佐々木りか子：おむつ皮膚炎の治療および予防. 大関武彦, 古川 漸, 横田俊伊知郎 編集、今日の小児治療指針 第14版. 医学書院、2006.
野崎誠：おむつかぶれ、VIII. 境界領域疾患-27、小児疾患診療のための病態生理、小児内科48（増刊）; 1151-1154, 2016.
Burdall O, Willgress L, Goad N.
Neonatal skin care: Developments in care to maintain neonatal barrier function and prevention of diaper dermatitis.
Pediatr Dermatol. 2019 Jan;36(1):31-35. doi: 10.1111/pde.13714. Epub 2018 Dec 2.
Abstract/Text
BACKGROUND: Understanding the importance of the barrier function of the skin of preterm and term neonates is crucial in effective neonatal skin and diaper care. This literature search aimed to review the development of different practices in neonatal care to maintain skin barrier function, in turn preventing diaper dermatitis.
METHODS: We performed two quantitative literature searches of English language studies: an initial literature search of studies published in the last 5 years was conducted using Cinahl, Medline, Embase, British Nursing Index, and DelphiS, followed by a second search of publications from 1990 to 2017 using the National Institute of Clinical Excellence Health Databases Advanced Search using key words, synonyms, and Boolean phrasing. Titles and abstracts were reviewed for relevance.
RESULTS: One hundred ten studies were analyzed for the purpose of this review; however, data are of variable quality. Guidance can be drawn from the existing literature relating to best practice options for diaper area cleansing methods, diaper type selection, and use of barrier creams. More research is required into the benefit or otherwise of diaper-free time.
CONCLUSIONS: Super-absorbent diapers reduce moisture at skin level and reduce diaper dermatitis. Barrier creams carry benefit both in prevention and cure but do not provide a substitute for frequent diaper changes. The literature does not demonstrate superiority of one cleansing method over another, but neither the use of wipes nor water increases diaper dermatitis prevalence. Further studies are required to explore the potential benefit of diaper-free time, taking due consideration of the practicalities, particularly for vulnerable neonates within the Intensive Care setting.
© 2018 Wiley Periodicals, Inc.
Yokoyama M, Yonezawa K, Matsubara M, Hikita N, Sasagawa E, Haruna M.
The factors related to recovery time of diaper dermatitis in infants: A prospective observational study.
Jpn J Nurs Sci. 2022 Oct;19(4):e12492. doi: 10.1111/jjns.12492. Epub 2022 Jun 1.
Abstract/Text
AIM: Prolonged diaper dermatitis may increase the risk of atopic dermatitis or infections. This prospective observational study aimed to investigate the prevalence, symptoms, areas, and recovery time of diaper dermatitis in infants aged 1 month and identify the factors related to recovery time.
METHODS: Diaper dermatitis was defined as the presence of erythema, papules, dryness, erosion, or ulceration in the diapered area. Recovery time was days between infant's 1-month medical check-up and disappearance of symptoms. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used to identify the factors related to recovery time.
RESULTS: Among 113 infants, 66 (58.4%) had diaper dermatitis, with erythema at the perianal area being the most common symptom. The median recovery time was 10 days. Four infants (6.1%) had diaper dermatitis for >5 weeks. Severity was not related to recovery time.
CONCLUSIONS: A frequency of diaper changing of ≤10 times per day was a risk factor for recovery time. Our data showed recovery in approximately 10 days, regardless of severity at study enrollment. Health care professionals could inform parents of recovery time and recommended diaper changing frequency.
© 2022 Japan Academy of Nursing Science.
吉田和恵：おむつ皮膚炎．特集 外来でよく見る子どもの皮膚疾患－臨床写真で覚える！小児内科54(8);1271-1273, 2022.
松村由美：おむつ皮膚炎・汗疹・多汗症, 小児皮膚診療パーフェクトガイド. Derma 2010;16415-19,.
Baer EL, Davies MW, Easterbrook KJ.
Disposable nappies for preventing napkin dermatitis in infants.
Cochrane Database Syst Rev. 2006 Jul 19;2006(3):CD004262. doi: 10.1002/14651858.CD004262.pub2. Epub 2006 Jul 19.
Abstract/Text
BACKGROUND: Napkin dermatitis is a common condition that occurs in otherwise healthy infants. It causes discomfort to infants, anxiety to parents and caregivers and contributes to the load on the health care system. A large variety of napkins, both disposable and non-disposable, are available. Evidence is required to assist carers and health care workers in making informed decisions when balancing the pros and cons of different napkin choices.
