Several years ago I was asked to see a little girl, 17 months old, suffering from a severe dermatitis of the diaper region. The skin of the buttocks, perineum, genitals, thighs, and lower abdomen was severely inflamed and numerous vesicles and blebs were scattered over this area. The infant appeared perfectly well otherwise. The mother stated that the diaper removed that morning had a very strong odor, "just like ammonia." She had saved the diaper in a closed receptacle. On unfolding the wet diaper, a very strong penetrating odor of ammonia was noticed. So strong was this gas that it irritated my eyes very disagreeably during the examination. It seemed clear to me that the skin lesions were induced by the ammonia in the urine, since ammonia is a powerful rubifacient and vesicant.This case served to interest me in the study of ammonia in the urine and the
ZAHORSKY J. THE AMMONIACAL DIAPER IN INFANTS AND YOUNG CHILDREN. Am J Dis Child. 1915;X(6):436–444. doi:10.1001/archpedi.1915.04110060041006
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