Diaper dermatitis is the leading cause of skin irritation and redness in the perianal and buttock regions for infants and younger children. It accounts for more than 1 million clinic visits each year. The term diaper dermatitis is used to describe a large variety of different sources of erythema, and it can often be difficult to distinguish the source of irritation and, therefore, the most effective treatment. Irritant dermatitis is the most common cause of erythema in the perianal region. The cause is multifactorial and includes friction, moisture, and exposure to urine and feces. Exposure to wetness and urine increases the pH of the skin, making it more susceptible to irritants and friction.

• Wearing highly absorbent disposable diapers is associated with a decreased incidence of diaper dermatitis.

• Children with diaper dermatitis are more likely to be colonized with yeast than other children. Candida albicans may be isolated in up to 80% of infants with perianal irritation that lasts more than 3 days.

• Infection with Staphylococcus aureus and Group A beta-hemolytic streptococcus (GABHS) can cause erythema, pruritus, and pain.

• It is important to determine whether the patient has had increased exposure to moisture and irritants from sources such as diarrhea, chemicals, or infrequent diaper changes.

• Diaper dermatitis can take on a variety of clinical manifestations. Irritant dermatitis begins as erythema on the buttocks and perianal areas, sparing the skin folds.

• An erythematous rash of the groin that affects the skin folds and has perianal papules and pustules is characteristic of a yeast infection.

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