What are the causes of candidal diaper rash in infants. How can you identify symptoms of yeast diaper rash. What are effective treatments for candida diaper rash in babies. How to prevent recurrence of fungal diaper rash.

Understanding Candidal Diaper Rash: A Common Infant Skin Condition

Candidal diaper rash, also known as yeast diaper rash, is a common skin condition that affects many infants and toddlers. This type of diaper rash is caused by an overgrowth of Candida, a type of yeast that thrives in warm, moist environments – making the diaper area an ideal breeding ground. While diaper rash can have various causes, candidal infections require specific treatment and care.

Identifying the Signs and Symptoms of Candidal Diaper Rash

Recognizing a candidal diaper rash is crucial for proper treatment. Here are the key characteristics to look out for:

• Bright red, raised rash covering the entire diaper area
• Smaller satellite patches blending with the main rash
• Small bumps or pus-filled pimples
• Scaly, very red scrotum in boys
• Itching and increased fussiness in the child

Can candidal diaper rash spread beyond the diaper area. In some cases, the rash may extend to the folds of the thighs and buttocks, and even to the lower abdomen. If you notice any of these symptoms, it’s important to consult with your child’s healthcare provider for proper diagnosis and treatment.

Causes and Risk Factors for Yeast Diaper Rash

Understanding the causes of candidal diaper rash can help in prevention and management. The primary factors contributing to this condition include:

1. Prolonged exposure to wet or soiled diapers
2. Warm, moist environment in the diaper area
3. Friction between the diaper and skin
4. Recent antibiotic use (which can disrupt the natural balance of skin flora)
5. Weakened immune system

Does diet affect the likelihood of developing candidal diaper rash. While diet isn’t a direct cause, infants who are breastfed by mothers taking antibiotics may be at higher risk due to changes in the mother’s microbiome. Additionally, introducing new foods to a baby’s diet can sometimes lead to changes in stool that may increase the risk of diaper rash.

Effective Treatment Options for Candidal Diaper Rash

Treating candidal diaper rash typically involves a combination of antifungal medication and proper diaper care. Here’s what you need to know:

Antifungal Creams and Ointments

Over-the-counter antifungal creams or ointments are usually the first line of treatment. These medications work by eliminating the excess yeast on the skin. Apply a thick layer of the cream to the affected area at each diaper change. In most cases, the rash should begin to clear within a few days of starting treatment.

Are prescription medications ever necessary for candidal diaper rash. If the over-the-counter treatments don’t work or if the infection is severe, your healthcare provider may prescribe a stronger antifungal medication. In rare cases where a bacterial infection is also present, antibiotics may be necessary.

Proper Diaper Care and Hygiene

In addition to medication, proper diaper care is crucial for treating and preventing candidal diaper rash:

• Change diapers frequently, especially when wet or soiled
• Clean the diaper area gently with warm water and a soft cloth
• Allow the skin to air dry completely before putting on a new diaper
• Apply a barrier cream or ointment to protect the skin
• Consider using breathable diaper covers or allowing diaper-free time

Preventing Recurrence of Candidal Diaper Rash

Once you’ve successfully treated a candidal diaper rash, taking steps to prevent its recurrence is important. Here are some preventive measures:

1. Keep the diaper area clean and dry
2. Change diapers promptly when wet or soiled
3. Use gentle, fragrance-free products on your baby’s skin
4. Allow for diaper-free time to expose the skin to air
5. Consider using a barrier cream at each diaper change

How often should you bathe a baby to prevent diaper rash. While regular bathing is important, excessive bathing can actually dry out and irritate a baby’s skin. Aim for 3-4 baths per week, using warm (not hot) water and mild, fragrance-free soap. Always pat the skin dry gently, paying special attention to skin folds.

When to Seek Medical Attention for Diaper Rash

While most cases of candidal diaper rash can be managed at home, there are instances when professional medical care is necessary. Contact your child’s healthcare provider if:

• The rash doesn’t improve after a few days of home treatment
• The rash is severe or appears to be spreading
• Your child develops a fever or seems unusually fussy
• You notice blisters, open sores, or bleeding in the diaper area
• There’s unusual or foul-smelling discharge

Should you continue using over-the-counter treatments if the rash persists. If the rash doesn’t show improvement after 3-4 days of consistent treatment, it’s best to consult with a healthcare provider. They may need to prescribe a stronger medication or investigate other potential causes of the persistent rash.

The Impact of Diapers and Diapering Practices on Skin Health

The type of diaper and diapering practices you use can significantly impact your baby’s skin health and the likelihood of developing diaper rash, including candidal infections. Consider the following factors:

Diaper Types and Materials

Different diaper types have varying levels of absorbency and breathability:

• Disposable diapers: Often highly absorbent but may trap moisture against the skin
• Cloth diapers: More breathable but require frequent changing
• Hybrid diapers: Combine elements of both disposable and cloth diapers

Is one type of diaper better for preventing candidal diaper rash. There’s no definitive evidence that one type of diaper is superior for preventing yeast infections. The key is to choose a diaper that fits well and to change it frequently, regardless of the type.

Diapering Techniques

Proper diapering techniques can help reduce the risk of diaper rash:

1. Clean the diaper area thoroughly but gently
2. Allow the skin to dry completely before putting on a new diaper
3. Apply a thin layer of protective barrier cream or ointment
4. Fasten the diaper snugly but not too tight
5. Consider using a larger diaper size to allow for better air circulation

How often should you change a baby’s diaper to prevent rash. Ideally, you should check your baby’s diaper every 2-3 hours and change it as soon as it becomes wet or soiled. Overnight, try to change the diaper at least once to minimize prolonged exposure to moisture.

The Role of Diet and Nutrition in Diaper Rash Prevention

While diet isn’t a direct cause of candidal diaper rash, it can play a role in overall skin health and the frequency and consistency of bowel movements, which can impact diaper rash occurrence. Consider the following dietary factors:

For Breastfed Babies

The mother’s diet can potentially affect the baby’s digestive system and, consequently, their stool:

• Some babies may be sensitive to certain foods in the mother’s diet
• Maintaining a balanced diet rich in nutrients can support the baby’s overall health

For Formula-Fed Babies

Choosing the right formula and feeding practices can help:

• Use a formula that agrees with your baby’s digestive system
• Avoid overfeeding, which can lead to more frequent stools

For Babies Starting Solids

Introducing new foods can sometimes lead to changes in stool consistency:

• Introduce new foods gradually
• Be aware that certain foods (like citrus fruits) may increase the likelihood of diaper rash in some babies

Can probiotics help prevent candidal diaper rash. While research is ongoing, some studies suggest that probiotics may help support a healthy balance of bacteria and yeast on the skin and in the gut. However, always consult with your pediatrician before giving your baby any supplements.

Managing Candidal Diaper Rash in Special Situations

Certain situations may require special considerations when managing candidal diaper rash:

Cloth Diaper Users

If you use cloth diapers, consider these additional steps:

• Use hot water and an extra rinse cycle when washing diapers
• Consider using a vinegar rinse to help eliminate yeast
• Dry diapers in direct sunlight when possible, as UV light can help kill yeast

Babies with Sensitive Skin

For babies prone to skin irritation:

• Use hypoallergenic products free from fragrances and dyes
• Consider using cloth diapers or diapers made from natural materials
• Be extra vigilant about keeping the diaper area clean and dry

Babies on Antibiotics

Antibiotics can increase the risk of yeast overgrowth:

• Be extra diligent about diaper changes and skin care during antibiotic treatment
• Consider using a preventive antifungal cream during the course of antibiotics

How long does it typically take for candidal diaper rash to clear up with proper treatment. With consistent and appropriate treatment, most cases of candidal diaper rash begin to improve within 2-3 days and clear up completely within 1-2 weeks. If you don’t see improvement within a few days of starting treatment, consult your healthcare provider.

By understanding the causes, symptoms, and treatment options for candidal diaper rash, parents and caregivers can effectively manage this common condition and help keep their little ones comfortable and healthy. Remember, prevention is key, and maintaining good diaper hygiene practices is crucial in reducing the risk of diaper rash and other skin irritations in infants and toddlers.

Diaper Rash, Candida (Infant/Toddler)

Candida is type of yeast. It grows best in warm, moist areas. It is common for Candida to grow in the skin folds under a child’s diaper. When there is an overgrowth of Candida, it can cause a rash called a Candida diaper rash.

The entire area under the diaper may be bright red. The borders of the rash may be raised. There may be smaller patches that blend in with the larger rash. The rash may have small bumps and pimples filled with pus. The scrotum in boys may be very red and scaly. The area will itch and cause the child to be fussy.

Candida diaper rash is most often treated with over-the-counter antifungal cream or ointment. The rash should clear a few days after starting the medicine. Infections that don’t go away may need a prescription medicine. In rare cases, a bacterial infection can also occur.

Home care

Medicines

Your child’s healthcare provider will recommend an antifungal cream or ointment for the diaper rash. He or she may also prescribe a medicine to help relieve itching. Follow all instructions for giving these medicines to your child. Apply a thick layer of cream or ointment on the rash. It can be left on the skin between diaper changes. You can apply more cream or ointment on top, if the area is clean.

General care

Follow these tips when caring for your child:

• Be sure to wash your hands well with soap and warm water before and after changing your child’s diaper and applying any medicine.

• Check for soiled diapers regularly. Change your child’s diaper as soon as you notice it is soiled. Gently pat the area clean with a warm, wet soft cloth. If you use soap, it should be gentle and scent-free. Topical barriers such as zinc oxide paste or petroleum jelly can be liberally applied to help prevent urine and stool contact with the skin.

• Change your child’s diaper at least once at night. Put the diaper on loosely. 

• Use a breathable cover for cloth diapers instead of rubber pants. Slit the elastic legs or cover of a disposable diaper in a few places. This will allow air to reach your child’s skin. Note: Disposable diapers may be preferred until the rash has healed.

• Allow your child to go without a diaper for periods of time. Exposing the skin to air will help it to heal.

• Don’t over clean the affected skin areas. This can irritate the skin further. Also don’t apply powders such as talc or cornstarch to the affected skin areas. Talc can be harmful to a child’s lungs. Cornstarch can cause the Candida infection to get worse.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to seek medical advice

Unless your child’s healthcare provider advises otherwise, call the provider right away if:

• Your child has a fever (see Fever and children, below)

• Your child is fussier than normal or keeps crying and can’t be soothed.

• Your child’s symptoms worsen, or they don’t get better with treatment.

• Your child develops new symptoms such as blisters, open sores, raw skin, or bleeding.

• Your child has unusual or foul-smelling drainage in the affected skin areas.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

• Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

• Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

• Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

• Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Diaper rash – Symptoms and causes

Overview

Diaper rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red skin on your baby’s bottom.

Diaper rash is often related to wet or infrequently changed diapers, skin sensitivity, and chafing. It usually affects babies, though anyone who wears a diaper regularly can develop the condition.

Diaper rash can alarm parents and annoy babies. But it usually clears up with simple at-home treatments, such as air drying, more frequent diaper changes and ointment.

Symptoms

Diaper rash is characterized by the following:

• Skin signs. Diaper rash is marked by red, tender-looking skin in the diaper region — buttocks, thighs and genitals.
• Changes in your baby’s disposition. You may notice your baby seems more uncomfortable than usual, especially during diaper changes. A baby with a diaper rash often fusses or cries when the diaper area is washed or touched.

When to see a doctor

If your baby’s skin doesn’t improve after a few days of home treatment, talk with your doctor. Sometimes, you’ll need a prescription medication to treat diaper rash.

