What does a food allergy diaper rash look like
Possible treatments include minimizing diaper use, barrier creams, mild topical cortisones, and antifungal agents. A variety of other inflammatory and infectious processes can happen in the diaper area and an awareness of these secondary types of diaper dermatitis aids in the precise diagnosis and treatment of patients.
Overall, there is sparse evidence of sufficient quality to be certain of the effectiveness of the various treatments.
Washcloths with cleansing, moisturising and protective properties may be better than soap and water, and skin cleansers may also be better than soap and water, but the certainty of evidence with regard other treatments is extremely low.
Another approach is to block moisture from reaching the skin, and commonly recommended remedies using this approach include oil-based protectants or barrier cream, various over-the-counter «diaper creams», petroleum jelly, dimethicone and other oils.
Such sealants sometimes achieve the opposite if the skin is not thoroughly dry, in which case they serve to seal the moisture inside the skin rather than exterior.
Zinc oxide-based ointments such as Pinxav can be fairly effective, especially in prevention, because they own both a drying and an astringent effect on the skin, being mildly antiseptic without causing irritation.
A 2005 meta-analysis found no evidence to support the use of topical vitamin A to treat napkin dermatitis (diaper rash).
Dangers of using powders
Various moisture-absorbing powders, such as talcum or starch, reduce moisture but may introduce other complications.
Airborne powders of any sort can irritate lung tissue, and powders made from starchy plants (corn, arrowroot) provide food for fungi and are not recommended by the American Academy of Dermatology.
The most effective treatment, although not the most practical one, is to discontinue use of diapers, allowing the affected skin to air out. Another option is simply to increase the frequency of diaper changing. Thorough drying of the skin before diapering is a excellent preventive measure because it is the excess moisture, either from urine and feces or from sweating, that sets the conditions for a diaper rash to occur.
Some sources claim that diaper rash is more common with cloth diapers. Others claim the material of the diaper is relevant insofar as it can wick and hold moisture away from the baby’s skin, and preventing secondary Candida infection. However, there may not be enough data from good-quality, randomized controlled trials to support or refute disposable diaper use thus far. Furthermore, the effect of non-biodegradable diapers on the environment is a concerning matter for public policy.
In persistent or especially bad rashes, an antifungal cream often has to be used.
In cases that the rash is more of an irritation, a mild topical corticosteroid preparation, e.g. hydrocortisone cream, is used. As it is often hard to tell a fungal infection apart from a mere skin irritation, numerous physicians prefer an corticosteroid-and-antifungal combination cream such as hydrocortisone/miconazole.
A food allergy or sensitivity is a person's immune system reaction to eating a specific food.
- ^ abFerrazzini G, Kaiser RR, Hirsig Cheng SK, et al. (2003). «Microbiological aspects of diaper dermatitis». Dermatology. 206 (2): 136–41. doi:10.1159/000068472. PMID 12592081.
- ^Baer, E. L.; Davies, M. W.; Easterbrook, K. J. (2006-07-19). «Disposable nappies for preventing napkin dermatitis in infants»(PDF).
The Cochrane Database of Systematic Reviews (3): CD004262. doi:10.1002/14651858.CD004262.pub2.
ISSN 1469-493X. PMID 16856040.
- ^Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN .
- ^Dib, Rania. «Diaper Rash». Medscape. Retrieved 31 August 2012.
- ^John Harper (MB; BS; MRCP.); Arnold P. Oranje; Neil S. Prose (2006). Textbook of pediatric dermatology. Wiley-Blackwell. pp. 160–. ISBN . Retrieved 9 May 2010.
- ^Atherton D.J.; Mills K. (2004). «What can be done to hold babies’ skin healthy?».
RCM Midwives Journal. 7 (7): 288–290.
