Characterization of diaper dermatitis in the United States.
BACKGROUND
Diaper dermatitis is the most common dermatologic disorder of infancy. This study evaluates the frequency of outpatient visits resulting in this diagnosis, specialties of physicians providing services, demographics of patients, and leading agents used in treatment.


METHODS
Records of 272,841 encounters from the National Ambulatory Medical Care Survey (1990-1997) were examined for visits in which diaper dermatitis was diagnosed in children. The likelihood of diagnosis in the general pediatric population was calculated and the leading treatment agents were ranked.


RESULTS
There were approximately 8.2 million visits in which diaper dermatitis was diagnosed. For the pediatric population in the at-risk age range, there was a 1 in 4 likelihood of being diagnosed with the skin disorder. Pediatricians provided 75% of services for the treatment of diaper dermatitis; the demographics of patients were similar to those of comparably aged individuals in the general population. Nystatin was the leading treatment agent prescribed (27% of visits), followed by clotrimazole (16%), a combination product of nystatin and triamcinolone (16%), hydrocortisone (8%), and a combination product of clotrimazole and betamethasone dipropionate (6%).


CONCLUSIONS
Visits for diaper dermatitis are frequent, and pediatricians are the physicians most often called on to provide treatment. No portion of the pediatric population is disproportionately diagnosed. The frequent use of potent corticosteroids contained in combination agents is a potential target for improving the management of diaper dermatitis.
Ward
D B
DB
Department of Dermatology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. sfeldman@wfubmc.edu
Fleischer
A B
AB
Feldman
S R
SR
Krowchuk
D P
DP
D000287:Administration, Topical; D017677:Age Distribution; D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001623:Betamethasone; D003022:Clotrimazole / Q000627:therapeutic use; D003963:Diaper Rash / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D004363:Drug Utilization; D005938:Glucocorticoids; D019538:Health Care Surveys; D006801:Humans; D006854:Hydrocortisone; D007223:Infant; D007231:Infant, Newborn; D009761:Nystatin / Q000627:therapeutic use; D010372:Pediatrics / Q000706:statistics & numerical data / Q000639:trends; D012307:Risk Factors; D014221:Triamcinolone / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D005938:Glucocorticoids; D009761:Nystatin; D014221:Triamcinolone; D001623:Betamethasone; D003022:Clotrimazole; D006854:Hydrocortisone