Have your child examined if the rash:

• Is severe or unusual
• Gets worse despite home treatment
• Bleeds, itches or oozes
• Causes burning or pain with urination or a bowel movement
• Is accompanied by a fever

Causes

Diaper rash can be traced to a number of sources, including:

• Irritation from stool and urine. Prolonged exposure to urine or stool can irritate a baby’s sensitive skin. Your baby may be more prone to diaper rash if he or she is experiencing frequent bowel movements or diarrhea because feces are more irritating than urine.
• Chafing or rubbing. Tightfitting diapers or clothing that rubs against the skin can lead to a rash.
• Irritation from a new product. Your baby’s skin may react to baby wipes, a new brand of disposable diapers, or a detergent, bleach or fabric softener used to launder cloth diapers. Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.
• Bacterial or yeast (fungal) infection. What begins as a simple skin infection may spread to the surrounding region. The area covered by a diaper — buttocks, thighs and genitals — is especially vulnerable because it’s warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.
• Introduction of new foods. As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of diaper rash. Changes in your baby’s diet can also increase the frequency of stools, which can lead to diaper rash. If your baby is breast-fed, he or she may develop diaper rash in response to something the mother has eaten.
• Sensitive skin. Babies with skin conditions, such as atopic dermatitis or seborrheic dermatitis (eczema), may be more likely to develop diaper rash. However, the irritated skin of atopic dermatitis and eczema primarily affects areas other than the diaper area.
• Use of antibiotics. Antibiotics kill bacteria — the good kinds as well as the bad. When a baby takes antibiotics, bacteria that keep yeast growth in check may be depleted, resulting in diaper rash due to yeast infection. Antibiotic use also increases the risk of diarrhea. Breast-fed babies whose mothers take antibiotics are also at increased risk of diaper rash.

Prevention

The best way to prevent diaper rash is to keep the diaper area clean and dry. A few simple strategies can help decrease the likelihood of diaper rash developing on your baby’s skin.

• Change diapers often. Remove wet or dirty diapers promptly. If your child is in child care, ask staff members to do the same.
• Rinse your baby’s bottom with warm water as part of each diaper change. You can use a sink, tub or water bottle for this purpose. Moist washcloths, cotton balls and baby wipes can aid in cleaning the skin, but be gentle. Don’t use wipes with alcohol or fragrance. If you wish to use soap, select a mild, fragrance-free type.
• Gently pat the skin dry with a clean towel or let it air dry. Don’t scrub your baby’s bottom. Scrubbing can further irritate the skin.
• Don’t overtighten diapers. Tight diapers prevent airflow into the diaper region, which sets up a moist environment favorable to diaper rashes. Tight diapers can also cause chafing at the waist or thighs.
• Give your baby’s bottom more time without a diaper. When possible, let your baby go without a diaper. Exposing skin to air is a natural and gentle way to let it dry. To avoid messy accidents, try laying your baby on a large towel and engage in some playtime while he or she is bare-bottomed.
• Consider using ointment regularly. If your baby gets rashes often, apply a barrier ointment during each diaper change to prevent skin irritation. Petroleum jelly and zinc oxide are the time-proven ingredients in many diaper ointments.
• After changing diapers, wash your hands well. Hand-washing can prevent the spread of bacteria or yeast to other parts of your baby’s body, to you or to other children.

In the past, it was common to use powders, such as cornstarch or talcum powder, to protect a baby’s skin and absorb excess moisture. Doctors no longer recommend this. Inhaled powder can irritate a baby’s lungs.

Cloth or disposable diapers?

Many parents wonder about what kind of diapers to use. When it comes to preventing diaper rash, there’s no compelling evidence that cloth diapers are better than disposable diapers or vice versa.

Because there’s no one best diaper, use whatever works for you and your baby. If one brand of disposable diaper irritates your baby’s skin, try another. If the laundry soap you use on cloth diapers seems to cause a diaper rash, switch products.

Whether you use cloth diapers, disposables or both kinds, always change your baby as soon as possible after he or she wets or soils the diaper to keep the bottom as clean and dry as possible.

Washing cloth diapers

If you use cloth diapers, careful washing can help prevent diaper rash. Washing methods vary and many routines work well. They key is to clean, disinfect and remove soap residue. Here’s one effective method:

• Pre-soak heavily soiled cloth diapers in cold water.
• Wash diapers in hot water with a mild detergent and bleach. Bleach kills germs. You could also add vinegar to the wash cycle to eliminate odors and rinse out soap residue.
• Double rinse the diapers in cold water to remove traces of chemicals and soap.
• Skip fabric softener and dryer sheets because they can contain fragrances that may irritate your baby’s skin.

When a simple diaper rash turns severe

Diaper rashes are one of the banes of infancy. Most are mild, caused simply by irritation of the skin, and disappear within a few days. But rashes complicated by a fungal infection can persist for weeks, making babies fussy and uncomfortable.

The combination of drugs used to treat these severe rashes is not ideal. One medication has side effects; the other hasn’t been tested on children. However, a new topical cream, called Zimycan, appears to safely treat both the cause and the symptoms in infants.

“This cream will be nice to have because these infections are so common and the kids are miserable, which makes the parents miserable too,” says Dr. Dennis B. Woo, chairman of the department of pediatrics at Santa Monica-UCLA Medical Center.

Each year, about 400,000 babies suffer from severe diaper rash caused by Candida, a yeast-like fungus that thrives in the warm and moist environment of the diaper. Typically, yeast rashes are a bright, beefy red with sharp, raised borders and white scales on the surface. The main patches are often surrounded by smaller patches and painful pus-filled sores or blisters. In severe cases, the rash can cover the entire diaper area.

Infants get yeast infections when their diapers chafe and break the surface of the skin. When this protective barrier is breached, it’s easier for microorganisms such as the yeast fungus to invade the skin, Woo says. Babies taking antibiotics for ear infections or other illnesses are prone to these severe rashes because penicillin kills off bacteria that fight yeast infections.

“And it’s not just babies,” says Dr. James J. Leyden, a dermatologist at the University of Pennsylvania School of Medicine in Philadelphia who helped develop Zimycan. “Even the very elderly, who are incontinent and unable to care for themselves, are getting these type of diaper rashes.”

No drugs have been approved for diaper rash complicated by a yeast infection, but pediatricians often prescribe antifungal agents designed for adults, plus topical steroids to reduce the inflammation. However, prolonged use of steroids can thin a baby’s sensitive skin, leaving stretch marks, and may exacerbate bacterial and fungal infections, says Dr. Mary K. Spraker, a pediatric dermatologist at Emory University in Atlanta who assisted in a recent study of Zimycan.

“With the adult antifungal preparations,” she adds, “we don’t know if they’re really safe for babies, or if they provide optimal relief because they have never been tested on infants.”

Zimycan, in contrast, contains zinc oxide and a weakened version of miconazole, a fungus-fighting medication used for adults. “Zinc oxide by itself doesn’t have much effect on the yeast,” Leyden says. “But we found that zinc oxide enhanced the effects of the miconazole, so the two compounds in combination were more potent than when they were used individually.”

A recent test comparing Zimycan with a zinc oxide ointment, which is the standard of care for diaper dermatitis, was encouraging. In the study, 236 children younger than 3 who had a Candida yeast infection in the diaper area were treated for seven days with either Zimycan or the zinc ointment. At the end of treatment, the Zimycan group experienced a 72% reduction in signs and symptoms of the disease, versus 25% with the ointment. “These results were exciting because we could prove the cream really works,” Spraker says.

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Keeping babies rash-free

More than half of infants younger than 15 months develop diaper rash at least once every two months because their skin is so sensitive.

Excessive moisture is the primary culprit. When the skin is wet, it rubs against other skin or the diaper, causing friction and redness, especially in the skin folds of the groin and upper thighs. Enzymes and other substances in the stool can also irritate the skin. Babies may also be allergic to the diaper material, soap or laundry detergent.

Today’s super-absorbent disposable diapers are better at keeping the skin dry, but experts say diapers should still be changed six or seven times a day, and immediately after stooling. If an allergy is the cause, then changing the diaper, soap or laundry detergent brand usually solves the problem. “If the rash persists more than three days or seems to get worse,” says Dr. Mary K. Spraker, “then it’s time to see your pediatrician.”

Yeast Diaper Rash (Candidiasis) | Latham, NY

A shiny red rash, pinker than usual skin, or red bumps in the diaper area that may be caused by a yeast called Candida. There are other causes of diaper rash that produce a similar skin appearance but are not caused by an infection.

What is diaper rash?

Red and irritated skin in the diaper area. There are many causes. The most common are fungal, irritant contact, and seborrheic dermatitis.

• Fungal diaper rash is caused by a yeast called Candida albicans. It can happen naturally, or commonly during or after a course of antibiotics.

• Irritant contact dermatitis is caused by skin rubbing against a wet, soiled diaper.

• Seborrheic dermatitis does not have a clear cause but may also be due to a fungus called Malassezia.

What are the signs or symptoms?

What are the incubation and contagious periods?

• Incubation period for fungal diaper rash: Unknown.

• Contagious period: The yeast that infects the diaper area is widespread in the environment, normally lives on the skin, and is found in the mouth and stool. Candida diaper rash may occur with or following antibiotic use. Repetitive or severe Candida diaper rash could signal immune problems.

How do you control it?

• Use good hand-hygiene technique at all the times listed in Chapter 2.

• Candidal (yeast) diaper rash: Treat with an antifungal cream so the quantity of yeast in any area is reduced to levels the body can control.

• Contact/irritant diaper dermatitis: Keep the skin dry and reduce irritation through friction from rubbing of a diaper or other clothing. Avoid soaps or wipes that contain fragrance. Frequent diaper changes, air exposure, or avoiding rubbing of material against the involved skin may help.

• Seborrhea: Treatment with antifungal cream or shampoo may help.

What are the roles of the teacher/caregiver and the family?

• Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts the parents/guardians so they can seek treatment for the child.

• Administer prescribed medication as instructed by the child’s health professional.

Exclude from group setting?

No.

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Yeast Diaper Rash (Candidiasis)

A shiny red rash, pinker than usual skin, or red bumps in the diaper area that may be caused by a yeast called Candida. There are other causes of diaper rash that produce a similar skin appearance but are not caused by an infection.

What is diaper rash?

Red and irritated skin in the diaper area. There are many causes. The most common are fungal, irritant contact, and seborrheic dermatitis.

• Fungal diaper rash is caused by a yeast called Candida albicans. It can happen naturally, or commonly during or after a course of antibiotics.

• Irritant contact dermatitis is caused by skin rubbing against a wet, soiled diaper.

• Seborrheic dermatitis does not have a clear cause but may also be due to a fungus called Malassezia.

What are the signs or symptoms?

What are the incubation and contagious periods?

• Incubation period for fungal diaper rash: Unknown.

• Contagious period: The yeast that infects the diaper area is widespread in the environment, normally lives on the skin, and is found in the mouth and stool. Candida diaper rash may occur with or following antibiotic use. Repetitive or severe Candida diaper rash could signal immune problems.

How do you control it?

• Use good hand-hygiene technique at all the times listed in Chapter 2.

• Candidal (yeast) diaper rash: Treat with an antifungal cream so the quantity of yeast in any area is reduced to levels the body can control.

• Contact/irritant diaper dermatitis: Keep the skin dry and reduce irritation through friction from rubbing of a diaper or other clothing. Avoid soaps or wipes that contain fragrance. Frequent diaper changes, air exposure, or avoiding rubbing of material against the involved skin may help.

• Seborrhea: Treatment with antifungal cream or shampoo may help.

What are the roles of the teacher/caregiver and the family?

• Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts the parents/guardians so they can seek treatment for the child.

• Administer prescribed medication as instructed by the child’s health professional.

Exclude from group setting?

No.

