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October 1978

Diaper Dermatitis

Arch Dermatol. 1978;114(10):1552. doi:10.1001/archderm.1978.01640220093032

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