TY - JOUR
T1 - Diaper dermatitis prevalence and severity
T2 - Global perspective on the impact of caregiver behavior
AU - Carr, Andrew N.
AU - DeWitt, Thomas
AU - Cork, Michael J.
AU - Eichenfield, Lawrence F.
AU - Fölster-Holst, Regina
AU - Hohl, Daniel
AU - Lane, Alfred T.
AU - Paller, Amy
AU - Pickering, Larry
AU - Taieb, Alain
AU - Cui, Tao Y.
AU - Xu, Zi G.
AU - Wang, Xeumin
AU - Brink, Susanna
AU - Niu, Yeuqing
AU - Ogle, Julie
AU - Odio, Mauricio
AU - Gibb, Roger D.
N1 - Funding Information:
Andrew N. Carr, Susanna Brink, Yueqing Niu, and Roger D. Gibb are full‐time employees at Procter & Gamble. Mauricio Odio and Julie Ogle are retired from Procter & Gamble. All authors acknowledge that this study was wholly funded by the Procter & Gamble Company.
Publisher Copyright:
© 2019 The Procter & Gamble Company. Pediatric Dermatology published by Wiley Periodicals, Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objectives: To compare prevalence and severity of diaper dermatitis (DD) in infants and toddlers (babies) across three countries (China, USA, and Germany), including diapered skin measures and caregiver practices. Methods: A cross-sectional study of 1791 babies (~600 from each country) was recruited at each clinical site. Based on regional toilet-training habits, exclusively diaper-wearing infants were recruited between ages 2-8 months in China and 2-18 months in the USA and Germany. DD was measured, as well as skin pH, transepidermal water loss (TEWL), and relative humidity (RH) in the diapered region. Caregiver habits were collected via a questionnaire and included information on hygienic practices. Results: Diaper dermatitis was highest in the perianal area, followed by the intertriginous, genital, and buttock regions. In general, DD was significantly lower in babies in China, highest in Germany, and intermediate in the USA. This rank ordering of DD by geography was also observed in baby age 2-8 months. The lower DD observed in China was associated with lower skin pH and TEWL on diapered skin and decreased RH in the diaper. Chinese caregivers had the highest rate of prophylactic topical product usage, the most robust cleaning of the diapered area, lack of cleansing after urine-only diaper changes, and Chinese infants spent the least time in an overnight diaper. Conclusions: These data suggest caregiver behaviors including prophylactic use of topical products, thorough cleaning after stooling and reduced time in an overnight diaper are associated with less DD, lower superficial skin pH, and enhanced skin barrier.
AB - Objectives: To compare prevalence and severity of diaper dermatitis (DD) in infants and toddlers (babies) across three countries (China, USA, and Germany), including diapered skin measures and caregiver practices. Methods: A cross-sectional study of 1791 babies (~600 from each country) was recruited at each clinical site. Based on regional toilet-training habits, exclusively diaper-wearing infants were recruited between ages 2-8 months in China and 2-18 months in the USA and Germany. DD was measured, as well as skin pH, transepidermal water loss (TEWL), and relative humidity (RH) in the diapered region. Caregiver habits were collected via a questionnaire and included information on hygienic practices. Results: Diaper dermatitis was highest in the perianal area, followed by the intertriginous, genital, and buttock regions. In general, DD was significantly lower in babies in China, highest in Germany, and intermediate in the USA. This rank ordering of DD by geography was also observed in baby age 2-8 months. The lower DD observed in China was associated with lower skin pH and TEWL on diapered skin and decreased RH in the diaper. Chinese caregivers had the highest rate of prophylactic topical product usage, the most robust cleaning of the diapered area, lack of cleansing after urine-only diaper changes, and Chinese infants spent the least time in an overnight diaper. Conclusions: These data suggest caregiver behaviors including prophylactic use of topical products, thorough cleaning after stooling and reduced time in an overnight diaper are associated with less DD, lower superficial skin pH, and enhanced skin barrier.
KW - diaper dermatitis
KW - neonatal
KW - skin barrier
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U2 - 10.1111/pde.14047
DO - 10.1111/pde.14047
M3 - Article
C2 - 31793090
AN - SCOPUS:85076153138
SN - 0736-8046
VL - 37
SP - 130
EP - 136
JO - Pediatric dermatology
JF - Pediatric dermatology
IS - 1
ER -