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Nappy Rash - Coggle Diagram
Nappy Rash
Differential
Allergic contact dermiatitis
Atopic eczema
Eczema herpeticum
Perianal streptococcal dermatitis
Infantile seborrhoeic dermatitis
Psoriasis
Lichen sclerosus
Miliaria rubra
Scabies
Fungal skin infection
Zinc deficiency
Management
self-management strategies
Change to high absorbency well fitting nappies
Nappy free periods as long as possible
Water of fragrance free wipes
Dry skin gently/ avoid vigorous rubbing
Avoid excessive bathing
Avoid soap/bubble bath/fragranced emollients
OTC barrier preparations
If severe
consider prescribing topical hydrocortisone 1% cream once a day in addition
Diagnosis
well-defined areas of confluent erythema
scattered papules over convex surfaces in contact with the nappy
sparing of the inguinal skin creases and gluteal cleft
glazed appearance if acute
skin erosions, oedema, and ulceration
fine scaling if more longstanding.
skin swabs are not normally needed if uncomplicated
Assessment
Location/duration/nature of rash
Previous episodes
Topical preparations being used
Presence of irritants such as diarrhoea/antibiotics
Assess for oral candidiasis
Evidence of secondary bacterial/fungal infection