Pediatrics, part 86: Integumentary Disorders - Diaper Dermatitis & Atopic Dermatitis

Cathy discusses diaper dermatitis (i.e., a diaper rash) and atopic dermatitis (i.e., eczema). She first explains the pathophysiology, risk factors, signs/symptoms, treatment, and family teaching for diaper dermatitis (i.e., diaper rash). Cathy then explains the pathophysiology, signs/symptoms, diagnosis, treatment, and family teaching for atopic dermatitis (i.e., eczema). At the end of the video, she provides a quiz to test your understanding of some of the key points she made in the video.

  • 00:00 Introduction
  • 00:31 Diaper Dermatitis (diaper rash)
  • 2:13 Atopic Dermatitis (eczema)
  • 4:16 Quiz Time!

Full Transcript: Pediatrics, part 86: Integumentary Disorders - Diaper Dermatitis & Atopic Dermatitis

Hi, I'm Cathy with Level Up RN. In this video, we are going to talk about two different types of dermatitis, including diaper dermatitis and atopic dermatitis, which is also known as eczema. And then at the end of the video, I'm going to give you guys a little quiz to test your understanding of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our Level Up RN Pediatric Nursing flashcards, go ahead and pull out your flashcards on dermatitis so you can follow along with me.

Diaper dermatitis, which is commonly known as a diaper rash, is inflammation of the skin in the diaper area due to moisture, friction, and contact with urine and stool. Other risk factors for diaper dermatitis include infrequent diaper changes as well as loose stool. Signs and symptoms include erythema as well as painful lesions in the diaper area.

Treatment of diaper dermatitis is focused on keeping the area as clean and dry as possible. So diapers need to be changed frequently, and ultra-absorbent diapers should be used to help draw wetness away from the baby's skin. The diaper area should be cleaned with a mild cleanser and water or cleansing wipes that do not contain alcohol. After gently cleaning and drying the area, a barrier cream, such as a zinc oxide-based ointment, should be applied. And as a wound care nurse, I can tell you that we use this type of ointment on the skin of our incontinent patients, and it works great. In addition, when possible, the caregiver should let the child go without a diaper to help get air into the area, which helps to treat and prevent diaper dermatitis. If the diaper rash does not get better with the interventions that we just talked about, then the provider may recommend a steroid cream for severe diaper dermatitis or an antifungal cream when candidiasis is present.

Now let's talk about atopic dermatitis, which is commonly known as eczema. This is a chronic inflammatory skin disease caused by a defect in the skin barrier that makes an individual more susceptible to allergens and environmental irritants. Signs and symptoms include dry, scaly skin as well as severe pruritus. So pruritus is a fancy name for itching. Other signs and symptoms include patches, papules, vesicles, crusting, as well as excoriation. So most cases of eczema can be diagnosed with visualization of the skin, but in some cases, a biopsy may be ordered.

Treatment of atopic dermatitis includes identifying and avoiding triggers, such as certain soaps, certain fabrics, and certain fragrances, for example. The provider may recommend a topical steroid cream to decrease inflammation, and then an oral antihistamine, such as diphenhydramine, can be used to decrease itching. Skin care is also essential in the treatment of eczema. Children should bathe in lukewarm water, not hot water, and as soon as they get out of the shower or bath and pat dry, they should immediately apply a moisturizer to help lock that moisture in. Harsh soap and bubble baths should be avoided. And then in terms of clothes, soft, loose clothing made of cotton is typically recommended, whereas wool and synthetic fibers should be avoided. Clothes should be washed with a mild detergent, and fabric softeners should not be used. And then finally, the child's fingernails should be kept short and clean to help minimize scratching and prevent skin damage and infection.

All right. It's quiz time. Are you guys ready? I've got three questions for you.

Question number one. Why are ultra-absorbent diapers recommended for a baby with diaper dermatitis?

The answer is they help draw wetness away from the baby's skin.

Question number two. What kind of ointment should be applied to the baby's diaper area when diaper dermatitis is present?

The answer is a barrier cream, such as a zinc oxide-based ointment.

Question number three. Why should the fingernails of a child with eczema be kept short and clean?

The answer is to minimize scratching and help prevent skin damage and infection.

All right. That is it for this video. I hope it was helpful. Take care, and thank you so much for watching.

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