October 6, 2011 by dailybolusoflr
· Diaper rash typically is used as a catch all phrase to describe both contact dermatitis as well as true Candida superinfection.
· Contact dermatitis is caused by moisture, elevated ammonia and pH, chaffing and tight fitting diapers with little breathability. It is usually easy to treat with good barrier treatment (such as desitin, balmex or triple paste), frequent diaper changing, and leaving the baby bare bottomed as often as possible.
· When diaper rash has been present for greater than 2-3 days without improvement, one should suspect Candida superinfection even if other evidence of the hallmark signs of Candida are not present.
· Hallmark signs of Candida include intensely raw, red areas, presence of satellite issues, and white exudates.
· Topical treatment with antifungal cream applied for two days usually does the trick, but if the rash is severe oral treatment with nystatin should be used. Avoid steroid creams as this can make the Candida infection worse.
· You can see images here: http://hardinmd.lib.uiowa.edu/dermnet/diaperrash6.html
Ref: Buttaravoli and Stair. Minor Emergencies