The skin is the largest organ of the human body and has secretory, metabolic and perceptual functions, as well as a protective function against factors of the external world [9]. It is a complex and dynamic organ, comprising many layers and appendages of the skin. The epidermis is the outermost part that protects against the loss of body fluids and the entry of toxins, microorganisms, irritants into the body. It is the first line of immune response and also protects against the harmful effects of ultraviolet radiation.
Nappy dermatitis (napkin dermatitis, nappy dermatitis) affects approximately 10% of children from birth to 18-24 months of age [10,12,13] and accounts for approximately 10-20% of all dermatitis in the paediatric population [5,14]. Observations suggest that 7-35% of infants have experienced at least one episode of nappy dermatitis [5,13,14]. Symptoms usually appear in early childhood, usually between 2 and 3 months of age of the child. However, they are most commonly observed in infants between 7 and 12 months of age, when children begin to eat more solid foods and the nature of stools changes.
The tendency to subside occurs around 2 years of age, when most children no longer need nappies and begin to use the toilet [2,5,13], and the skin functionally and anato-mically resembles that of an adult [9].
The clinical picture of nappy rash dermatitis is characterised by erythematous lesions, with the presence of papular eruptions and secondary epidermal scaling and oedema [2,3,6,7,10,12,13]. In more severe forms, erosions, blisters covered with honey-yellow scabs and pustules may appear, which may indicate the attachment of infection, as inflamed, macerated skin is prone to damage and the development of infection [5]. Yeast as well as staphylococci and streptococci are common aetiological agents. A concurrent fungal infection caused by Candida albicans is found in up to 70% of cases of nappy rash, as the fungi like a warm, moist environment, and these conditions prevail under nappies [3,10,12,13]. Recurrent or chronic exposure to irritants leads to permanent changes in the form of lichenisation (thickening) of the skin [5]. Lesions in nappy rash dermatitis can be sparse, confined to a small area, or severe, spreading to the thighs and abdomen, usually not extending beyond the areas covered by the nappy [13]. It is important to identify and remove the irritant causing the inflammation, as subsequent exposure leads to more severe lesions [10,12,13].
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photo: Sudocrem
Nappy dermatitis is a common cause of concern for parents, it can be accompanied by itching, which causes considerable discomfort for babies, but in most cases it does not require any special treatment and the skin heals after simple skin care measures.
How to recognise nappy rash dermatitis? Click HERE
Management of nappy rash dermatitis. Click HERE