OBJECTIVES: To assess whether disposable napkins prevent napkin dermatitis in infants.
SEARCH STRATEGY: We searched the Skin Group Specialised Register (up to June 2003), the Cochrane Central Register of Controlled Trials in (The Cochrane Library, Issue 3, 2004), MEDLINE (from 1966 to November 2004), EMBASE (from 1980 to February 2003) and CINAHL (from 1982 to November 2004). We searched reference lists of articles. We contacted lead investigators in the area and companies that manufacture disposable napkins for access to unpublished trials.
SELECTION CRITERIA: Randomised controlled trials in which disposable napkins were compared with other types of disposable napkins or non-disposable napkins, in infants up to two years of age, for preventing napkin dermatitis.
DATA COLLECTION AND ANALYSIS: Two authors independently extracted data. The same two authors independently assessed trials for methodological quality. Attempts were made to contact trial authors of the trials identified for clarification of methods and results of published trials.
MAIN RESULTS: We identified 28 studies of the effects of various napkin types on napkin dermatitis. Seventeen studies from nine reports were included. Eleven studies were excluded due to methodology that did not fit the inclusion criteria of this review. Due to the poor reporting of methodology and results of the studies found in this review, there were no quantitative data available for analysis (or meta-analysis). Although the included studies appeared to favour cellulose-core disposable napkins over cloth, absorbent gelling material over cellulose-only core napkins, breathable outer shell over occlusive outer shell napkins and linings impregnated with formulations over plain linings, all of these studies were open to bias due to flawed methodology.
AUTHORS' CONCLUSIONS: There is not enough evidence from good quality randomised controlled trials to support or refute the use and type of disposable napkins for the prevention of napkin dermatitis in infants.
Blume-Peytavi U, Kanti V.
Prevention and treatment of diaper dermatitis.
Pediatr Dermatol. 2018 Mar;35 Suppl 1:s19-s23. doi: 10.1111/pde.13495.
Abstract/Text
Diaper dermatitis (DD) is one of the most common skin conditions that infants suffer from and their caregivers manage in the first months post-birth. As such, questions of effective prevention and treatment of the condition often arise. Nonmedical skincare practices that support healthy skin barrier function can prevent DD manifestation or alleviate the condition in many cases. The usage of barrier emollients and improved diaper technology contributes to keeping moisture and irritants away from an infant's delicate skin. This paper addresses facts behind commonly asked questions from caregivers regarding DD and discusses effective measures to prevent and treat the condition.
© 2018 Wiley Periodicals, Inc.
Blume-Peytavi U, Lavender T, Jenerowicz D, Ryumina I, Stalder JF, Torrelo A, Cork MJ.
Recommendations from a European Roundtable Meeting on Best Practice Healthy Infant Skin Care.
Pediatr Dermatol. 2016 May;33(3):311-21. doi: 10.1111/pde.12819. Epub 2016 Feb 26.
Abstract/Text
BACKGROUND: European roundtable meeting recommendations on bathing and cleansing of infants were published in 2009; a second meeting was held to update and expand these recommendations in light of new evidence and the continued need to address uncertainty surrounding this aspect of routine care.
METHODS: The previous roundtable recommendations concerning infant cleansing, bathing, and use of liquid cleansers were critically reviewed and updated and the quality of evidence was evaluated using the Grading of Recommendation Assessment, Development and Evaluation system. New recommendations were developed to provide guidance on diaper care and the use of emollients. A series of recommendations was formulated to characterize the attributes of ideal liquid cleansers, wipes, and emollients.
RESULTS: Newborn bathing can be performed without harming the infant, provided basic safety procedures are followed. Water alone or appropriately designed liquid cleansers can be used during bathing without impairing the skin maturation process. The diaper area should be kept clean and dry; from birth, the diaper area may be gently cleansed with cotton balls/squares and water or by using appropriately designed wipes. Appropriately formulated emollients can be used to maintain and enhance skin barrier function. Appropriately formulated baby oils can be applied for physiologic (transitory) skin dryness and in small quantities to the bath. Baby products that are left on should be formulated to buffer and maintain babies' skin surface at approximately pH 5.5, and the formulations and their constituent ingredients should have undergone an extensive program of safety testing. Formulations should be effectively preserved; products containing harsh surfactants, such as sodium lauryl sulfate, should be avoided.
CONCLUSION: Health care professionals can use these recommendations as the basis of their advice to parents.
© 2016 Wiley Periodicals, Inc.
