Which physical findings are characteristic of candidal diaper dermatitis?

Updated: Jan 17, 2020
  • Author: Richard Harold "Hal" Flowers, IV, MD; Chief Editor: Dirk M Elston, MD  more...
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Candidal diaper dermatitis usually starts in the perianal area, spreading to involve the perineum and, in severe cases, the upper thighs, lower abdomen, and lower back. Maceration of the anal mucosa and the perianal skin often is the first clinical manifestation. Scaly papules merge to form well-defined, weeping, and eroded lesions with a scalloped border. A collar of overhanging scales and an erythematous base may be demonstrated. Satellite flaccid vesicopustules around the primary intertriginous plaque also are characteristic and represent the primary lesions.

Rarer and severe forms of candidal diaper dermatitis include granuloma gluteale infantum and Jacquet erosive diaper dermatitis. Granuloma gluteale infantum can be a complication of diaper dermatitis and presents as erythematous-to-purplish nodules and plaques in the anogenital region of infants. [51] In addition to candidal diaper dermatitis, other risk factors that indicate a predisposition to granuloma gluteale infantum are restrictive synthetic pants and topical corticosteroid use. Jacquet erosive diaper dermatitis is an uncommon variant of diaper dermatitis often seen in occluded skin in lengthy contact with urine or feces. [52] It presents on the genital and perianal skin as superficial ulcerations or pustules. [52]

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