Prospective aetiological study of diaper dermatitis in the elderly.
BACKGROUND
The different causes of diaper dermatitis (DD) in the elderly are not well known and the treatment is often empirical.


OBJECTIVE
To determine the causes of DD in the elderly and to evaluate the efficacy of antifungal treatments in this indication.


METHODS
Consecutive patients presenting with DD were included. Clinical evaluation, skin swabs for bacterial and mycological cultures, patch testing and skin biopsy were performed at inclusion. This was followed by 1 month of topical antifungal cream and, if needed, by oral fluconazole for the second month.


RESULTS
Forty-six patients were included (mean age 85 years). Causes of DD were established for 38 patients: 24 had candidiasis (63%), six irritant dermatitis (16%), four eczema (11%) and four psoriasis (11%). After 2 months of treatment, 27 of 37 (73%) patients were cured and five of 37 were improved.


CONCLUSIONS
Mycoses and irritant dermatitis are the main causes of DD in the elderly, and emollient skin care and topical antifungal treatment can be considered a first-line therapy for this indication.
Foureur
N
N
Service de Gérontologie V et Consultation de Dermatologie, Hôpital Charles Foix, 7 avenue de la République, 94205 Ivry sur Seine, France.
Vanzo
B
B
Meaume
S
S
Senet
P
P
D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D002179:Candidiasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D017453:Dermatitis, Irritant / Q000175:diagnosis / Q000209:etiology; D003963:Diaper Rash / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011565:Psoriasis / Q000175:diagnosis / Q000209:etiology; D016896:Treatment Outcome
D000935:Antifungal Agents