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Diaper Dermatitis: Clinical Characteristics and Differential Diagnosis – Coughlin – 2014 – Pediatric Dermatology

Abstract

A diverse group of diseases can cause skin conditions in the diaper area including those which are directly caused by diapers or the diaper environment, some which are not directly due to, but are worsened by, the wearing of diapers, and those which are independent of the presence of the diaper or its resulting environment. Many of these conditions are limited to this area of the skin, but others extend to skin outside this area, and some are signs of systemic disease. We review many of the important causes of eruptions in the diaper area and emphasize key points in the differential diagnosis.

Diagnosing rashes in the diaper area is an important skill. Diaper dermatitis (DD) is common, estimated to occur in 25% of children seeking care from a pediatrician 1. To help facilitate diagnosis, eruptions in the diaper region can be divided into three subgroups: skin conditions caused by the presence of the diaper, rashes exacerbated by the diaper (but not directly caused by it), and eruptions present regardless of the presence of the diaper (Table 1).

Table 1.
Quick Guide to Eruptions in the Diaper Area

Dermatitis Due to the Diaper or Diaper Environment

The most common cause of DD is irritant DD (Fig.  1A), triggered by prolonged contact between the skin and urine and feces. Irritant DD is most prominent in areas where the diaper is in direct contact with the skin, particularly on the convex surfaces, typically sparing the inguinal creases and gluteal cleft. At the same time, an increasingly common location for irritant DD is the perianal skin, where, in the presence of frequent stools or diarrhea, the diaper is not able to adequately wick away feces. When severe, this can cause erosions (Fig. 1B). Clinical manifestations are variable and include redness, papules, scaling, superficial erosions, and, less commonly, elevated papules or nodules, referred to as “pseudoverrucous papules and nodules (PVPN).” PPVN (Fig. 2) are typically due to chronic, severe irritant DD 2. Jacquet’s DD, an erosive DD, and granuloma gluteal infantum, a nodular DD, are often considered on a spectrum with PVPN because they have the same predisposing factors.

Perianal erythema and superficial erosions present in this 2 month-old infant are common in infants with a high frequency of bowel movements. The areas of macular erythema and fine papules lateral to this with a sharp cut-off are other common features of irritant diaper dermatitis (DD) (A). Irritant DD can be more severe, as shown by this erosive perianal irritant DD in a 1 month-old infant (B).

Pseudoverrucous papules and nodules.

Management of irritant DD requires attention to multiple contributing factors. First, decreasing exposure to urine and liquid stool is paramount. This often requires frequent diaper changes, regardless of whether infants are in cloth or disposable diapers. Next, if using disposable diapers, diapers with absorbent gel material (AGM), which moves moisture away from the skin more efficiently, should be considered. Barrier pastes are also important to decrease contact between skin and urine and feces. Antifungal and antiyeast topical medications can be beneficial in infants with a rash for longer than 3 days, because they commonly develop Candida infection, which complicates the irritant dermatitis 3. Mild topical steroids (e.g., hydrocortisone) can help treat the inflammatory component of these rashes. If this management strategy is not effective, other causes of diaper rash should be considered. For infants with PVPN, treatment of the root cause of the chronic fecal exposure, if possible, is the best approach 3. Otherwise, frequent diaper changes, use of superabsorbent diapers, and thick application of barrier creams is the best approach 2.

Allergic contact dermatitis (ACD) also occurs in the diaper area. Some children are allergic to dyes 4, adhesives, rubber 5, and other components of disposable diapers. Clues to this etiology of diaper rash include rash only in areas the allergen contacts, such as linearly arranged pink patches or plaques corresponding to areas of skin contact with elastic diaper components (typically waistline and upper thighs). More generally, rash in the areas in contact with the diaper, but not in protected areas, can point to ACD as the etiology of DD. Products used to clean the diaper area, such as disposable wipes, can also cause ACD. The 2013 Contact Allergen of the Year, as chosen by the American Contact Dermatitis Society, was methylisothiazolinone, which is found in many diaper wipes 6. For selected patients, patch testing can be helpful in identifying the causative allergy 7.

Miliaria, most commonly miliaria rubra, can occur as a result of the heat and humidity of the diaper environment. It is caused by retention of eccrine sweat in the eccrine duct. Typical findings include erythematous papules, but small pustules are occasionally present 8. The eruption can be pruritic. Treatment involves decreasing the exacerbating heat and humidity, airing the diaper area, if possible, and using diapers with AGM, which can wick away moisture more effectively.

Dermatitis Worsened by the Diaper or Diaper Environment

The second main group of diaper rashes includes eruptions exacerbated, but not directly caused by, the diaper. This group includes eruptions with infectious and noninfectious causes. The most common cause of diaper rash other than irritant DD is infection with Candida albicans (Fig. 3). Candida infection can be a primary cause of DD, although in many chronic cases of DD, Candida albicans acts as a secondary infectious organism, exacerbating preexisting DD. Primary Candida infection typically presents as bright, beefy-red patches with satellite macules or pustules. Small collarettes are also often present. The rash from Candida is typically accentuated in the skin folds and in male infants can involve the scrotum. Topical treatment with nystatin ointment or topical imidazole antifungals is often sufficient. Examination for oral thrush is essential. Cases with oral candidiasis, recurrent cases, and recalcitrant cases may require systemic antifungal therapy, such as nystatin solution or oral fluconazole. Severe, chronic Candida DD can sometimes be a clue to underlying immunodeficiency.

Candida albicans diaper dermatitis with confluent erythema and satellite macules.

Staphylococcal and streptococcal infections can also cause DD. Perianal streptococcal infection, due to group A beta-hemolytic streptococcus, is most often characterized by bright red perianal patches. Streptococcal infection in the diaper area also presents with fiery-red erythema and maceration without satellite lesions in the intertriginous folds, similar to its presentation on the neck and axillary folds, but is less common. Pain, low-grade fever, and malaise may accompany this infection.

Staphylococcus aureus infection (Fig. 4) can develop in newborns due to colonization of the umbilical stump. Staphylococcus aureus infection affects older diapered children as well. Small papules and pustules may be present, or in the case of toxin-producing bacteria, larger, fragile blisters of bullous impetigo can be seen. Other findings such as folliculitis or—much less commonly—furuncles or abscesses may also occur with S. aureus infection. Staphylococcus aureus infection can also present with perianal dermatitis with a virtually identical appearance to classic perianal streptococcal infection 9. Bacterial infections in the diaper area typically require oral antibacterial treatments, although topical agents such as mupirocin may be helpful in recurrent cases or as adjunctive treatment 10.

Staphylococcal infection of the diaper area with erythematous papules, subtle flaccid vesicles, and collarettes of scale.

Inflammatory conditions such as seborrheic dermatitis and psoriasis may also present in the diaper area. Seborrheic dermatitis is most commonly recognized as “cradle cap,” with white to yellow scaling on the scalp, but the diaper area may be affected in conjunction with scalp or intertriginous involvement (Fig. 5). Diaper rashes due to seborrheic dermatitis usually present as well-demarcated, erythematous patches with inguinal fold involvement but without the degree of scale often seen on the scalp. Resolution of seborrheic dermatitis usually occurs by age 6 to 9 months 11. Treatment with mild topical corticosteroids is usually sufficient.

Faintly red patches with a minor degree of scale in the inguinal creases; the presence of severe “cradle cap” helped in diagnosing this as seborrheic dermatitis in the diaper area.

So-called napkin psoriasis in the diaper area may present as an unusually persistent DD, even in the absence of other signs of psoriasis. It typically involves the skin folds and often the gluteal cleft; patients can have a family history of psoriasis, which together with the eruption’s lack of complete response to low-potency steroids, can be a clue to diagnosis.

A unique eruption seen in the setting of Candida infection or napkin psoriasis is the so-called psoriasiform id eruption (Fig. 6A, B) 12. It is typically seen after a fairly severe Candida DD and often develops soon after the initiation of treatment, with scaly papules and plaques spreading onto the torso, neck, and face. It usually resolves spontaneously, although treatment with low- to mid-potency corticosteroids may hasten resolution. It does not necessarily indicate a tendency toward the future development of psoriasis 12.

A widespread eruption in the diaper area with erythematous patches with overlying scale (A) extending beyond the diaper area (B) is characteristic of psoriasiform id eruption.

Eruptions in the Diaper Area Independent of the Diaper

Eruptions can be located in the diaper area independent of the presence of the diaper. The list of such conditions is long and beyond the scope of this article, but several important ones are highlighted 3. Infantile hemangiomas (IH), can present in the diaper area as localized superficial vascular plaques or nodules or as an area of erythema and ulceration, which is occasionally misdiagnosed as a “diaper rash” (Fig. 7). In cases with involvement of a territory of skin, extracutaneous anomalies can be present with a Lower body infantile hemangioma, including Urogenital anomalies or ulceration, Myelopathy, Bony deformities, Anorectal malformations or arterial anomalies, and Renal anomalies (LUMBAR syndrome). Patients with suspected LUMBAR syndrome warrant more-detailed examination with imaging. Ulceration can complicate IH in the diaper area in up to 50% of cases 13.

This 1-month-old infant presented with a unilateral, bright-red plaque with ulceration (now partially healed) as the presentation of a perineal infantile hemangioma. Evidence of an incidental Candidal diaper dermatitis is also present.

Langerhans cell histiocytosis is one of the most serious causes of eruptions in the diaper area. Typically, patients with this rare disorder will have scale, crusting, and barely palpable hemorrhagic papules resembling petechiae, often involving the inguinal creases. They can also have atrophy and deep ulcerations. Clues to this diagnosis include additional involvement of the scalp, ears, or oral mucosa. The majority of patients with Langerhans cell histiocytosis have skin findings 14, and skin biopsy can be vital to making the diagnosis. Early recognition of these findings in the diaper area facilitates timely treatment for affected infants.

Zinc deficiency is an important cause of diaper rashes, most often presenting with a sharply demarcated eruption with accentuated scale at the margin. The scale typically has a slightly golden brown to mahogany color. These plaques may also occur around the mouth and eyes and in the neck folds. The most commonly affected infants are exclusively breastfed premature infants. These children can become zinc deficient as they outgrow the zinc supplied in breast milk. Other causes include cystic fibrosis and an autosomal-recessive disorder (acrodermatitis enteropathica) in which patients lack a zinc transporter to aid in gastrointestinal absorption.

Kawasaki disease (KD; mucocutaneous lymph node syndrome) is another important, potentially life-threatening condition in which a perineal eruption may be an important clue to diagnosis. The majority of patients with KD have accentuated erythema in the diaper area 15. Erythematous macules and patches with early desquamation are typical.

The exanthem seen with hand, foot, and mouth syndrome often involves the diaper area. With the advent of epidemics of Coxsackie virus A6 infection, this may be even more commonly seen than with other causative enteroviruses 16. The rash with Coxsackie A6 infection is more exuberant than with other strains of the virus and presents with variable morphologies, including vesicles, bullae, eczema herpeticum–like punched-out erosions, purpura, petechiae, and Gianotti-Crosti–like papules 16. Although the diaper area, especially the groin and buttocks, is often affected, the exanthem may be more generalized. Involvement of the hands, feet, and perioral area are seen in most cases.

In sum, cutaneous eruptions in the diaper area can be caused by the diaper, exacerbated by the diaper, or occur independent of the presence of the diaper. Using this classification scheme can aid in efficient diagnosis and treatment of these conditions.

Conflicts of interest

Lawrence F. Eichenfield has served as a consultant for Procter and Gamble.

