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2016 ; 181
(9-10
): 671-9
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Superficial Mycoses Associated with Diaper Dermatitis
#MMPMID27193417
Bonifaz A
; Rojas R
; Tirado-Sánchez A
; Chávez-López D
; Mena C
; Calderón L
; María PO
Mycopathologia
2016[Oct]; 181
(9-10
): 671-9
PMID27193417
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Diapers create particular conditions of moisture and friction, and with urine and
feces come increased pH and irritating enzymes (lipases and proteases). Fungi can
take advantage of all these factors. Candida yeasts, especially C. albicans, are
responsible for the most frequent secondary infections and are isolated in more
than 80 % of cases. Correct diagnosis is important for ensuring the correct
prescription of topical antimycotics. Nystatin, imidazoles and ciclopirox are
effective. It is important to realize there are resistant strains. Dermatophytes
can infect the diaper area, with the most common agent being Epidermophyton
floccosum. The clinical characteristics of dermatophytosis are different from
those of candidiasis, and it can be diagnosed and treated simply. Malassezia
yeasts can aggravate conditions affecting the diaper area, such as seborrheic
dermatitis, atopic dermatitis, and inverse psoriasis. Additional treatment is
recommended in this case, because they usually involve complement activation and
increased specific IgE levels. Erythrasma is a pseudomycosis that is
indistinguishable from candidiasis and may also occur in large skin folds. It is
treated with topical antibacterial products and some antimycotics.
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