Clinical Presentation and Diagnosis of Diaper Dermatitis Typical Symptoms

• Erythema is the most common symptom presented with a diaper rash. The rash may begin as light to medium pink with poorly defined edges, but when further developed may become dark red and raised lesions with distinct edges.

• Rashes generally appear in the folds of the skin around the diaper area, thighs, genitals, and buttocks.

• Other typical symptoms include irritation and pruritus. Atypical symptoms

Patients presenting with the following symptoms may indicate the need for more aggressive antibiotic or antifungal therapy and should be referred to a primary care physician for further evaluation:

• Rashes not responding to typical creams and concurrent nonpharmacologic treatment

• Rashes extending beyond the diaper region (upper abdomen, back)

• Formation of papules, bullae, ulceration

• Excessive oozing

• Presence of genital discharge

• Concurrent fever

• Rashes appearing when diapers have not been used or rashes that fail to improve upon discontinuing diaper usage for extended periods of time (several days or more)

• Bleeding or open skin Diagnosis

The diagnosis of diaper dermatitis is clinical. The presence of Candida albicans can be determined by KOH testing or culture, but is generally not necessary.

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