References

• 1Ward DB, Fleischer AB Jr, Feldman SR et al. Characterization of diaper dermatitis in the United States. Arch Pediatr Adolesc Med 2000; 154: 943– 946.
• 2Goldberg NS, Esterly NB, Rothman KF et al. Perianal pseudoverrucous papules and nodules in children. Arch Dermatol 1992; 128: 240– 242.
• 3Krol A, Krafchik B. Diaper area eruptions. In: L Eichenfield, I Frieden, N Esterly, eds. Neonatal dermatology, 2nd ed. Philadelphia, PA: Saunders Elsevier, 2008: 245– 266.
• 4Alberta L, Sweeney SM, Wiss K. Diaper dye dermatitis. Pediatrics 2005; 116: e450– e452.
• 5Roul S, Ducombs G, Leaute-Labreze C et al. ‘Lucky Luke’ contact dermatitis due to rubber components of diapers. Contact Dermatitis 1998; 38: 363– 364.
• 6Chang MW, Nakrani R. Six children with allergic contact dermatitis to methylisothiazolinone in wet wipes (baby wipes). Pediatrics 2014; 133: e434– e438.
• 7Smith WJ, Jacob SE. The role of allergic contact dermatitis in diaper dermatitis. Pediatr Dermatol 2009; 26: 369– 370.
• 8Wenzel FG, Horn TD. Nonneoplastic disorders of the eccrine glands. J Am Acad Dermatol 1998; 38: 1– 17; quiz 18–20.
• 9Honig PJ, Frieden IJ, Kim HJ et al. Streptococcal intertrigo: an underrecognized condition in children. Pediatrics 2003; 112: 1427– 1429.
• 10Heath C, Desai N, Silverberg NB. Recent microbiological shifts in perianal bacterial dermatitis: Staphylococcus aureus predominance. Pediatr Dermatol 2009; 26: 696– 700.
• 11Yates VM, Kerr RE, Frier K et al. Early diagnosis of infantile seborrhoeic dermatitis and atopic dermatitis—total and specific IgE levels. Br J Dermatol 1983; 108: 639– 645.
• 12Rattet JP, Headley JL, Barr RJ. Diaper dermatitis with psoriasiform ID eruption. Int J Dermatol 1981; 20: 122– 125.
• 13Berk DR, Bayliss SJ, Merritt DF. Management quandary. Extensive perineal infantile hemangioma with associated congenital anomalies: an example of the PELVIS syndrome. J Pediatr Adolesc Gynecol 2007; 20: 105– 108.
• 14Satter EK, High WA. Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society. Pediatr Dermatol 2008; 25: 291– 295.
• 15Bayers S, Shulman ST, Paller AS. Kawasaki disease: part I. Diagnosis, clinical features, and pathogenesis. J Am Acad Dermatol 2013; 69: 501.e1– 501.e11; quiz 511–502.
• 16Mathes EF, Oza V, Frieden IJ et al. “Eczema coxsackium” and unusual cutaneous findings in an enterovirus outbreak. Pediatrics 2013; 132: e149– e157.

Yeast Infections – Clinical Pediatric Associates of North Texas

Yeast infections are a very common cause of a beefy, red diaper rash that can often cover the entire diaper area. Infants under 3 months of age can often develop a yeast infection with no apparent cause. In older infants, toddlers and young children, the treatment of a bacterial infection with oral antibiotics can cause yeast to overgrow in moist, dark areas such as the diaper area. 

Yeast may also appear in the mouth as white patches on the tongue or inside the cheeks, which do not scrape off as milk curds would. This condition is called “thrush.” If your child has thrush, call the office. We can prescribe a medicine to swab the inside of his mouth. You will also need to boil all pacifiers and nipples daily. If you are breastfeeding and your baby gets thrush, you will also need to be treated so that you are not passing the yeast infection back and forth. 
If you notice the diaper rash described above, things to do include: 

• Change diapers frequently and keep the areas as dry as possible, but do not use powders or cornstarch.
• Clean the diaper area with warm water or Cetaphil Cleanser with each diaper change.
• Eliminate rubber pants for infants and use only white, cotton pants for toddlers or young children.
• Buy Gyne-Lotrimin Cream (used for vaginal yeast infections) or Lotrimin AF and apply 3 times daily.
• Call the office during office hours if the rash is not improving after 3 days of medication. If this is an uncomplicated yeast infection, we can prescribe a cream for the diaper area and/or oral medication for the oral infection. Continue these medications for at least three full days following disappearance of the rash or thrush. 

If you notice no improvement of the rash or thrush after one week of treatment, call back for further advice. It may take two weeks for the yeast to totally clear, and it may persist as long as your child is on oral antibiotics. Yeast infections also frequently recur each time a child is placed on antibiotics. If you require a refill on medication for yeast infections, please call during office hours, as yeast infections are not medical emergencies.

What is the connection between thrush and diaper rash?

Thrush, or candidal yeast infection, is a common cause of diaper rash. Thrush and diaper rash are often linked because the diaper area can be warm and damp, providing ideal conditions for the growth of Candida, the organism responsible for thrush or candidiasis. The skin usually has the ability to ward off yeast infections, but not when its integrity is violated. A diaper rash is often caused by chronic warmth and dampness in the diaper area, combined with an irritating discharge from the baby’s body.When the diaper area remains warm, damp and irritated, the integrity of the skin suffers, it loses its ability to repel yeast, and a swaddling rash may develop from a yeast infection.

Diaper rash does not always occur due to thrush. Most diaper rashes occur when the diaper area is constantly warm and damp. Human urine and feces are usually acidic in nature, and these acids can increase skin irritation, which manifests itself in the form of diaper rash.

Thrush and diaper rash occur together when the integrity of the skin is compromised by chronic moisture and acidity. Diaper rash, not complicated by a bacterial or fungal infection, usually occurs before thrush. Diaper rash thrush usually begins with destruction of the skin in the anal area. Diaper rash thrush can also begin in the folds of the body around the legs, where diaper contact rashes do not usually appear. Generally, the flexion areas of the body are more protected from irritants, but in the case of thrush and diaper rash, the flexion areas of the body become warmer and more moist and provide a better environment for the development of candida yeast.

Canidida yeast occurs naturally in the body as part of its normal flora. However, under the right conditions, overgrowth of Candida can occur, resulting in candidiasis, also known as thrush or yeast infection. Candidal yeast associated with thrush and diaper rash can come from the gastrointestinal tract. Caregivers may also unknowingly expose their children to Candida yeast. Thrush and diaper rash can also occur at the same time as oral thrush, and infants can spread the skin infection back and forth to their mothers during breastfeeding.

Thrush and diaper rash occur together in up to 25 percent of children. Many babies contract this minor fungal skin infection due to chronic warmth and dampness in the diaper area, but antibiotic use can also contribute to thrush and diaper rash. This is because antibiotics can kill too many of the normal flora bacteria that keep the candida yeast in check. Diaper rash, as with diaper contact rash, usually goes away and does not recur after the baby stops wearing diapers in favor of cloth underwear.

OTHER LANGUAGES

90,000 Skin problems in children

Infants have very sensitive skin , prone to irritation, especially in the groin folds and buttocks. Diaper rash caused by overheating, infection or allergies occurs at least once in every baby. Almost all children have at least once 90,023 diaper rash or irritation on the buttocks . The skin under the diaper becomes red and inflamed, whether it is dry or wet.

Babies with sensitive and allergy-prone skin are more likely to suffer from diaper rash and require special care. This condition most often develops when the skin is irritated with wet or poor-quality diapers. Other causes include candidiasis, diarrhea, allergies, and skin conditions such as seborrheic dermatitis and eczema. We will cover all skin problems in a newborn baby.

Diaper dermatitis as a skin problem in children

If the baby spends a long time in wet diapers, ammonia is formed in the urine, which “burns” the baby’s skin.As a consequence of this problem, small red rashes and peeling of the skin appear. Diaper dermatitis is not common these days because disposable diapers keep skin relatively dry longer than traditional cotton diapers. However, only those children whose diapers are changed regularly are protected from dermatitis. The rash usually goes away with the systematic application of baby cream, zinc and castor oil, or a special treatment for diaper dermatitis. To avoid this problem, it is recommended to change diapers every 2-3 hours, regardless of how full it is.

Treatment of damaged skin and skin problems in children

For the treatment and prevention of diaper dermatitis in a child, air baths are useful. Access of fresh air to the damaged area dries and promotes skin healing. At each diaper change, wipe the baby’s skin with special wet wipes or cotton wool dipped in boiled water. When choosing products for baby’s skin care, preference should be given to odorless hypoallergenic wet wipes.However, it must be remembered that the use of wipes is not a substitute for washing under a stream of warm water. For diarrhea, a newborn baby’s diaper needs to be changed after each bowel movement. If the diaper rash does not go away within a few days, you should seek the advice of a pediatrician. In the absence of adequate treatment, a fungal infection may occur. Candidiasis is characterized by a red rash on large areas of the skin in combination with satellite lesions. The spots merge and protrude above the surface of the skin.A diagnostically important symptom is the lesion of skin folds not affected by diaper dermatitis.

Candida infection is very common and not always due to poor hygiene. Candida fungi are a conditionally pathogenic flora that is constantly present in the human intestine. Under the influence of a number of factors, their number can increase, causing infectious inflammation. Candidiasis is common in children receiving antibiotics. It is recommended to regularly check the mouth of the newborn baby and the nipples of the mother, if she is breastfeeding, for fungal infection.Candidal diaper rash is well treated with antifungal creams. Sometimes, with severe inflammation, hormonal ointments may be prescribed. There are rare types of diaper rash that require timely diagnosis and appropriate treatment.

Seborrheic dermatitis. In infants with seborrheic dermatitis, sebaceous rashes may appear on the face and sometimes in the buttocks. This condition is manifested by redness, oily skin, and a scaly, painless rash.The scales protrude above the skin and can spread to the lower abdomen and groin. When a secondary infection is attached, the elements of the rash become inflamed. Seborrheic dermatitis always begins in the first 12 weeks after birth and disappears by the end of the first year of life. Treatment usually includes hydrocortisone ointment.

Eczema in children

In infantile eczema, the infant develops dry red spots on the buttocks and external genitals. For treatment, emollient ointments are used, if necessary, on a hormonal basis.It is recommended to give up soap and add special oil to the bathtub.

Contact dermatitis in young children

Infants with sensitive skin or early eczema may be allergic to wet wipes or perfumed hygiene products. As a result, even with frequent changes of diapers, a rash appears on the skin of a newborn baby. When using reusable diapers, some babies develop an allergic reaction to the powder or fabric rinse used.Therefore, it is important to rinse everything that comes into contact with the baby’s skin very thoroughly. In the event of a severe rash, it is recommended to switch to disposable diapers. If they also cause skin irritation, the baby’s mother should use regular gauze or cotton diapers. Bath soaps and bubble baths cause dry skin and are not suitable for a child with eczema or dermatitis. If your skin is sensitive, you should also avoid using wet wipes. Because of the chemical compounds they contain, they can cause irritation.

Bacterial infection of baby skin

If the skin is damaged in the area of ​​the buttocks, a bacterial infection may occur. At the same time, the skin becomes inflamed and reddens, the body temperature rises, the child becomes restless and irritable. If yellow pustules appear on the skin in the area of ​​the buttocks and groin folds, an urgent need to consult a doctor. Most likely, there is bacterial inflammation requiring antibiotics.

Source nmedicine

90,000 Diaper rash in children… – I’ll be Mom. Comfortable motherhood

Diaper rash in children

What does diaper rash look like?

If a baby has diaper rash, you will notice it immediately. Skin affected by diaper rash – most often the genital area, skin folds on the thighs and buttocks – turns red and looks inflamed. At the same time, the skin can be dry or damp, sometimes it is covered with pimples.

If treatment is not started on time, complications may arise, for example, fungal or infectious diaper rash.Fungal infections (thrush or candidal stomatitis) are more common in children who have undergone a course of antibiotics (these drugs kill not only disease-causing, but also beneficial bacteria, which usually inhibit the growth of the fungus). The disease usually begins with the appearance of small red spots, which become more and more numerous and finally merge into one solid red spot. Bacterial infections, which can be accompanied by fever, most often appear as weeping yellowish spots or purulent pimples.

