Diaper dermatitis

Diaper dermatitis occurs due to prolonged contact with skin and face and many cases get infected secondarily with bacteria and candida albicans. These dermatitis conditions are somehow in one or the other way related to diapers that the baby wears and there are three main types of diaper dermatitis i.e. chafing dermatitis, irritant contact dermatitis and candida diaper dermatitis.

Chafing dermatitis: It is generally seen in areas which are more prone to friction and where regular skin contact occurs like inner surface of thighs, genitalia and buttocks. It manifests in the form of eruptions and mild scaling which waxes and wanes quickly. Frequent changing of diaper and good hygiene yields good response and relief and no such medication is required.

Irritant contact diaper dermatitis: it mainly involves the convex surfaces of the perineal area, the buttocks, the vulva, the perineal area, the lower abdomen and the proximal thighs with the intertriginous creases being spared. The cause of this disorder can be traced to the contact with proteolytic enzymes present in stool and different kinds of chemical irritants such as soaps, detergents, disinfectants and other topical preparations. The constant use of diaper can also lead to excessive heat, moisture and sweat retention locally.

Candida diaper dermatitis: It is characterized by raised edge and sharp margin with white scales on the border and pinpoint pustulovesicular satellite lesions which are also the diagnostic hallmark. It is a beefy red erythema and is widespread on lower abdomen, buttocks and inner aspects of thighs. Candida albicans is found in the feces, thus lower intestine acts as a primary source of candida diaper dermatitis.

Other are Seborrheic dermatitis, Erythema toxicum neonatorum, Ringworm ,Roseola.

Scarlet fever

Streptococcal infection causes scarlet fever, a very commonly occurring illness that begins with a sore throat, fever, malaise and other nonspecific complaints. The rash, which starts after the other symptoms, feels like sandpaper and may or may not be itchy.Pastia lines are characteristic feature seen on skin folds. Its manifestations are also seen on tongue known as strawberry and raspberry tongue. Scarlet fever is highly contagious, and although it generally resolves on its own.

Milia Rubra or Prickly heat (Heat Rash or Summer Rash)

Young babies often get heat rash. Blocked sweat glands cause heat rash, which results in a red pimply eruption on the head and neck. It’s important to dress your infant appropriately (not too hot and not too cold) to prevent the eruption. Generally, heat rash resolves on its own.

Epidermis and its appendages are not well differentiated at birth, particularly in cases of preterm infants which often leads to sweat retention phenomenon which are vesicular eruptions followed by maceration and obstruction of eccrine sweat glands as the ducts of the sweat glands are relatively immature.

They are more common in first few weeks. They are mainly of two types, milia crystalline (sudamina) are clear fluid filled pin point vesicles which are superficial and milia rubra (pricklyheat)is seen as small erythematous, macules, papules, vesicles or papulovesicular.