Diaper dermatitis - Candida-associated Health Article

Definition

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

Alternative Names

Dermatitis - diaper and Candida; Candida-associated diaper dermatitis

Causes, incidence, and risk factors

Diaper rashes caused by infection with Candida species are very common in children. Candida is found everywhere in the environment, and takes advantage of the warm, moist area under a diaper to cause infections on the skin.

The infection may begin as a very red patch with irregular (but sharp) borders. Smaller red patches can spread out from the original border 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.

Candidal diaper rashes can be associated with oral candidiasis, or thrush. In this case, the oral infection must also be treated.

Symptoms

• Bright red patch of rash that gets bigger (patch is made up of small papules and vesicles with pus)
• Smaller red patches (satellite lesions) that grow and blend in with the other patches
• The infant scratches when the diaper is removed
• Scrotum may become fiery red and scaly (boys)
• The infant may also have oral thrush

Signs and tests

Candidal diaper dermatitis can be diagnosed by examination alone because the rash has a unique appearance. The KOH test can confirm a Candida diagnosis.

Treatment

Topical antifungal skin creams and ointments will clear up infections caused by yeast. Miconazole and clotrimazole are available over-the-counter.

Prescription antifungals include:

• Nystatin
• Ketoconazole

Expectations (prognosis)

The rash usually responds well to treatment.

Complications

Complications from Candida-associated diaper rash can include:

• Secondary infection

Calling your health care provider

If your baby has a diaper rash that doesn't respond to home treatment, you should have the baby examined by your health care provider.

Prevention

It can be hard to prevent Candida infections, because these organisms are in the environment. Using highly absorbent disposable diapers to keep the skin dry reduces the chance of getting an infection. Changing the diaper soon after the baby urinates or passes stool also can help prevent infection.