What is the cause of diaper rash in children?

Diaper rash can be caused by a variety of reasons – from the introduction of a new food product into the diet to contact with the skin of urine.
Root causes:

The main cause is excess moisture. Newborns have frequent urination and frequent bowel movements. Diarrhea can also be a cause of diaper rash. Even in the best diapers, a certain amount of moisture remains on the baby’s delicate skin. And when urine comes in contact with bacteria from your baby’s stool, it breaks down and forms ammonia, a pretty corrosive chemical.The likelihood of diaper rash increases if diapers are not changed for a long time. However, even with a fairly frequent diaper change, diaper rash can appear in children with particularly sensitive and allergy-prone skin.

Friction or sensitivity to chemical compounds. Diaper rash in a baby can be the result of rubbing the diaper against the skin, especially if he or she has a sensitivity to chemical compounds. Fragrances that improve the odor of disposable diapers or detergents that you use to wash cloth diapers can cause the reaction.Even lotion or powder can irritate your baby’s delicate skin.

New products. Very often, babies develop diaper rash when complementary foods or just some new product are introduced. New food changes the composition of the stool and affects bowel function. If you are breastfeeding, your baby’s skin may react to the foods you eat.

Infection. The skin under the diaper is usually warm and damp – an excellent breeding ground for bacteria and fungi. Therefore, bacterial and fungal infections develop there so easily, causing diaper rash, especially in the cracks and folds of children’s skin.

If the baby is undergoing antibiotic treatment (or if the mother is breastfeeding), the baby may develop a fungal infection. The fact is that antibiotics fight off pathogenic bacteria and simultaneously reduce the level of beneficial bacteria that inhibit the fungus. In addition, antibiotics can cause diarrhea, which can lead to diaper rash.

Thrush is a type of oral fungal infection. In some babies, thrush also spreads to the skin under the diaper.
Do I need to show my child to the doctor if he has diaper rash?
This is most likely not required. With some effort, you can get rid of diaper rash in three to four days without the intervention of a doctor.

But it is necessary to visit a specialist if the diaper rash looks as if an infection has got there – there are blisters, pus-filled pimples, spots with yellow discharge or open sores. The doctor will prescribe an antibiotic in the form of an ointment or for oral administration.

If the baby has diaper rash caused by a fungal infection, the doctor will prescribe an antifungal ointment for problem areas of the skin.See your doctor if your child has a fever or diaper rash persists after a few days of home treatment.

What is the best treatment for diaper rash?

The best medicines are cleanliness and dryness. Change diapers regularly (you may need to do this at night) and leave your baby to lie down naked from time to time. Such “air baths” accelerate healing.

Make sure the room is warm enough to prevent the child from catching a cold. Place it on a towel or sheet, which can then be washed if necessary.Older children can be left to crawl without a diaper.

Only a cotton cloth and water should be used to wash the baby when changing the diaper. This can help eliminate the cause of the disease if it was associated with an allergic reaction. After washing, gently blot the skin, do not rub it while wiping it! You can try choosing diapers that absorb moisture better. You can use both cotton and disposable diapers – there is no evidence that one or the other is more preferable in terms of prevention and treatment of diaper rash.

To protect the baby’s irritated skin from the effects of feces and urine, every time after changing the diaper, a special cream can be applied to it, which creates a protective film on the skin. In pharmacies and stores, you can find a variety of products, including those based on petroleum jelly and white zinc oxide. Zinc oxide is a thick ointment that protects sensitive skin well.

How to prevent diaper rash?

Pay attention to the following recommendations:
Change wet or dirty diapers as often as possible: every 3-4 hours.Choose diapers according to the child’s body weight.

After each chair, wash your child thoroughly, then let the skin dry. Do not dry your baby’s skin with a towel, but pat it dry.

After each diaper change, lubricate the baby’s buttocks with a protective cream. Do not use powders containing talcum powder, which can enter the baby’s lungs. If powder is needed, use cornstarch. Only shake the jar over your hand, away from the baby.Don’t leave powder next to your baby. When changing a diaper, wash the powder thoroughly if it clogs up in the folds of the skin.

Do not fix the diapers too tightly so that the air can circulate underneath. Your baby’s diapers, diapers, and clothing should be loose enough for the skin on the buttocks to breathe.
When you start complementary foods, each new food should be introduced gradually into the diet, waiting a few days before introducing the new food. This will make it easier to determine if your diaper rash is due to a food allergy.

Do not use perfumed products or fabric softeners to wash cloth diapers. They can irritate the baby’s skin. Use hot water and rinse the diapers well. During the first rinse, you can add a little vinegar to help flush out alkaline irritants.

Breastfeed your baby for as long as possible. Breast milk strengthens your baby’s overall resistance to infections, making it less likely to use antibiotics.

If your child goes to a creche, pay attention to whether the people who work there understand how important it is to make some effort to prevent diaper rash.

I would like to note that the advice of grandmothers to use starch to dust the folds is not suitable for the treatment of diaper rash, since the starch hardens, rolls into lumps and even more damages the skin. In addition, starch is an excellent breeding ground for the growth and reproduction of pathogens.

instructions, use, analogues of the drug, composition, indications, contraindications, side effects in the reference book of medicines from UNIAN

Application of Mikoseptin

Mikoseptin – composition and release form of the drug

Mikoseptin: how to take the drug

Mikoseptin – contraindications, side effects

Mikoseptin’s analogs

Antifungal agents for topical use.

Zinc, which is a constituent of zinc undecylenate, tightens the skin, reducing irritation and accelerating healing.

Application of Mikoseptin

Superficial mycoses of the skin caused by microorganisms sensitive to the active ingredients of the drug, in particular dermatomycosis of smooth skin, inguinal dermatomycosis, dermatomycosis of the feet, interdigital dermatomycosis, including mixed candidal and bacterial infections.

For prophylactic purposes, the drug should be prescribed in case of excessive sweating, with manifestations of irritation in places of wet diaper rash (inguinal areas, under the mammary glands), prickly heat.

Mikoseptin – composition and release form of the drug

Ointment tube 30 g, No. 1

• Undecylenic Acid 1.5 g
• Zinc undecylenate 6 g

Excipients : liquid paraben, paraffin wax, solid paraffin white, stearic acid, palm oil monoglycerides, white wax, oleomacrogol, purified water.

Ointment. An almost white to yellowish ointment with a characteristic odor and small granules of fat.

Mikoseptin: how to take the drug

For the treatment of adults and children over 2 years old, apply the ointment to washed dry skin twice a day for at least one week.After the disappearance of clinical signs, continue treatment, applying the ointment once a day for another 1 week, and then every other day or twice a week. In general, treatment lasts 1 month. A reduction in the course of treatment may lead to a relapse.

Mikoseptin – contraindications, side effects

Hypersensitivity to active ingredients and to any other components of the preparation, in particular undecylenates and parabens. Children under 2 years of age. The ointment should not be applied to wet skin, ulcers and blisters; contact with the eyes and around the eyes should be avoided.

Side effects. The drug is generally well tolerated.

During the course of treatment, a hypersensitivity reaction to some of the ingredients of the drug may develop. Signs of this hypersensitivity include itching, redness (flushing), skin swelling (edema), burning sensation, and skin rashes. Sometimes – the appearance of small pustules, vesicles or blisters, minor skin irritation, eczema (disappears on its own after stopping the use of the drug).

Analogues of Mikoseptin

Nitrofungin Neo

Source: State Register of Medicines of Ukraine. The instructions are published with abbreviations for information only. Before use, consult your doctor and read the instructions carefully. Self-medication can be harmful to your health.

90,000 💊 Yeast infection, diaper rash, home remedies, treatment and symptoms

What is a diaper rash yeast infection?

Most diaper rash is associated with a breakdown in the integrity of the skin, and not with any particular bacterial or fungal infection.Acidity of urine and stool (the latter occurs with diarrhea) and chronic moisture combined with a warm barrier environment are all factors suggested as causes of diaper rash. However, sometimes a superficial skin infection is a factor in diaper rash. The most common infectious cause of diaper rash is Candida albicans (yeast, fungus).

Such diaper rash can begin with softening and destruction of tissue around the anus.The infected area is red and raised, and fluid may be visible under the skin. Small, raised, infected red bumps (pustules) appear on the periphery of the rash. These satellite pimples are characteristic of Candida diaper rash and make it easy to distinguish yeast diaper rash from other types of diaper rash such as contact (irritant) diaper rash. A yeast rash can appear on the thighs, genital folds, abdomen, and genitals.

Another characteristic of the distribution of the diaper C.albicans – the likelihood of its appearance in the folds of the skin (for example, in the folds of the skin where the legs connect to the pelvis). Typically, contact diaper rash does not affect these areas because the overlapping skin “protects” the area from harmful irritants.

Skin Candida infection may come from the upper gastrointestinal tract, lower gastrointestinal tract, or contact with a healthcare professional. Candida Diaper rash may be accompanied by Candida infection of the mouth (thrush).A nursing infant with thrush may accidentally infect the mother’s nipple / areola area. If such an infection is suspected, your doctor may prescribe simple topical medications.

What are the Causes and Risk Factors of Yeast Infection Diaper Rash?

It goes without saying that the need to wear a diaper is probably the main factor. Cotton underwear is much better for breathing and preventing yeast from thriving in a dark, warm and moist skin surface.Cloth diapers and non-absorbent disposable diapers help create a favorable environment for yeast growth. Many experts believe that thrush in a child’s mouth (thrush) is a risk factor for developing diaper yeast dermatitis. Finally, recent oral antibiotics may also promote intestinal yeast overgrowth.

Are diaper rashes common?

Between a quarter and a half of children experience diaper rash.Of these, 15% -50% are due to yeast. Yeast diaper rash tends to decrease as babies get older and ends when the baby stops using diapers. Exposure to the air generated by the underwear reduces the likelihood of infection on the surface of macerated skin. This explains the derisive opinion of pediatricians that a quick cure for diaper rash (contact or infectious) is a successful workout in the toilet.

If few organisms are present C.albicans , they may not be essential. However, the symptoms are exacerbated by a more extensive infection. One study noted that C. albicans was present in 37% -40% of diaper rash patients, suggesting that infection of C. albicans from the gastrointestinal tract plays a major role in diaper rash. Another study noted that 30% of healthy children and 92% of children with diaper rash in the stool had C. albicans . This reveals a definite link between candidal stool colonization and diaper dermatitis.However, such information does not reveal the whole picture. The actual presence of C. albicans in stool by itself is not a complete history, as most healthy intestinal tracts in adults are colonized by C. albicans . These generally asymptomatic (asymptomatic) adults may also develop Candida groin infections, if they become compromised or suffer from extremely poor hygiene. Several studies have shown promising results in reducing the incidence and severity of candidal infections when probiotics (eg, yogurt with “active cultures”) are taken whenever antibiotics are needed.

The use of antibiotics may increase the growth of Candida species . Thus, the fact that the use of commonly prescribed antibiotics such as amoxicillin increases the risk of developing diaper rash is not surprising. Use of amoxicillin in infants reduces bacteria and increases C. albicans .

What are the signs and

symptoms of yeast infection?

Yeast-induced diaper rash does not cause pain.The characteristic bright red area of ​​skin in the groin and around the anus, including in the area between the halves (deep folds of skin where the legs attach to the child’s torso), is characteristic of diaper rash from a yeast infection.

How do health professionals evaluate and diagnose diaper rash with yeast infection?

Careful examination of the diaper area for the characteristic diaper rash described above allows rapid diagnosis and treatment.An oral yeast infection (thrush) may be supporting evidence of a diagnosis of diaper rash. A laboratory examination and / or examination by a dermatologist is rarely required.

