Resident Rounds Part III. Case Report: Diaper Dermatitis Presenting as Pustules

September 2014 | Volume 13 | Issue 9 | Features | 1153 | Copyright © September 2014


Ann R. Tucker BA,a Ashley N. Emerson MD,a Julie P. Wyatt MD,b Robert T. Brodell MDc

aUniversity of Mississippi Medical Center, Jackson, MS
bDivision of Dermatology, Department of Otolaryngology and Communicative Services,
University of Mississippi Medical Center, Jackson, MS
cDivision of Dermatology, Department of Otolaryngology and Communicative Services, University of Mississippi Medical Center, Jackson, MS and University of Rochester School of Medicine and Dentistry, Rochester, NY

table 1
In the setting of a negative KOH and a lack of response to treatment measures, Gram staining or a bacterial culture can easily be performed to exclude bacterial folliculitis. If these measures fail to confirm a diagnosis, the more rare causes of diaper dermatitis should be considered. These include allergic contact dermatitis, psoriasis, Langerhans cell histiocytosis, and acrodermatitis enteropathica.6 A consideration of family history, a complete dermatologic examination, a biopsy, and serologic testing for zinc levels may be considered in this circumstance.

Disclosures

Robert Brodell declares the following potential conflicts of interest: Speaker's Bureau: Allergan; Galderma; 3M/Graceway Pharmaceuticals; GlaxoSmithKline/Stiefel; Dermik; Novartis Pharmaceuticals Corporation; Sanofi-Aventis; Medicis; PharmaDerm, a division of Nycomed US Inc. Consultant: Galderma Laboratories, LP; Medicis; Dow Pharmaceuticals Sciences; Promius. Advisory Boards: Dow Pharmaceuticals Sciences; Nycomed US Inc. Grant/Research Support; Galderma; Abbott Laboratories; Dow Pharmaceuticals Sciences. Ms. Tucker, Dr. Emerson, and Dr. Wyatt have no conflicts.

References

  1. Ward DB, Fleischer AB, Feldman SR, Krowchuk DP. Characterization of diaper dermatitis in the United States. Arch Pediatr Adolesc Med. 2000; 154:943-946.
  2. Adam, R. Skin care of the diaper area. Pediatr Dermatol. 2008; 24(4):427-433.
  3. Scheinfeld N. Diaper dermatitis a review and brief survey of eruptions of the diaper area. Am J Clin Dermatol. 2005; 6(5):273-281.
  4. Gupta AK, Skinner AR. Management of diaper dermatitis. Int J Dermatol. 2004; 43:830-834.
  5. Nanda S, Reddy BS, Ramji S, Pandhi D. Analytical study of pustular eruptions in neonates. Pediatri Dermatol. 2002; 19(3):210-215.
  6. Ravanfar P, Wallace J, Pace N. Diaper dermatitis: a review and update. Curr Opin Pediatr. 2012; 24:1-8.

AUTHOR CORRESPONDENCE

Robert T. Brodell MDrbrodell@umc.edu
Close Menu