Diaper irritant contact dermatitis
There have been several reports in the literature of laxative use in infants leading to a severe irritant dermatitis. Laxative-induced diarrhea contained and occluded by a diaper can cause bullae and erosions.
Related topics: Jacquet erosive diaper dermatitis, Diaper dermatitis candidiasis
L22 – Diaper dermatitis
91487003 – Diaper rash
Alternative causes include atopic and seborrheic dermatitis (look for rash at distant sites such as the face and scalp for seborrheic dermatitis and flexural regions for atopic dermatitis).
- Allergic contact dermatitis, particularly due to dyes in diapers or ingredients such as methylisothiazolinone in baby wipes.
- Psoriasis will present as well-demarcated pink plaques that do not spare the skin folds and may be associated with perianal streptococcal infections.
- Granuloma gluteale infantum (nodules are present)
- Hereditary acrodermatitis enteropathica, acquired zinc deficiency, and other nutritional deficiencies should be considered in persistent conditions.
- Langerhans cell histiocytosis (LCH) is a crucial differential diagnosis not to overlook. LCH lesions are petechial papules, often in the skin folds, that do not respond to standard therapies for diaper dermatitis.
- Perianal streptococcal infection
- Human papillomavirus
- Herpes simplex virus
- Bullous impetigo
- Molluscum contagiosum
- Hand-foot-and-mouth disease
- Nonaccidental trauma (see physical child abuse and sexual child abuse)
- Kawasaki disease
- Cystic fibrosis
- Lichen sclerosus
- Congenital syphilis
- Hyperimmunoglobulinemia E syndrome
- Methylmalonic acidemia