How to treat rash with

diaper for yeast infection?

Primary treatment for diaper rash Candida includes topical antifungal treatment and moisture reduction in the diaper area. Nystatin (mycostatin), clotrimazole (lotrimin) and miconazole (mykatin, monistat-derm) are topical over-the-counter (OTC) drugs of the same strength for the treatment of candidal diaper dermatitis .Occasionally, other prescription antifungal creams such as ketoconazole (nizoral cream) and econazole (spectazole) may be needed. How long the treatment should last has not been fully determined, although usually a cream or ointment is applied with every diaper change until the rash has disappeared, usually after four to seven days.

Because of the intestinal reservoir of Candida species , some doctors recommend oral antifungal medications in addition to topical creams in most yeast diaper rash patients.No study has provided definitive answers to the question of whether oral antifungal drugs are beneficial.

Some dermatologists and infectious disease specialists in children note that the effectiveness of these topical creams has been declining over the past few years. An alternative oral medication (fluconazole) taken once a day for two weeks can be very effective. Many pediatricians initially recommend one of the topical medications for simplicity and simplicity, and use fluconazole if topical treatments are ineffective.

Some studies have shown that diaper rash can be prevented by applying protective creams such as zinc oxide (A + D ointment, desitin, diaparen) or petroleum jelly (petroleum jelly, aquaphor) to the diaper area after bathing. These products can help reduce moisture in the diaper area after bathing or changing the diaper. Gentle cleansing to minimize skin breakdown can also be beneficial. Exposure to air (eg without a diaper) is also therapeutic.

Are there

home remedies for diaper rash?

There are several approaches that will be helpful in eradicating and preventing yeast infections in the diaper area. The impact on the skin (without diapers) of the skin area is invaluable. There is often a place in the backyard where the baby can be without diapers. Building a learning toilet is also very helpful. Since the baby is ready for development, the transition from diapers to cotton underwear is beneficial. If diapers are needed, using disposable absorbent articles is better than disposable cloth or non-absorbent diapers.Keeping the skin of the diaper clean by changing diapers quickly is also beneficial, as indicated. Finally, topical prophylactic barriers such as petroleum jelly (petrolatum) or zinc oxide (ointment A + D) are useful preventive measures.

Does the type of diaper affect diaper rash with yeast?

Diaper rash is reduced to the point that diaper skin can have a closer environment than non-diaper skin.The less time babies wear diapers, the less likely they are to develop diaper rashes. However, the need to wear diapers must also be considered. Disposable diapers are associated with less diaper rash than cloth diapers. Disposable diapers have absorbent gelling materials that wick moisture away from delicate skin surfaces. Children who wear breathable disposable diapers have significantly fewer diaper rashes of any type than children who wore standard non-breathable disposable diapers in a series of clinical trials.

Evaluation of past clinical studies conducted before and after the introduction of absorbent gelling materials into diapers confirms that the use of these materials was associated with a definite reduction in the severity of diaper rash. Survival of colonies Candida was reduced by almost two-thirds in the areas covered with a breathable diaper compared to the control areas.

Simple Tips to Keep Your Baby’s Skin Healthy

Any anti-yeast remedies are not suitable?

Betamethasone Dipropionate is a topical fluorinated high potency corticosteroid that contains clotrimazole in the brand name Lotrisone product.This product is often used inappropriately in internecine (diaper areas where deep folds of skin overlap) areas. Such potent corticosteroids play no role in the treatment of diaper rash Candida . The ingestion of such a potent steroid can cause multiple (and potentially serious) side effects.

Can yeast infection be prevented?

Topical therapies, including barrier creams and disposable diapers, reduce the frequency and severity of yeast diaper rash.Frequent diaper changes with superabsorbent disposable diapers create an environment that prevents yeast from thriving. Cleansing that is gentle and minimizes skin breakdown can also help. Exposure to air is also beneficial.

What is the prognosis of a diaper rash with a yeast infection?

Prevention and the above treatment methods provide an excellent prognosis for a yeast infection in the diaper area. The naturally recurrent nature of a yeast infection in the diaper area should not be interpreted as a lack of parenting skills.Sometimes it just happens.