- ^Akin, Frank; Spraker, Mary; Aly, Raza; Leyden, James; Raynor, William; Landin, Wendell (2001-08-01). «Effects of Breathable Disposable Diapers: Reduced Prevalence of Candida and Common Diaper Dermatitis». Pediatric Dermatology. 18 (4): 282–290.
doi:10.1046/j.1525-1470.2001.01929.x. ISSN 1525-1470. PMID 11576399.
- ^Beeckman, D; Van Damme, N; Schoonhoven, L; Van Lancker, A; Kottner, J; Beele, H; Gray, M; Woodward, S; Fader, M; Van den Bussche, K; Van Hecke, A; De Meyer, D; Verhaeghe, S (10 November 2016). «Interventions for preventing and treating incontinence-associated dermatitis in adults». The Cochrane Database of Systematic Reviews. 11: CD011627. doi:10.1002/14651858.CD011627.pub2. PMC 6464993. PMID 27841440.
- ^Hockenberry, M.J.
(2003) Wong’s Nursing Care of Infants and Children. St. Louis, MO; Mosby, Inc.
- ^Ward DB, Fleischer AB, Feldman SR, Krowchuk DP (2000). «Characterization of diaper dermatitis in the United States». Arch Pediatr Adolesc Med. 154 (9): 943–6. doi:10.1001/archpedi.154.9.943. PMID 10980800.
- ^«What is diaper rash: What causes diaper rash?». MedicalBug. Retrieved 31 August 2012.
- ^ abScheinfeld, N., Diaper dermatitis : a review and brief survey of eruptions of the diaper area. American Journal of Clinical Dermatology. 2005;6:273-81. PMID 16252927
- ^Prasad, H.
R. Y.; Srivastava, Pushplata; Verma, Kaushal K. (October 2004). «Diapers and skin care: merits and demerits». Indian Journal of Pediatrics. 71 (10): 907–908. doi:10.1007/bf02830834. ISSN 0019-5456. PMID 15531833.
- ^Davies, Mark W; Dore, Amanda J; Perissinotto, Kaylene L (2005-10-19). «Topical Vitamin A, or its derivatives, for treating and preventing napkin dermatitis in infants». Cochrane Database of Systematic Reviews (4): CD004300. doi:10.1002/14651858.CD004300.pub2. ISSN 1465-1858. PMC 6718230. PMID 16235358.
- ^Wolf, R.; Wolf, D.; Tüzün, B.; Tüzün, Y. (November 2000).
«Diaper dermatitis». Clinics in Dermatology. 18 (6): 657–660. doi:10.1016/s0738-081x(00)00157-7. ISSN 0738-081X. PMID 11173200.
- ^Atherton DJ (2004). «A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis». Curr Med Res Opin. 20 (5): 645–9. doi:10.1185/030079904125003575. PMID 15140329.
- ^Weston, W. L.; Lane, A. T.; Weston, J. A. (October 1980). «Diaper dermatitis: current concepts». Pediatrics. 66 (4): 532–536.
ISSN 0031-4005. PMID 7432838.
- ^Payne, D (2017), «Stop the rash: managing incontinence-associated dermatitis in the community», Br J Community Nurs, 22 (Suppl 3): S20–S26, doi:10.12968/bjcn.2017.22.Sup3.S20, PMID 28252336.
- ^ abAbzug, Mark; Deterding, Robin; Hay, William; Levin, Myron (2014-04-29). Current diagnosis & treatment : pediatrics. Hay, William W., Levin, Myron J., Deterding, Robin R., Abzug, Mark J.
(Twenty-second ed.). New York. ISBN . OCLC 877881324.
- ^Gupta AK, Skinner AR (2004). «Management of diaper dermatitis». Int. J. Dermatol. 43 (11): 830–4. doi:10.1111/j.1365-4632.2004.02405.x. PMID 15533067.
- ^«How to Treat Baby Rash? Identify and Treat Baby Rash». thebabyrash.com. 2017-05-02. Retrieved 2017-05-21.
