Dermatitis - diaper and Candida

Alternative names

Diaper dermatitis - Candida-associated; Candida-associated diaper dermatitis

Definition

Candida-associated diaper dermatitis is an infection of the skin beneath an infant's diaper. It is caused by Candida organisms (yeasts).

Causes, incidence, and risk factors

Diaper rashes caused by infection with Candida species are extremely common in children. Candida is found everywhere in the environment and takes advantage of the warm, moist conditions beneath a diaper to cause superficial skin infections.

The infection may begin as an intensely red patch with irregular (but sharp) boarders. Satellite lesions, smaller red patches just separated from the original patch's boarder, spread and blend in with the larger patch. The rash may spread to include the entire area covered by the diaper, including the scrotum and penis in boys, and the labia and vagina in girls.

Symptoms

• Rash, bright red patch which enlarges (patch is made up of small papules and vesicopustules)
  
• Satellite lesions, smaller red patches which grow and blends with the other patches
  
• scratching by the infant when the diaper is removed
  
• scrotum may become fiery red and scaly (boys)
  
• Other
  o the infant may also have oral thrush
  

Signs and tests

The classic appearance of the rash makes diagnosis of candidal diaper dermatitis possible by examination alone. The presence of yeast in a KOH (potassium hydroxide) preparation of skin scrapings is diagnostic.

KOH test (microscopic examination of skin scrapings in KOH) demonstrates the presence of Candida.

Treatment

Topical antifungal skin preparations will clear candidal infections. Some preparations are available as over-the-counter (OTC) creams and ointments.

Some of these antifungals include:

• Nystatin (prescription)
  
• Clotrimazole (OTC) (Lotrimin)
  
• Miconazole (OTC)
  
• Ketoconazole (Rx)
  

Expectations (prognosis)

The rash usually responds well to treatment.

Complications

• secondary infection