Diaper rash

Case history

An 8-month-old girl presents with mild erythema of the labia majora, perianal area, and convex surfaces of buttocks for the past 2 days following a 3-day history of diarrhea.

Other presentations

Other presentations include cases where diaper rash lasts longer than 3 days, cases that have accompanying worrisome signs or symptoms (i.e., child with faltering growth, recurrent infections), or rash that persists despite recommended treatments. Diaper rashes that last longer than 3 days are suspicious for secondary candidal infection and secondary bacterial infection (i.e., Staphylococcus aureus).​​​[1]Mohamadi J, Motaghi M, Panahi J, et al. Anti-fungal resistance in candida isolated from oral and diaper rash candidiasis in neonates. Bioinformation. 2014 Nov 27;10(11):667-70. http://www.bioinformation.net/010/97320630010667.htm http://www.ncbi.nlm.nih.gov/pubmed/25512681?tool=bestpractice.com ​​

Red, moist erosions in the diaper area accompanied by perioral or extremity involvement may signal acrodermatitis enteropathica. Scaly papules on face, scalp, and axilla may be secondary to histiocytosis. Nutritional deficiencies (zinc, biotin, essential fatty acids, protein), metabolic disorders (i.e., organic acidurias), or immune deficiencies may also be the cause of recalcitrant cases. A child who is neglected and/or abused and whose caregiver is noncompliant with treatment may present with consistently poor hygiene, bruises, or other suspicious skin findings.