ABSTRACT
Anogenital skin care for the elderly remains an umbrella term concerning protective and non-interventional regimens, particularly for ordinary diaper users. Our recent investigation has demonstrated the preventive effect of daily anogenital washing with miconazole nitrate-containing soap to the development of diaper candidiasis. We extended this work to cover our hypothesis as to whether the miconazole soap has a therapeutic benefit in genital candidiasis. The study outline includes: (i) the enrollment of 21 bedridden inpatients (84 ± 9 years; eight men and 13 women) who were diagnosed clinically and mycologically with genital candidiasis, and who had never received topical and/or systemic antifungal agents; (ii) administration of anogenital washing with 0.75% miconazole-containing soap once daily for 4 weeks; and (iii) assessment of clinical symptoms and detection of Candida materials by culture and microscopic examination. As assessed by clinical symptom scoring for incontinence-associated dermatitis (IAD), the ratio of patients with severe to moderate symptoms dramatically decreased by 2 weeks and 10 of 21 patients became symptom-free at 4 weeks. The IAD clinical severity score was significantly decreased at 4 weeks. Compared with the baseline positivity, both microscopic and cultured Candida-positive rates were significantly decreased at 4 weeks after washing. All culture-detected fungi were Candida albicans. Severe adverse events did not occur in all participants. Individual medical and risk factors had no significant correlation with clinical severity and duration of candidiasis on variance analysis. In conclusion, topical washing with miconazole soap is a safe and reliable non-medical approach for soothing diaper-associated genital candidiasis in bedridden inpatients in whom it is difficult to perform prompt medical examination.
Subject(s)
Antifungal Agents/administration & dosage , Candidiasis, Cutaneous/therapy , Candidiasis, Vulvovaginal/therapy , Diaper Rash/therapy , Skin Care/methods , Soaps/therapeutic use , Aged , Aged, 80 and over , Candida/isolation & purification , Candidiasis, Cutaneous/diagnosis , Candidiasis, Cutaneous/microbiology , Candidiasis, Vulvovaginal/diagnosis , Candidiasis, Vulvovaginal/microbiology , Diaper Rash/diagnosis , Diaper Rash/microbiology , Diapers, Adult/adverse effects , Female , Humans , Male , Miconazole/administration & dosage , Prospective Studies , Severity of Illness Index , Soaps/chemistry , Treatment Outcome , Urinary Incontinence/therapyABSTRACT
Mild diaper dermatitis often occurs in children before toilet training is complete, particularly from 9 to 12 months of age, and the most common presentation is an irritant contact dermatitis. Diaper dermatitis may account for up to 25% of dermatology visits to health care providers during the first year of life. Fortunately, since the introduction of hypoallergenic, superabsorbent modern disposable diapers, the incidence and severity of irritant and allergic contact dermatitis has decreased dramatically. Diaper dermatitis broadly refers to skin disorders that occur in the diaper area, such as skin eruptions triggered by diapers, rashes exacerbated by the diaper, and other events that occur in the diaper area. A number of skin conditions that can occur anywhere on the skin may present with distinctive findings in the diaper area. The following discussion will review the most common triggers of diaper dermatitis and contact irritant dermatitis, while focusing on the skin conditions that may be associated or overlap clinically with contact dermatitis.
Subject(s)
Diagnosis, Differential , Diaper Rash/diagnosis , Acute Disease , Candidiasis, Cutaneous/etiology , Dermatitis, Contact/etiology , Diaper Rash/complications , Diaper Rash/pathology , Diapers, Infant , Disposable Equipment , Female , Humans , Infant , Infant, Newborn , Keratosis, Seborrheic/pathology , Male , Staphylococcal Skin Infections/etiologyABSTRACT
Diaper dermatitis in infants is commonly seen by clinicians in both primary care and acute care settings. The condition can cause significant discomfort for infants and distress for their parents and caregivers. Nursing for Women's Health convened a group of nursing clinicians who work in a variety of settings to discuss the issues and challenges related to preventing and treating diaper dermatitis in both healthy term newborns and premature newborns.
Subject(s)
Diaper Rash/therapy , Breast Feeding , Diaper Rash/nursing , Diaper Rash/pathology , Humans , Infant, Newborn , Infant, Premature/metabolismABSTRACT
Diaper dermatitis is a common cutaneous condition characterized by an acute inflammatory eruption of the skin in the diaper area of an infant. Although this condition is relatively common, it can cause considerable pain and stress for infants and can be troublesome for their caregivers. In the United States, the frequency of diaper dermatitis is substantial and accounts for a high number of visits to health care providers. The three most common types of diaper dermatitis are chafing dermatitis, irritant contact dermatitis and diaper candidiasis. This article reviews common causes, differential diagnosis, current prevention and treatment recommendations, nursing implications and practical tips for families to utilize while caring for their infants at home.