Original ArticleOpen Access

Prevalence and Risk Factor of Diaper Dermatitis among Saudi Children

DOI: 10.23958/ijirms/vol06-i10/1244· Pages: 642 - 648· Vol. 6, No. 10, (2021)· Published: October 1, 2021
PDF
Views: 751 PDF downloads: 191

Abstract

Background: Diaper dermatitis (DD), commonly known as diaper rash is an inflammatory disease of the skin of diaper wearing area. It is usually seen in children belowss 24 months and is not considered by doctors as a serious problem. However, it often causes discomfort and apprehension among parents. Methods: A cross-sectional study performed through patient questionnaires. A total of 1344 patients were included in the study. A pilot was done to test the validity and reliability of developed questionnaire and also to calculate the minimum sample size for our study. By considering the values derived from the pilot study done among 50 parents of children aged 1-24 months who used diapers. A standardized methodology was followed in the validation of this questionnaire that included focus group discussion, expert evaluation, pilot study, reliability and validity assessment etc. Three experts in the field of medicine (dermatologist, pediatrician, and internist) and one biostatistician were involved in the validation of our questionnaire. Result: In our study majority of the participants were females (87.3%), and 55.3% belonged to the 20-25 years age group. The fixed orthodontic related history showed 59.8% had undergone the treatment for 1 to 3 years and 31.6% of the participants reported that they had removed the fixed braces for more than five years. Among these participants, 89.5% (n=34) reported that the fascia (space) closed between the upper frontal teeth after Frenectomy, and 65.8% (n=25) agreed that spaced between the two upper front teeth still closed after removing the retainer. Conclusion: The reported prevalence of diaper dermatitis in our study was found to more in the Kingdom of Saudi Arabia. There is huge anxiety created among parents, and this would result in increased pediatric consultations.

