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April 2013

Nodular Lesions in the Diaper Area—Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

JAMA Dermatol. 2013;149(4):475-480. doi:10.1001/jamadermatol.2013.1172b

Histologic examination revealed hyperorthoparakeratosis, acanthosis, focal spongiosis, and a dermal mixed inflammatory infiltrate of histiocytes, lymphocytes, and numerous eosinophils. Once the irritation caused by the urine was removed and topical benzocaine was discontinued, the lesions began to resolve, leading to marked improvement after 8 weeks.

Irritant contact dermatitis (ICD) is a common cause of genital and perianal eruptions. It usually affects infants but can also arise in adults with urinary and/or fecal incontinence.13 In aged skin occluded by diaper, incontinence can produce chemical irritation, mechanical injury, and increased susceptibility to infection.1

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