The rash is usually over the areas in contact with the wet diaper- buttocks, lower abdomen, medial thighs, labia, mons pubis, and scrotum. Because of the lack of contact, the fold areas are usually spared. The rash is erythematous, papular, and has areas of scaling. The skin appears edematous and inflamed causing the infant to be irritable. With chronicity, the skin will get dry.
Chronic irritation can lead to ulcerations.
Because of increased moisture, there is a change in the permeability of the epidermis allowing increased entrance of irritants. This is enhanced by stool enzyme activation. Secondary bacterial and yeast infections are common. Prevention and Treatment a. Keep area dry by frequent diaper changing and using disposable diapers that have increased absorption. It is not necessary to remove barrier agent after each change because scrubbing it off can further irritate the area.