90,000 Epidemiology. Candidiasis – Online Presentation

Candida
Continued
Based on materials from
Internet
Epidemiology
The incidence of candidiasis
growing steadily
Candida
ubiquitous
(= ubiquitous
/ all over the planet /)
In the USA 1000
deaths per year 90,071
from candid.
+
Candida albicans
Commensal (normal flora) or pathogen
(organism). 70% of people are colonized by Candida
(in the oral cavity, colon, vagina, some
areas of the skin).
Candidate carriers in PR (= oral cavity) – 30-50%;
with age and in people at risk more.
Competition with the bacterial microbiome.
Microbiome-mycobiome interaction
(mycobiome is larger in biomass).
Immune probing to maintain
commensalism.
Endogenous microbe (PS, MBS)
Candida
Skin, non-mycotic lesions
– 101 CFU / cm2
Vagina – 102 CFU / ml.
75% of women will have candidiasis
vagina (throughout life).
Urethra – 103-4 CFU / cm2
Rectum –
103-4
CFU / ml
[CFU – colony forming units,
those. live microbes]
• Candida albicans (most often affects women)
• Candida parapsilosis (in 50% of cases
affects children)
• Candida glabrata (found
in old age)
http://nekashljaj.ru/vse-o-lechenii-gorla/gribkovaja-infekcija-vgorle-lechenie.html
Colonization with yeast fungi
infants increased rapidly in the first 90,071
months of life.
Colonized at 6 months 55% 90,071
babies; the number of candidates was 100 times
more per unit area than children 3 years old.
If the child drank breast milk, then the amount is
Candida was smaller.
https://academic.oup.com/mmy/article-abstract/58/4/485/5560179
Risk Factors
* Neutropenia (radicals)
* Cellular
ID
– children (infants and children 3-9 years old are more likely to get sick)
– pregnant
– elderly people
– GCS therapy
– seriously ill patients (injuries, cancer patients …)
– HIV infection …
* ABT (= antibiotic therapy)
antibacterial
– Liberation of ecological niches for mushrooms.Recolonization
Gastrointestinal tract after ABT.
– ID (= immunosuppression)
* Taking anti-inflammatory drugs
Obesity
Sweating (candida overgrowth)
Invasive procedures (heart surgery,
catheters)
Intestinal dysbiosis and PR
Crowns and prostheses in PR
Female gender (F: M = 8: 1)
Consumption of refined sugars, alcohol,
caffeine
Overwork
Kissing
Pools, showers
Iron deficiency
Risk factors
oral candidiasis
Immunosuppression
(babies,
old age,
pregnancy,
oncology,
HIV-infected,
malnutrition …)
Diet high
content
carbohydrates
Poor hygiene
oral cavity
Long-term wearing removable
dentures
Dry mouth
Endocrinopathy
GCS-therapy ID
Diabetes glucose growth
Candid growth / food for
microbes /
Smoking
Oral pathology
Epithelial changes
Radiation therapy, chemotherapy
If risk factors are eliminated, then prognosis
good;
if not, then even primary candidiasis is dangerous.
In most cases, oral candidiasis is one of the causes of
secondary superficial infections.
CLINIC
“Spectra of candidal infection”
State of “carriage”
1. Superficial infection (mucous membrane
oral cavity / skin infection)
2. Local invasive candidiasis
(rare)
3. Disseminated candidiasis
(rare)
–
https://www.brainscape.com/flashcards/fun
gal-infections-3998273 / packs / 5860471
Candidiasis
Regular
defeat
Rare
defeat
skin
system
(folds …), nails
mucous
candidiasis
pneumonia
endocarditis
sepsis
Pulmonary candidiasis
https: // www.health-ua.org/faq/pulmonologiya-ftiziatriya/3188.html
Generalized candidiasis
Cutaneous candidiasis
Paronychia and onychomycosis
Diaper candidiasis
Diaper rash candidiasis
CHRONIC CANDIDOSIS (onychomycosis)
thumbnail causing
destruction of the nail plate
Interdigital candidiasis on the hand
SURFACE CANDIDOSIS
in an infant (diaper dermatitis)
Diaper rash or candidiasis on the fold
knee back showing
extensive erythematous lesions
The underwear should be from
natural materials
(absorbent).
“What, where, when?”
Question. Behavior error.
Chukchi when moving in severe frost on reindeer
undress and put on deerskin clothes.
Geologists have done the same. We arrived a little alive
with frostbite.
Mistake – left underpants (retaining moisture).
Panty liners provoke
inflammation of the urethra.
Gynecologists do not recommend the use of synthetic pads,
especially with inflammation.
Gaskets made from natural materials are desirable
(gauze, cotton, cambric).
If a woman does not want to give up the use of synthetic products
hygiene, then they should be changed every 2 hours, regardless of the amount
discharge.
https://drlady.ru/disease/molochnica/vaginalnaja-drozhzhevaja-infekcija.html
6 forms of candidiasis PR
(oral cavity)
1. Pseudomembranous (“thrush”)
2.chronic hyperplastic
(leukoplakia)
3.chronic atrophic
4. erythematous “acute atrophic”
(against the background of ABT)
[Synonym – erythematous candidiasis]
5.median rhomboid glossitis
(form of erythematous candidiasis)
6.Angular cheilitis
https://www.brainscape.com/flashcards/exam-5-infectivestomatitis-fungal-5133544/packs/7056984
1. Pseudomembranous candidiasis
(thrush)
Localization – the mucous membrane of the cheek, palate or tongue.
Components of white plaque
– tangled mushroom hyphae
– candida yeast cells,
– dead epithelial cells
– rubbish!
Characteristics of the fabric under white bloom
with pseudomembranous candidiasis
1.normal fabric or
2.erythematous mucous membrane
Clinic of pseudomembranous candidiasis
White curdled plaques that are
scraped off (usually on the cheeks, palate,
spinal tongue)
Burning sensation
Alternating unpleasant salty /
bitter taste
Metallic taste in the mouth
Pain while eating and swallowing
Loss of taste
https://www.brainscape.com/flashcards/chpt-6-fungal-infections1561460/packs/2
1 …
2. Chronic hyperplastic candidiasis
(candidal leukoplakia)
• May be at the corners of the mouth (white spot or
mixed red and white layer)
• Considered precancerous
• Includes Candida hyphae (histologically)
• White bloom does not rub off
Treatment
• Treatment of candidiasis
• Identify the presence of risk factors
• Conduct a second biopsy
https: // www.brainscape.com/flashcards/aetiology-epidemiologyclinical-and-path-8344415/packs/13849706
3. Chronic atrophic candidiasis
May
develop
due to
24/7
use
dentures
Clinic of hyperplastic candidiasis
Always found on internal labial
adhesions on both sides or on the back of the tongue
Raised white affected area
Primarily observed in
smokers and diabetics
Biopsy examination (i.e.since maybe
malignant transformation)
4. Acute atrophic candidiasis
(erythematous candidiasis)
Erythematous “acute atrophic”
candidiasis
It is more common than thrush.
Reasons
ABT / antibiotic therapy /. Danny candidiasis
often associated with antibiotic use
(“Antibiotic pain in the mouth”).
Xerostomia (dry mouth)
– Sjogren’s disease
– pharmacological xerostomia
https: //www.brainscape.com / flashcards / exam-5-infectivestomatitis-fungal-5133544 / packs / 7056984 …
Clinic for erythematous candidiasis
Mouth pain (soreness worse from
hot or spicy food)
Burning in the mouth (burning feeling)
Diffuse loss of filiform papillae
dorsal tongue
Red bald tongue (red, shiny,
atrophic mucous membrane)
Sometimes bilateral angular cheilitis
https://www.brainscape.com/flashcards/chp
t-6-fungal-infections-
Examples of erythematous candidiasis
Acute atrophic candidiasis (“pain in the mouth after
taking antibiotics “)
Central papillary atrophy
Dental stomatitis (?)
Angular cheilitis
Perioral candidiasis
Chronic multifocal candidiasis
Localization of erythematous candidiasis – tongue (usual place), less often
– palate,
– oral adhesions,
– the skin of the perioral area.
https://www.brainscape.com/flashcards/fun
gal-infections-3998273 / packs / 5860471
5. Median rhomboid glossitis
(candidal seizures)
https://ohi-s.com/uchebnikstomatologa/glossit/ – Glossite
Median rhomboid
glossitis is a form of
erythematous candidiasis.
– Central papillary tongue atrophy
– Midline, back dorsum tongue
6. Angular candidal angular cheilitis
(candidal seizures)
[from lat. angulus – angle]
Cracking corners of the mouth
Maceration of the skin in the corners of the mouth
Burning
Soreness when opening the mouth
90% of cases – Candida
10% of cases – staphylococcus
or streptococcus
Usually responds well
local antimicrobial therapy.
http://www.myshared.ru/slide/459798/
Heilokandiosis (angular cheilitis) –
exfoliative lesions of the border zone and skin
perioral region caused by superficial
candidal infection.
Causes of angular cheilitis
– Loss of vertical position
– Vitamin B deficiency
– Immunosuppression with candidiasis
Angular cheilitis cases
20% – Candida only
60% – candida + S. aureus
20% – only S. aureus
https: //www.brainscape.com / flashcards / chpt-6-fungal-infections1561460 / packs / 2
1
http://www.myshared.ru/slide/459798/
http://www.myshared.ru/slide/459798/
Vulvovaginitis
TREATMENT
https://www.youtube.com/watch?v=cOlLPg8WgfM
Classes
preparations
Azoles
Polyene
Echinocandins
Antifungal
vye
Fluconazole,
clotrimazole,
miconazole,
ketoconazole,
itraconazole
Nystatin,
amphotericin B
Mechanism of Action
Inhibition of lanosterol 14 Expression regulated
α-demethylase (ERG11;
genes ERG
biosynthesis of ergosterol)
Binds to ergosterol in Cell sterol replacement
cell membranes
membrane
mushrooms; education
transmembrane pores that
results in loss of integrity
membrane and disruption
ion gradient
Kaspofungin,
Inhibition of β-1,3 micafungin,
glucan synthase
anidulafungin
Controlled Expression
glucan biosynthesis genes
Suppression of DNA and RNA synthesis Enzyme mutations,
in fungal cells
which catalyze
pyrimidine analogs such as
as Fur1
Enhanced Synthesis
pyrimidine nucleotides,
which are competitive
https: // sfamjournals.onlinelibrary.wiley.com/
inhibit analogs
Analogs
nucleosides
Flucytosine
C. albicans resistance
Most candidiasis is treatable and
complications are minimal (redness, itching,
the discomfort).
Untreated complications can be severe
or deadly.
Treatment
Minor; acute form – topical nystatin
Minor; chronic – topical nystatin + clotrimazole (tablets)
Persistent (refractory) in persons with ID without generalization of the process
– add fluconazole (oral)
Severe forms – IV amphotericin B with or without fluconazole
Maternity sole
recommended treatment regimen
vulvovaginal candidiasis is
appointment of topical azoles for 7 days.
http://www.slideshare.net/vijaymgims/common-benign-oral-cavity-disorders-by-drvijay-kumar
Azoles 5-membered heterocycles with at least two heteroatoms in the cycle,
one of which is a nitrogen atom, and also
bi – and polycyclic compounds including an azole ring.
The main representatives are oxazole, thiazole, imidazole, isoxazole, etc.
Treatment of oral candidiasis
http://candidagone.blogspot.ru/2015/04/oral-candidiasis-treatment.html
Neonatal candidiasis
shows high mortality and is often associated with a poor prognosis
nervous development in surviving patients.
Amphotericin B and fluconazole are the first drugs
of choice for the treatment of neonatal candidiasis.
Caspofungin – Alternative Antifungal Agent,
which is recommended for invasive candidiasis in adults, but
still ineffective for newborns and babies.
Cases. Two infants with candidal liver abscesses,
receiving caspofungin.
In the first infant, blood flow and liver lesions were eliminated
combination therapy with fluconazole, liposomal
amphotericin and caspofungin, and
the second has only caspofungin.
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1651-2227.2009.01225.x
Prevention
Early Diagnosis
Hygiene (oral cavity …)
Rinsing your mouth or brushing your teeth after
inhaled corticosteroid use
Chlorhexidine mouthwash
(for cancer patients)
Avoid sweating
Elimination of excess moisture
Non-synthetic linen (absorbent
moisture), free; shoes must be dry
Timely diaper change
Withdrawal of immunosuppressants (if possible)
Taking probiotics or microbial products
(yoghurt when taking antibiotics …)
https: // www.brainscape.com/flashcards/chpt-6-fungal-infections1561460/packs/2
1 …
Unwanted
Products
• Carbohydrates (sugar …),
yeast bread
Canned food or
recycled
Products
Fermented milk
Products
Beer
Sausages
Vinegar
Allergic
Products
Recommended
diet
Vitamin-rich diet
and minerals.
Plant and animal food
(red caviar, fish, beets …)
Immunostimulants
Probiotics (fresh yogurt …)
Tea tree oil, fir
Olive oil
Garlic
Berry juice, green juices
Almond
Potassium, magnesium
Ant tree bark
Diagnostics
Material
Vaginal discharge
Leather material or
mucous lesions
Blood
Piss
Cal
Nail clippings
Laboratory diagnostics
1.
Microscopy of material and culture
2.
Culture Study
3.
4.
Serological methods (ELISA)
Molecular Genetic Methods
(PCR)
with indication of the prevailing morphoform
– Determination of CFU – amount
– Species identification
– Determination of sensitivity
for antimycotics
To isolate yeast-like fungi, medium
is used
Sabouraud with the addition of chloramphenicol (400 mg / l). At
for a quantitative study, sowing is performed
from a dilution of 10-3.The incubation of crops is carried out within
24-48 hours at a temperature of + 370C.
https://studfiles.net/preview/1148570/page:3/
Chromogenic
Wednesday
(type Candid
defined
by color of colonies)
Thus, key provisions on the topic
Candida albicans is a polymorphic fungus that is
can grow as yeast, pseudohyphae or hyphae.
Can colonize mucous membranes with albicans or
cause infections (superficial to
generalized)
Candida as commensal
Candida as a virulent pathogen (UPM)
In PR (atrophic oral cavity or
hyperplastic processes)
C albicans are virulent in the form of hyphae (NCAC – in the form of yeast)
Yeast cells spread throughout the body
Leading role in defense – phagocytosis by neutrophils and cellular
immunity (pro-inflammatory cytokines that increase
radical formation / completeness of phagocytosis /)
THANKS FOR ATTENTION!
+ …
Candida
(in.presentation choir. – 53 slides)
http://slideplayer.es/slide/153658/
Oral Candidiasis
http://www.slideshare.net/DrArsalan/candidal-
infections-of-the-oral-cavity
http://www.slideshare.net/vijaymgims/common-benign-oral-cavity-disorders-by-drvijay-kumar
http://www.nature.com/articles/ srep12287 / figures / 6
Candida
http://slideplayer.es/slide/153658/
Candida
http://slideplayer.es/slide/153658/
https://www.rmj.ru/articles/dermatologiya/Glubokiy_kandidoz_-
https: // www.rmj.ru/articles/dermatologiya/Glubokiy_kandidoz_-
What is the most common
neutrophilic disorder?
Myeloperoxidase deficiency (MPO)
When to Suspect a Deficiency
IGO? With systemic candidiasis
https://www.brainscape.com/flashcards/clin
ical-immunology-18254 / packs / 31123
Which candidal infection is associated with
leukemia?
C. tropicalis
https://www.brainscape.com/flashcards/ste
m-cell-transplants-18404 / packs / 31123
Many pharmaceuticals can
contribute to the distribution of Candidates
(antibiotics, oral contraceptives)
http: // www.askanaturopath.com/faqs/mushrooms-candida/p/161
Natural Remedies for Fungal Infection
Some herbs that help “cleanse” the digestive tract:
wormwood, dandelion, rhubarb, black cumin, Oregon
grape, bitter orange, clove, gentian,
garlic, thuja, black walnut, olive leaves, echinacea,
burdock, barberry.
Probiotics May Help Balance Flora
intestines (Candida growth can be promoted by
abnormal gut bacteria).
Super greens (green barley, wheatgrass, chlorophyll or
spirulina) helps to keep the pH balance of the blood, which is
reduces the survival rate of fungi.
http://www.askanaturopath.com/faqs/mushrooms-candida/p/161
Candida albicans can be detected
on CO (mucous membranes), in intestinal
tract and oral cavity of healthy people.
Cultural diagnostics
5-7 days
Dear Analysis
But AB-resistance can be investigated
Candida is identified by characteristics
mycelium and conidiophores.
S. 431
https://books.google.ru/books?id=ZwklCwAAQBAJ&pg=PA435
& dq = Rubella + pathogenesis & hl = ru & sa = X & ved = 0ahUKEwjmye
6ItrPiAhULtIsKHZDFDqEQuwUIRTAD # v = onepage & q = Rubella
% 20pathogenesis & f = true
why pregnancy increases the risk
opportunistic candidiasis
infections?
Increased estrogen levels cause
glycogen, a carbon source, contributing to
Candida growth and adhesion to
epithelial cells
https: // www.brainscape.com/flashcards/can
dida-5791337 / packs / 8823213
Recurrent candidal
vulvovaginitis (PKVV) affects up to 8%
women. Immunopathogenesis poorly understood,
but it has been suggested that
RVVC could be a consequence of
dysregulation of the innate immune
answer.
Tumor necrosis factor-α production
(TNF-α) in response to C. albicans hyphae was
significantly higher in patients than in
control group, https://academic.oup.com / jid / advancearticle / doi / 10.1093 / infdis / jiaa444 / 5875655
Candida albicans contributes
tooth decay causing microbial
dysbiosis of the oral cavity
https://www.nature.com/articles/s41396-020-00823-8
Candidiasis diagnostics
Microscopy of vaginal contents
Culture method for detection
fungus species and assessment of sensitivity to
antibiotics
PCR (for those mushrooms that are bad
grow on media / s. auris… /)
+ Methods for identifying the causes of defects
immunity (intestinal dysbiosis,
concomitant diseases …)
https: // www.youtube.com/watch?v=cOlLPg8WgfM
Intermittent fasting (if you fast for 18 hours, then
the body removes low-damaged cells and
microbes). A very effective way to clean
rubbish.
Low-carb diet (no more than 20 grams of carbohydrates per
day; keto diet), remove and dairy products
Thyme oil (from candida)
+ Grapefruit (seed extract)
Garlic, cranberry juice
Birth control pills speed up
growth candida
https: // www.youtube.com/watch?v=46eLtvVFHks – in.
…
Thrush in the mouth does not interfere with the baby.
It is necessary to remove carbohydrates from food, from the mouth
(feed no more often). 1 cup boiled
water with 1 tsp. soda (room
temperature) Wipe with gauze with this
solution of the oral cavity (wrap your finger
gauze)
https://www.youtube.com/watch?v=o6Jp5_tnfzk – Komarovsky
Treatment with candida biofilms is difficult.
https://www.mdpi.com/2309-608X/6/1/21/htm
210 patients with sinusitis.96% had 90,071
candida in mucus.
https://www.youtube.com/watch?v=LFdPk6xXpTA
Candida themselves cause hormonal
imbalance.
The liver is affected in 50-75% of patients with
disseminated Candida
albicans, which are submitted for autopsy.
Lifetime diagnosis of liver candidiasis
rarely placed. In about 50% of cases
blood culture is negative, and
biochemical parameters of the lesion
liver may have nonspecific
meaning.
More often kidney, heart, and
respiratory tract.
https://aasldpubs.onlinelibrary.wiley.com/do
i / abs / 10.1002 / hep.1840020415
Treatment of recurrent thrush
(vaginal candidiasis)
Fluconazole 150 mg
3 times every other day
Then, once a week, 150-200 mg 3-6
months
Success 80% of the time.
https://www.youtube.com/watch?v=ZMlNaYBP25c
Candida krusei most often
associated with malignant
hematological diseases
(61%; P
stem cells (22%; P sign
equals 0.004), neutropenia (57%; P sign
equal to 0.001) and previous
use of antifungal
azole agents (26%; P
https: // www.journalofhospitalinfection.com/article/S01956701(10)00440-8/fulltext
Treatment of cutaneous candidiasis, candidiasis
nail
Local treatment first (ointments, varnishes,
candles)
If it does not help, then systemic treatment
(up to stationary)
https://www.youtube.com/watch?v=ZMlNaYBP25c
Candidiasis
By localization
By …
If candidiasis is caused by candidiasis
pseudotropicalis, the plaque has
frothy character.
Among the NAC species C. parapsilosis, C.
glabrata and C. tropicalis were usually
associated with candidemia among
cancer patients
https://www.frontiersin.org/articles/10.3389/fcimb.2020.00094/full
How to treat candidal vaginitis?
– local antifungal cream
(e.g. clotrimazole or miconazole,
over the counter)
or
oral dose of fluconazole is sufficient
for infection control
https://www.brainscape.com/flashcards/candida-
5791337 / packs / 8823213

