine and keeps the skin dry. Read More

Kinderkrankenschwester 2001 Dec;20(12):517-8

Pediatr Case Rev 2002 Oct;2(4):220-5

Departments of *Pediatrics and dagger Dermatology, University of Pennsylvania School of Medicine, and The Children's Hospital of Philadelphia, PA.