To the Editor.—
The study by Leyden et al (Archives 113:1678-1680,1977) on urinary ammonia and diaper dermatitis is of great interest. In 1964 and 1965, over a period of 12 months, I kept careful notes of all new outpatients attending the Queen Elizabeth Hospital for Children, London, for diaper dermatitis. These numbered 50. In seven (14%) the eruption began on the buttocks. In 43 (86%) the rash began in the anal and genital region. I thought, perhaps wrongly, that those commencing on the buttocks were due to ammonia but I was struck by the fact that these were a minority.I patch tested 18 infants with their own stools. The tests were applied to the back for 48 hours. Thirteen gave a brisk positive reaction, one an equivocal result, and four were negative. These tests were carried out in sequence and without selection. My tentative conclusion was that most diaper
Pegum JS. Diaper Dermatitis. Arch Dermatol. 1978;114(10):1552. doi:10.1001/archderm.1978.01640220093032
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