Prospective aetiological study of diaper dermatitis in the elderly.

ABSTRACT

BACKGROUND: The different causes of diaper dermatitis (DD) in the elderly are not well known and the treatment is often empirical. OBJECTIVES: To determine the causes of DD in the elderly and to evaluate the efficacy of antifungal treatments in this indication. METHODS: Consecutive patients presenting with DD were included. Clinical evaluation, skin swabs for bacterial and mycological cultures, patch testing and skin biopsy were performed at inclusion. This was followed by 1 month of topical antifungal cream and, if needed, by oral fluconazole for the second month. RESULTS: Forty-six patients were included (mean age 85 years). Causes of DD were established for 38 patients 24 had candidiasis (63%), six irritant dermatitis (16%), four eczema (11%) and four psoriasis (11%). After 2 months of treatment, 27 of 37 (73%) patients were cured and five of 37 were improved. CONCLUSIONS: Mycoses and irritant dermatitis are the main causes of DD in the elderly, and emollient skin care and topical antifungal treatment can be considered a first-line therapy for this indication.