- ^Barthel, W.; Markwardt, F. (1975), «PubMed search «incontinence-associated dermatitis[Title]»», Biochemical Pharmacology, 24 (20): 1903–4, doi:10.1016/0006-2952(75)90415-3, PMID 20
- ^James, William; Berger, Timothy; Elston, Dirk (2005).
Andrews’ Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
- ^Borkowski S (2004). «Diaper rash care and management». Pediatr Nurs. 30 (6): 467–70. PMID 15704594.
- ^«Nappy Rash». Medinfo. Retrieved 31 August 2012.
- ^ abcdShin, Helen T. (2014-04-01).
«Diagnosis and Management of Diaper Dermatitis». Pediatric Clinics of North America. Pediatric Dermatology. 61 (2): 367–382. doi:10.1016/j.pcl.2013.11.009. PMID 24636651.
- ^Chiou, Y.B.; Blume-Peytavi, U. (2004). «Stratum Corneum Maturation».
Skin Pharmacology and Physiology. 17 (2): 57–66. doi:10.1159/000076015. ISSN 1660-5527. PMID 14976382.
- ^«Mom and baby skin care». American Academy of Dermatology. Archived from the original on 17 August 2012. Retrieved 31 August 2012.
Food allergies and sensitivities
Food allergies and sensitivities
The expression allergy comes from two Greek words: alos, meaning "other" and argon, meaning "action." When one has an allergy, he or she has a reaction other than the one expected.
Food allergies and sensitivities are the body's reaction to a specific food. In a food allergy or sensitivity, when the kid eats a specific food, (such as eggs, for example) generally by the time the eggs reach the stomach or the intestines, the body reads the presence of eggs as an allergen (something harmful). It sends out immunoglobulin E (IgE), an antibody, to destroy the eggs and protect the body, releasing histamines. The body remembers and produces histamines every time the food is eaten.
These histamines trigger allergic symptoms that affect numerous areas of the body, particularly the skin, respiratory system, nervous system, and digestive system. Digestive disorders after eating specific foods are not always allergies. These reactions can be food sensitivities or intolerances. They can also be symptoms of other, more serious digestive diseases and malfunctions.
In the United states, 90 percent of every food allergies are caused by wheat, peanuts, nuts, milk, eggs, shellfish, soy, and fish.
Numerous other foods can be at the root of food allergies or sensitivities, especially berries and other fruits, tomatoes, corn, and some meats love pork. Migraine headaches own been associated with sensitivities to chemicals contained in red wine, deli meats, aged cheeses, and the tannins in tea.
Generally, when a kid is allergic to one food in a food family, he or she will most likely react to other foods in that food family. For example, if a kid is sensitive to one type of fish, he or she also may be sensitive to other types of fish. This is called cross-reactivity.
Irritant diaper dermatitis develops when skin is exposed to prolonged wetness, increased skin pH caused by the combination, and subsequent reactions, of urine and feces, and resulting breakdown of the stratum corneum, or outermost layer of the skin. This may be due to diarrhea, frequent stools, tight diapers, overexposure to ammonia, or allergic reactions. In adults, the stratum corneum is composed of 25 to 30 layers of flattened dead keratinocytes, which are continuously shed and replaced from under.
These dead cells are interlaid with lipids secreted by the stratum granulosum just underneath, which assist to make this layer of the skin a waterproof barrier. The stratum corneum’s function is to reduce water loss, repel water, protect deeper layers of the skin from injury, and to repel microbial invasion of the skin. In infants, this layer of the skin is much thinner and more easily disrupted.
The interaction between fecal enzyme activity and IDD explains the observation that baby diet and diaper rash are linked because fecal enzymes are in turn affected by diet. Breast-fed babies, for example, own a lower incidence of diaper rash, possibly because their stools own higher pH and lower enzymatic activity. Diaper rash is also most likely to be diagnosed in infants 8–12 months ancient, perhaps in response to an increase in eating solid foods and dietary changes around that age that affect fecal composition.
