Diaper dermatitis

Template

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TypeChoose oneFirst line

FindingsChoose one

Candida contextChoose anyNot in the note with these choices

AntifungalChoose oneNot in the note with these choices

Oral antifungalChoose anyNot in the note with these choices

BarrierChoose any

SteroidChoose any

Follow-upChoose one

Counseling

Recommended supportive care with an emphasis on frequent diaper changes, rinsing with water or fragrance-free wipes, patting dry, diaper-free time, and a thick layer of zinc oxide paste at every change that does not need to be wiped all off between changes. Return precautions given including a rash that is not improving, bumps in the folds, blisters, pus, bleeding, fever, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

This rash is from yeast. Apply the antifungal cream first and the zinc oxide paste over it at every change. Recommended supportive care with an emphasis on frequent diaper changes and diaper-free time. Return precautions given including a rash that is not improving, white patches in the mouth, fever, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Diaper dermatitis
Irritant
• Sparing the skin folds
• Thick zinc oxide barrier paste with every diaper change
• Follow up if not improving in a few days

Recommended supportive care with an emphasis on frequent diaper changes, rinsing with water or fragrance-free wipes, patting dry, diaper-free time, and a thick layer of zinc oxide paste at every change that does not need to be wiped all off between changes. Return precautions given including a rash that is not improving, bumps in the folds, blisters, pus, bleeding, fever, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Irritant vs candidal
Irritant spares folds; Candida in folds with satellites
Barrier paste
Low-potency steroid for moderate irritant dermatitis; no mid-potency
Topical antifungal (nystatin, clotrimazole); fluconazole if persistent
Add antifungal after antibiotics or > 72 h

Return precautions in the template

a rash that is not improvingbumps in the foldsblisterspusbleedingfever

Sources

Few formal guidelines cover this topic, so the template also leans on expert opinion.