Course
1. Rash starts in perianal area and spreads contiguously
Signs
1. Erythematous confluent Plaque
  1. Papules
  2. Vesiculopustules
2. Scalloped border with sharply demarcated edge
3. Satellite lesions at a distance from primary eruption
Differential Diagnosis
1. Irritant Diaper Dermatitis
2. Perianal Streptococcal Dermatitis
Management
1. General
  1. Keep diaper area dry
  2. Keep diaper off as much as possible to aerate area
  3. Zinc oxide paste
    1. Soothing and protective after the acute phase
  4. Baby powder
    1. May help to dry area (Risk of aspiration)
2. Topical Antifungal
  1. Superior cure rates
    1. Miconazole
    2. Clotrimazole
  2. Other agents
    1. Ketoconazole
    2. Nystatin
    3. Amphotericin
3. Oral Antifungal and Thrush agents
  1. Consider to treat dermatitis and GI Infection
4. Consider Burow's Solution compresses before Antifungal
5. For severe inflammatory reaction
  1. Mix Topical Corticosteroid with Antifungal 50:50 or
  2. Alternate applications of Antifungal and steroid
Reference
1. Hoppe (1997) Pediatr Infect Dis 16:885

Navigation Tree

Please see the Terms and Conditions. Please also see the privacy statement regarding advertising on this page. Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians.

This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.