Keywords

Diaper DermatitisAllergicSaudi Children

References

  1. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol. 2014;31:1‐7.Google Scholar ↗
  2. Jordan WE, Lawson KD, Berg RW, et al. Diaper dermatitis: frequency and severity among a general infant population. Pediatr Dermatol. 1986;3:198‐207Google Scholar ↗
  3. Carr AN, DeWitt T, Cork MJ, et al. Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior. Pediatr Dermatol. 2020;37(1):130-136.Google Scholar ↗
  4. Adalat S, Wall D, Goodyear H. Diaper dermatitis – frequency and contributory factors in hospital attending children. Pediatr Dermatol. 2007;5:483-488.Google Scholar ↗
  5. Ward DB, Fleischer AB, Feldman SR, Krowchuk DP. Characterization of diaper dermatitis in the United States. Arch Peds Adol Med. 2000;154:943-946.Google Scholar ↗
  6. Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018;35:s19-s23.Google Scholar ↗
  7. Philipp R, Hughes A, Golding J. Getting to the bottom of nappy rash. ALSPAC Survey Team. Avon Longitudinal Study of Pregnancy and Childhood. Br J Gen Pract. 1997;47(421):493-497.Google Scholar ↗
  8. Martins N, Ferreira IC, Barros L, Silva S, Henriques M. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment. Mycopathologia. 2014;177(5-6):223-240.Google Scholar ↗
  9. Tüzün Y, Wolf R, Bağlam S, Engin B. Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clin Dermatol. 2015;33(4):477-482.Google Scholar ↗
  10. Verbov JL. Skin problems in children. Practitioner. 1976;217(1299):403-415.Google Scholar ↗
  11. Suebsarakam P, Chaiyarit J, Techasatian L. Diaper Dermatitis: Prevalence and Associated Factors in 2 University Daycare Centers. J Prim Care Community Health. 2020;11:2150132719898924Google Scholar ↗
  12. Zheng Y, Wang Q, Ma L, et al. Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Exp Dermatol. 2019;28(11):1289-1297.Google Scholar ↗
  13. Owa A, Oladokun R, Osinusi K. Skin pH and Transepidermal Water Loss Values in Children with Diaper Dermatitis in Ibadan, Nigeria. Pediatr Dermatol. 2017;34(3):303-307.Google Scholar ↗
  14. Roul S, Ducombs G, Leaute-Labreze C, et al. “Lucky Luke” contact dermatitis due to rubber components of diapers. Contact Dermatitis. 1998;38:363-364.Google Scholar ↗
  15. Di Landro A, Greco V, Valsecchi R. “Lucky Luke” contact dermatitis from diapers with negative patch tests. Contact Dermatitis. 2002;46:48-49.Google Scholar ↗
  16. Belhadjali H, Giordano-Labadie F, Rance F, et al. "Lucky Luke" contact dermatitis from diapers: a new allergen? Contact Dermatitis. 2001;44:248.Google Scholar ↗
  17. Storrs F. Dermatitis from clothing and shoes. In: Fischer A, ed. Contact Dermatitis. Philadelphia: Lea & Febiger; 1986. p. 283-337.Google Scholar ↗
  18. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol 2014; 32:477.Google Scholar ↗
  19. Šikić Pogačar M, Maver U, Marčun Varda N, Mičetić-Turk D. Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol. 2018;57(3):265-275.Google Scholar ↗
  20. Rasmussen JE. Classification of diaper dermatitis: an overview. Pediatrician. 1987;14 Suppl 1:6-10.Google Scholar ↗
  21. Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Curr Opin Pediatr 2012; 24:472.Google Scholar ↗
  22. Li CH, Zhu ZH, Dai YH. Diaper dermatitis: a survey of risk factors for children aged 1-24 months in China. J Int Med Res. 2012;40(5):1752-60.Google Scholar ↗
  23. Visscher MO, Chatterjee R, Munson KA, Bare DE, Hoath SB. Development of diaper rash in the newborn. Pediatr Dermatol. 2000 Jan-Feb;17(1):52-7.Google Scholar ↗
  24. Zheng Y, Wang Q, Ma L, Chen Y, Gao Y, Zhang G, Cui S, Liang H, Song L, He C. Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Exp Dermatol. 2019 Nov;28(11):1289-1297.Google Scholar ↗
  25. Matamoros S, Gras-Leguen C, Le Vacon F, et al. Development of intestinal microbiota in infants and its impact on health. Trends Microbiol 2013; 21: 167–173.Google Scholar ↗
  26. Kellen PE. Diaper dermatitis: differential diagnosis and management. Can Fam Physician. 1990 Sep;36:1569-72.Google Scholar ↗
  27. Merrill L. Prevention, treatment and parent education for diaper dermatitis. Nurs Womens Health 2015; 19: 324–336; quiz 337.Google Scholar ↗
  28. Coughlin CC, Eichenfield LF, Frieden IJ. Diaper dermatitis: clinical characteristics and differential diagnosis. Pediatr Dermatol 2014; 31(Suppl 1): 19–24.Google Scholar ↗
  29. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32:477‐487.Google Scholar ↗
  30. Smith WJ, Jacob SE. The role of allergic contact dermatitis in diaper dermatitis. Pediatr Dermatol. 2009;26:369-370.Google Scholar ↗
  31. Campbell RL, Bartlett AV, Sarbaugh FC, Pickering LK. Effects of diaper types on diaper dermatitis associated with diarrhea and antibiotic use in children in day-care centers. Pediatr Dermatol. 1988 May;5(2):83-7.Google Scholar ↗
  32. Buckingham KW. Berg RW. Etiologic faetors in diaper dermatitis: the role of feces. Pediatr Dermatol 1986:3:107-112.Google Scholar ↗
  33. Berg RW, Buckingham KW, Stewart RL. Etiologic faetors in diaper dermatitis: the role of urine. Pediatr Dermatol 1986:3:102-106.Google Scholar ↗
  34. Zimmerer RE, Lawson KD, Calvert CJ. The effects of wearing diapers on skin, Pediatr Dermatol 1986:8:95-101.Google Scholar ↗
  35. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol 2014; 32: 477–487.Google Scholar ↗
  36. Shin HT. Diagnosis and management of diaper dermatitis. Pediatr Clin North Am 2014; 61: 367–382.Google Scholar ↗
  37. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol 2014; 31: 1–7.Google Scholar ↗
Author details