Dermatology Book

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Candida Diaper Dermatitis

Aka: Candida Diaper Dermatitis, Monilial Rash
  1. Course
    1. Rash starts in perianal area and spreads contiguously
  2. 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
  3. Differential Diagnosis
    1. Irritant Diaper Dermatitis
    2. Perianal Streptococcal Dermatitis
  4. 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
  5. Reference
    1. Hoppe (1997) Pediatr Infect Dis 16:885-94 [PubMed]

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