A 14-month old boy was evaluated for a “diaper rash ” of 4 months' duration. He had undergone a pull-through procedure for treatment of Hirschsprung disease and subsequently developed hypomotility, for which he was treated with 2.125 mL/d of oral senna (Little Tummys; Little Remedies) leading to frequent stools. On physical examination, he was found to have a bright red plaque with round erosions involving the bilateral buttocks. He was diagnosed as having irritant diaper dermatitis and began treatment with twice-daily application of fluticasone ointment with a barrier cream. Fluconazole was added to the regimen 1 week later.