Pediatr Dermatol 2018 Mar;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

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

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.

Dermatol Online J 2002 Oct;8(2)

Department of Dermatology, Wake Forest University School of Medicine.

Clotrimazole-betamethasone diproprionate (C-BMV) is a fluorinated, high potency topical steroid that has been formulated with clotrimazole in the brand-named product, Lotrisone. The product is frequently used inappropriately in intertriginous areas, particularly in children. The following evaluates the use of this combination based upon a survey of 106 US-based pediatricians with at least two years post-residency, who attended the 1999 American Academy of Pediatrics. Read More

MMW Fortschr Med 2002 Jun;144(25):24-8, 30

MMW-Stipendiat, Forschungsschwerpunkt Genodermatosen, Klinik u. Poliklinik für Dermatologie u. Allergologie der LMU München.

Infections may lead to a multitude of pathological skin alterations, and represent the most common diseases in pediatric dermatology. A prerequisite for successful treatment is an accurate diagnosis based on the medical history, clinical presentation and the culture of pathogens. Of importance among the bacterial skin diseases in pediatrics are impetigo, scarlet fever, borreliosis and cat-scratch fever. Read More

Turk J Pediatr 2001 Jan-Mar;43(1):65-6

Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakir, Turkey.

Henna is a traditional cosmetic agent and is used worldwide, especially in the Middle East. Its active agent is lawsone (2-hydroxy-1,4-naphthoquinone). Henna is not only applied to hands or hair as a cosmetic agent in traditional ceremonies, but is also applied to the body on lesions in the treatment of seborrheic dermatitis or fungal infections. Read More

Indian J Pediatr 2001 Jan;68(1):15-9

Department of Pediatrics, Uludag University Faculty of Medicine, Bursa, Turkey.

Recently, new broad spectrum carbapenem has been investigated on a world-wide scale for the treatment of moderate to severe infections. In the neonatal intensive care units the extensive use of third generation cephalosporins for therapy of neonatal sepsis may lead to rapid emergence of multiresistant gram-negative organisms. We report the use of meropenem in 35 infants with severe infections due to Acinetobacter baumanii and Klebsiella pneumoniae. Read More

Arch Pediatr Adolesc Med 2000 Sep;154(9):943-6

Department of Dermatology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.

Background: Diaper dermatitis is the most common dermatologic disorder of infancy. This study evaluates the frequency of outpatient visits resulting in this diagnosis, specialties of physicians providing services, demographics of patients, and leading agents used in treatment.

Design: Records of 272,841 encounters from the National Ambulatory Medical Care Survey (1990-1997) were examined for visits in which diaper dermatitis was diagnosed in children. Read More

Pediatr Clin North Am 2000 Aug;47(4):757-82

Department of Pediatrics and Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

The relative importance of neonatal health and neonatal skin care has been highlighted in recent years as infant mortality rates have decreased while death rates during the neonatal period remain unacceptably high in many areas of the world. During the neonatal period, many newborns develop preventable, clinically apparent skin problems, and many more, especially preterm neonates, experience morbidity caused by compromised skin barrier integrity. Several strategies are available for protecting the integrity and promoting the hygiene of the skin and augmenting its function as a barrier to TEWL and heat loss and the entrance of infectious or toxic agents. Read More

Acta Paediatr 2000 Jan;89(1):18-21

Department of Paediatrics, University Hospital, Lund, Sweden.

This study found that two casein hydrolysate formulas varying in composition were equally effective in managing colicky symptoms associated with protein sensitivity. Both hydrolysate formulas were associated with a significant, comparable reduction in crying duration and intensity from baseline in 15 of 22 infants with complete data. Subsequent challenge data suggest that the population studied were infants experiencing colicky symptoms due to protein sensitivity. Read More

Pediatr Emerg Care 1999 Aug;15(4):294-7

Division of Emergency Services, Children's Hospital of Michigan, Detroit, USA.

Pediatr Rev 1998 May;19(5):166-71

Department of Pediatrics, UCSD School of Medicine, USA.

Pediatrics 1997 Jul;100(1):E11

Institute of Child Health, University of Bristol, Bristol, England.

Objective: To assess whether the recommendations that infants sleep supine could have adverse health consequences.

Design: A prospective study of infants, delivered before, during, and after the Back to Sleep Campaign in the United Kingdom (UK), followed to 6 months of age. The children were part of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Read More

Ann Emerg Med 1995 Jan;25(1):111-4

Department of Pediatrics, Brown University, Providence, Rhode Island.

Three children who presented with localized vesicular rash in the diaper area were found to have primary varicella-zoster infections. Primary varicella can closely mimic genital herpes simplex virus (HSV 1 or 2), which may be an indicator of sexual abuse. To avoid unfounded investigation for sexual abuse, primary varicella-zoster infection must be included in the differential diagnosis. Read More

Pediatrics 1994 Dec;94(6 Pt 1):847-52

Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.

Objective: To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media.

Design: Randomized, multicenter, investigator-blinded.

Setting: Outpatient. Read More

Pediatrics 1992 Mar;89(3):523