Nappy rash is an irritant contact dermatitis affecting the skin where the moist nappy is in contact. It spares intertriginous areas.
Change nappies 6-8 times a day, dry thoroughly, use barrier eg zinc oxide cream.
Differential diagnosis:
- candidiasis,
- atopic dermatitis, seborrhoeic dermatitis
- psoriasis,
- Langerhans cell histiocytosis,
- Acrodermatitis enteropathica (autosomal recessive zinc disorder), else nutritional zinc deficiency – +/- acral dermatitis, alopecia, malabsorptive diarrhoea)
Intertrigo (inflammation in the creases) can similarly be infective (bacterial or candidal), eczematous/seborrhoeic or psoriatic.