title: Re-emergence of papulonodular napkin dermatitis with use of reusable diapers: report of 5 cases.
abstract: The use of reusable diapers, often made of cotton and bamboo material, is becoming more widespread in France--with the "eco" fashion, as they are considered more natural, ecologic and economic. We report 5 cases of papulonodular lesions in convex skin areas associated with the use of these diapers in infants. One case was typical Sevestre and Jacquet erosive dermatitis. The 4 others presented skin-coloured umbilicated papules or nodules with slight or no erythema and could be considered early-stage Sevestre and Jacquet erosive dermatitis, granuloma gluteale (1 case) or pseudo-verrucous papules. These 3 diagnoses probably belong to the same disease spectrum, proposed as "irritant napkin papulonodules". Napkin lesions occurred subsequent to 1) in all cases, use of reusable diapers, which are probably less absorbent than disposable diapers; 2) in 2 cases, insufficient food, which was responsible for lack of weight gain and delayed healing; and 3) in 1 case, diarrhea, which worsened the moisture. We alert physicians to possible papulonodular napkin dermatitis in infants wearing reusable diapers.
authors.affiliation: Department of Dermatology, University Hospital, François Rabelais University, Trousseau Hospital, 37044 Tours, France. annabel-maruani@wanadoo.fr
authors.forename: Annabel
authors.initials: A
authors.lastname: Maruani
authors.forename: Gérard
authors.initials: G
authors.lastname: Lorette
authors.forename: Sébastien
authors.initials: S
authors.lastname: Barbarot
authors.forename: Alexandra
authors.initials: A
authors.lastname: Potier
authors.forename: Didier
authors.initials: D
authors.lastname: Bessis
authors.forename: Caroline
authors.initials: C
authors.lastname: Hasselmann
authors.forename: Juliette
authors.initials: J
authors.lastname: Mazereeuw-Hautier
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D003898:Desonide / Q000627:therapeutic use; D003963:Diaper Rash / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D041381:Diapers, Infant / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D063465:Skin Cream / Q000627:therapeutic use; D013392:Sucralfate / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D013392:Sucralfate; D003898:Desonide
keywords: Jacquet dermatitis; dermatitis; diaper; granuloma gluteale; napkin; papulonodular