Any time an infant’s diet undergoes a significant change (i.e. from breast milk to formula or from milk to solids) there appears to be an increased likelihood of diaper rash.
The link between feces and IDD is also apparent in the observation that infants are more susceptible to developing diaper rash after treating with antibiotics, which affect the intestinal microflora. Also, there is an increased incidence of diaper rash in infants who own suffered from diarrhea in the previous 48 hours, which may be because fecal enzymes such as lipase and protease are more athletic in feces which own passed rapidly through the gastrointestinal tract.
Although wetness alone has the effect of macerating the skin, softening the stratum corneum, and greatly increasing susceptibility to friction injury, urine has an additional impact on skin integrity because of its effect on skin pH.
While studies show that ammonia alone is only a mild skin irritant, when urea breaks below in the presence of fecal urease it increases pH because ammonia is released, which in turn promotes the activity of fecalenzymes such as protease and lipase. These fecal enzymes increase the skin’s hydration and permeability to bile salts which also act as skin irritants.
There is no detectable difference in rates of diaper rash in conventional disposable diaper wearers and reusable cloth diaper wearers.
«Babies wearing superabsorbent disposable diapers with a central gelling material own fewer episodes of diaper dermatitis compared with their counterparts wearing cloth diapers. However, hold in mind that superabsorbent diapers contain dyes that were suspected to cause allergic contact dermatitis (ACD).» Whether wearing cloth or disposable diapers they should be changed frequently to prevent diaper rash, even if they don’t feel wet.
To reduce the incidence of diaper rash, disposable diapers own been engineered to tug moisture away from the baby’s skin using synthetic non-biodegradable gel.
Today, cloth diapers use newly available superabsorbent microfiber cloth placed in a pocket with a layer of light permeable material that contacts the skin. This design serves to tug moisture away from the skin in to the microfiber cloth. This technology is used in most major pocket cloth diapers brands today.
The significance of secondary infection in IDD remains controversial. There seems to be no link between presence or absence of IDD and microbial counts. Although apparently healthy infants sometimes culture positive for Candida and other organisms without exhibiting any symptoms, there does seem to be a positive correlation between the severity of the diaper rash noted and the likelihood of secondary involvement. A wide variety of infections has been reported, including Staphylococcus aureus, Streptococcus pyogenes,Proteus mirabilis, enterococci and Pseudomonas aeruginosa, but it appears that Candida is the most common opportunistic invader in diaper areas.
Almost three million children in the United States own been diagnosed with food allergies.
Almost 600,000 of them own severe allergies to peanuts and possibly twice as numerous own severe shellfish allergies. Each year about 200 adults and children in the United States die from food-related anaphylaxis , an extreme reaction that causes swelling of the throat and bronchial passages, shock, and a severe drop in blood pressure.
Nevertheless, food allergies tend to be under-diagnosed by doctors.
Genetics seems to frolic a part in food allergies. If one parent has a food allergy, the child's risk of having a food allergy is doubled. If both parents own food allergies, the risk is even higher. The kid, however, may be allergic to a completely diverse food from the one to which the parent has demonstrated sensitivity. There also is increased risk when there are other kinds of allergy-related diseases in the family, such as hay fever or asthma .
The diagnosis of IDD is made clinically, by observing the limitation of an erythematous eruption to the convex surfaces of the genital area and buttocks. If the diaper dermatitis occurs for greater than 3 days it may be colonized with Candida albicans, giving it the beefy red, sharply marginated, appearance of diaper candidiasis.
Other rashes that happen in the diaper area include seborrhoeic dermatitis and atopic dermatitis.
Both Seborrheic and Atopic dermatitis require individualized treatment; they are not the subject of this article.
- Seborrheic dermatitis, typified by oily, thick yellowish scales, is most commonly seen on the scalp (cradle cap) but can also appear in the inguinal folds.
- Atopic dermatitis, or eczema, is associated with allergic reaction, often hereditary. This class of rashes may appear anywhere on the body and is characterized by intense itchiness.