causes of formation, methods of treatment of dermatitis

Diaper rash, or intertriginous dermatitis, is an infectious and inflammatory skin disease that develops in folds and places with increased friction.It is preventable, but it is difficult for women with large breasts to avoid unpleasant symptoms. Treatment for diaper rash under the breast can also take a long time.

Mechanism of development and main causes

Leather has many functions. It protects against the negative influence of external factors, helps to cool the body, and is the organ of excretion. The skin has a large number of sweat glands, in the most actively sweating areas, their number reaches a thousand per 1 cm ² .Sweat is produced continuously, 600-800 ml of liquid evaporate from the body surface per day at room temperature. In folds of the skin, where ventilation is poor, sweat is absorbed into the clothing, so the skin remains moderately hydrated.

Women with large breasts develop a poorly ventilated area underneath. Sweat glands do not stop producing sweat, it has no way to evaporate or be absorbed into clothing. The skin remains constantly moist, and friction with movement causes irritation and maceration.

Sweat is formed as a result of filtration of the liquid part of the blood plasma, therefore it contains many blood components:

• water;
• sodium and potassium chloride;
• urea;
• uric acid;
• creatinine;
• fatty acids;
• aromatic substances.

The composition of sweat gives it bactericidal properties, but with profuse perspiration and lack of personal hygiene, it mixes with the secretion of the sebaceous glands and becomes a breeding ground for the reproduction of microorganisms.On the surface of the skin, a conditionally pathogenic microflora lives, which includes cocci, sticks, yeast fungi can be found. Their active reproduction is inhibited by the immune system.

The fold under the mammary gland creates favorable conditions for the reproduction of microorganisms. Excessive sweating, a warm, constantly humid environment, maceration and reduced immune defenses lead to even greater microbial damage or fungal infection.

Diaper rash under the breast often occurs in older women.In this case, hormonal changes that occur after the onset of menopause are a risk factor and lead to a shift in the acidity of sweat and fluctuations in its composition. The immune defense decreases, the ability of tissues to regenerate worsens.

Sometimes maceration occurs during pregnancy or after childbirth. In the first case, the chest and the enlarged abdomen form a fold between them. If, at the same time, a woman has incorrectly selected underwear or it is absent, it is difficult to avoid the appearance of intertriginous dermatitis.

After childbirth, milk arrives on the 3-4th day, the volume of the breast increases, its temperature rises. Local immunity in the postpartum period is reduced, sweating is increased, therefore, if hygiene is not observed, good conditions are created for the appearance of maceration and the addition of infection.

The risk group includes women with the following diseases:

• diabetes mellitus;
• obesity;
• hyperhidrosis;
• hyperthyroidism;
• Itsenko-Cushing’s syndrome.

Any immunodeficiency condition can cause diaper rash under the breast. You can prevent the problem by using a properly selected bra. But many older women ignore this clothing accessory.

Symptoms and clinical manifestations

The rate of development of intertriginous dermatitis is individual. Initially, under the breast there is a feeling of constant humidity, fever, sweating. In premenopausal women, this condition is aggravated during hot flashes, which occur most often in the evening.

Gradually redness appears on the epithelium. It is limited by the area of ​​contact between the skin of the lower chest and the chest underneath. The area looks swollen, slightly rises above the healthy tissue.

Then there is an itching and burning sensation. Constant scratching leads to microtrauma. Unpleasant sensations become unbearable after increased sweating. Hygiene procedures at the initial stage can bring relief, but later, due to the water, dryness appears, a feeling of tightness, and the itching intensifies.

When the form is started, a change in the structure of the skin appears. In the foci, a rash, bubbles, cracks form, and when infected with a staphylococcal infection, pustules. With a fungal infection, the plaque acquires a whitish tint; when trying to remove it, the lower inflamed, bleeding layer is exposed.

Clinical manifestations of diaper rash under the mammary glands

Sometimes the intensity of the symptoms decreases, the foci of dermatitis dry up, and small scaly peeling appears.

In advanced cases, when treatment is carried out with ineffective methods or the doctor’s recommendations are ignored, complications may arise in the visa of erosion, long-term non-healing ulcers, adhesion to diaper rash of a mixed infection that does not respond to treatment. Fear should be caused by diaper rash with an unpleasant odor, reminiscent of rotten meat.

In what cases is additional diagnostics necessary

When dermatitis appears under the breast, the diagnosis is made based on the results of the examination and the medical history.The doctor draws attention to concomitant diseases and conditions:

• pregnancy;
• lactation period;
• premenopausal age;
• diabetes mellitus;
• obesity;
• immunodeficiency states.

The following diagnostic tests are carried out:

1. Microbiological research. It is indicated in case of ineffectiveness of the therapy or deterioration of the condition. For diagnostics, scraping from the surface of the diaper rash is used.A wet preparation with potassium hydroxide is prepared from it, which is studied under a microscope. From the outbreak, sowing is done on special nutrient media. After obtaining a pure culture, a study of its sensitivity to antibiotics is carried out.
2. Polymerase chain reaction. With its help, it is possible to determine the DNA of microorganisms that are present in the outbreak. When using PCR in real time, it is possible to identify not only the qualitative composition, but also the number of microorganisms.

Additional diagnostic methods can be used in cases where it is necessary to determine the concomitant diseases that caused the appearance of dermatitis.These are:

• blood glucose test;
• glucose tolerance test;
• HIV test;
• Determination of the hormonal profile.

Differential diagnosis is carried out with inguinal dermatomycosis caused by molds from the genus actinomycetes. Also, psoriasis can have similar symptoms.

Treatment methods

To cure diaper rash under the mammary glands, you must strictly follow the doctor’s recommendations.The main therapy is carried out with local remedies. But what exactly to treat the disease should be decided by a dermatologist. The choice of the right remedy depends on the comorbidities and the cause of the problem.

It is imperative to use comfortable, properly selected cotton underwear that lifts the chest and improves skin ventilation. Bras with hard underwire are not recommended for the duration of treatment.

Uncomplicated forms of pathology

For uncomplicated diaper rash, ointments or creams are used, which accelerate the healing of the skin, improve its ability to regenerate.They start with safe drugs, and if they are ineffective, they switch to hormone therapy.

Places of diaper rash are washed daily with warm water. You can use tar soap, which dries the skin less and has an antiseptic effect. After hygiene procedures, the affected areas are thoroughly dried. Some experts suggest using not only a towel, but also the warm air of a hair dryer. Care must be taken with this method. Drying for too long or applying hot air will cause additional irritation and overheating will stimulate additional perspiration.

It is necessary to treat the diaper rash area with ointments with a drying effect. Zinc paste, preparations based on copper sulfate help. To accelerate healing, an ointment or cream based on dexpanthenol is indicated. Dexpanthenol penetrates the skin tissue and is converted into pantothenic acid. It speeds up cell metabolism, stimulates cell division and restores the integrity of the membrane.

For uncomplicated forms of diaper rash, a cream with betamethasone Celestoderm

is successfully applied

If the above funds are ineffective, you can smear the foci of diaper rash with Celestoderm.It is based on beclamethasone, a topical glucocorticosteroid. It reduces the inflammatory response and speeds up healing. Among the contraindications is the lactation period. It is possible to use Celestoderm and its analogues during pregnancy, but not more often 1-2 times a day in a short course. Large doses are prohibited, since hormones in this case can have a systemic effect. All hormonal ointments reduce local immunity, therefore, with prolonged treatment, a secondary bacterial or fungal infection often joins.

Inflammation with bacterial contamination

When joining a bacterial infection, drugs with antiseptic and antibacterial action must be used:

• Furacillin;
• Chlorhexidine;
• Miramistin;
• alcohol tincture of calendula;
• Burov’s liquid – 8% aqueous solution of aluminum acetate.

Treatment of diaper rash under the mammary glands in older women is more difficult. Age-related changes in the skin, decreased immunity do not allow you to quickly get rid of the disease.Even in the absence of bacterial flora in the microbiological study, prophylactic treatment with solutions with an antiseptic effect is carried out.

For drying, apply:

• decoction of oak bark, chamomile;
• resorcinol solution;
• copper sulfate solution;
• Lassar paste – salicylic-zinc ointment.

Teimurova paste

Teymurov’s paste helps to get rid of sweating, unpleasant odor. It includes:

• boric acid;
• zinc;
• lead acetate;
• salicylic acid;
• talc;
• sodium tetraborate;
• formaldehyde.

Duration of use depends on the severity of the condition and compliance with other medical recommendations.

Dermatitis with candidiasis

Candida infection easily joins the diaper rash under the breast, especially in women with diabetes mellitus. Getting rid of the fungus with herbal remedies will not work. Antifungal medications are needed. The following ointments are effective:

• Pimafucin;
• Clotrimazole;
• Miconazole;
• Nystatin.

If fungal treatment is ineffective, the exact type of infection and its susceptibility to drugs should be determined.

Women with diabetes are prohibited from using solutions containing alcohol for the treatment of diaper rash. They dry out the skin and increase the area of ​​damage.

Powder with talcum powder is used as a drying agent. It absorbs excess moisture and prevents the wound from getting wet all the time.

In case of fungal infection, local remedies are applied at least 2-3 times a day after hygiene procedures.The duration of treatment is individual. If therapy is ineffective, systemic therapy with antimycotic drugs may be required.

How to avoid diaper rash under the breast

Prevention of diaper rash consists in the correct selection of underwear. During pregnancy, the mammary gland increases by 1-2 sizes, so for this period it is necessary to change the bra to a comfortable one, sewn from cotton fabric.

The basis of prophylaxis is careful adherence to personal hygiene.During the shower, be sure to wash the area under the mammary gland. After a shower, carry out air baths. You can not refuse to wear a bra, citing its inconvenience. In order for the underwear not to cause discomfort, you need to choose the right size, cup shape, and also give preference to wide shoulder straps that can provide good support.

See also: Mastalgia – pain in the mammary glands

.