At a glance: Nappy dermatitis versus candida nappy rash

Nappy dermatitis may cause itching and pain
Nappy dermatitis may cause itching and pain

Nappy dermatitis

Discriminatory signs

  • Flexures are spared.
  • Patchy rash.
  • Erythema, if severe erosions and ulcers.
  • May itch and cause pain.
  • Urine and faeces will cause a rash on skin if left in contact for long.
  • Ammonia is formed and burns the skin.
  • May be associated with cradle cap or atopic dermatitis.

Management

  • Change the nappies frequently.
  • Neonates urinate more than 20 times daily; by the age of 1 year this has reduced to seven times daily.
  • Give evening fluids early to reduce wetting at night.
  • Wash the bottom at every change and pat dry. Apply moisturiser.
  • Leave the nappy off as much as possible.
  • Do not use powders such as talcum powder.

Candida nappy rash

Discriminatory signs

  • The rash includes creases.
  • Causes discomfort.
  • Beefy red papules.
  • Whitish scaling.
  • Pustules and satellite lesions seen around the margins of the main red area.
  • May be associated with oral lesions.
  • Enquire if the baby had recently had antibiotic therapy.

Management

  • Topical antifungal ointment such as nystatin can be followed in some cases by oral antifungals or be given simultaneously.
  • Topical imidazole cream should be considered in resistant cases.
  • Consider referral to a specialist if not responsive to therapy.

Contributed by Dr Vasa Gnanapragasam, GP in Sutton, Surrey.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

UK COVID-19 alert level raised as GPs prioritised for testing

UK COVID-19 alert level raised as GPs prioritised for testing

The government has raised the UK's COVID-19 alert level to four amid reports that...

UK on course for 50,000 COVID-19 cases a day by mid-October

UK on course for 50,000 COVID-19 cases a day by mid-October

The UK could see 50,000 COVID-19 cases per day by mid-October, with the epidemic...

Stricter short-term COVID-19 measures needed to avoid second national lockdown, BMA warns

Stricter short-term COVID-19 measures needed to avoid second national lockdown, BMA warns

COVID-19 infection rates will ‘soar’ and the NHS will ‘once again be crippled’ if...

Practices handed one-month opt-out window as revamped network DES unveiled

Practices handed one-month opt-out window as revamped network DES unveiled

NHS England has unveiled a revamped DES package for 2020/21 confirming new targets,...

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered a huge increase in face-to-face appointments in the week before NHS...

RCGP facing legal action over stance on assisted dying

RCGP facing legal action over stance on assisted dying

The RCGP is facing legal action over its decision to remain opposed to assisted dying...