Infant diaper dermatitis (DD) is a prevalent condition and is associated with numerous interactive factors, such as – increased skin hydration, irritant exposure and increased skin pH.

A new study published in Skin Research and Technology examined diaper dermatitis versus within diaper and non-diaper controls over time, and characterized the association of skin color and texture relative to skin barrier integrity, hydration and pH.

This prospective study included 46 infants with DD, at routine visits. Skin integrity was evaluated over 15 days – including visual skin condition, rate of stratum corneum transepidermal water accumulation, hydration, pH and skin color and texture—through high-resolution digital skin surface images. 

Overall, six distinct texture patterns were observed. All the three sites differed significantly for texture class frequency. Normal dermatoglyphics were more frequent for non-diaper. Dermatoglyphics with marked furrows or lines (class 3) were common within diaper versus rash, but not for non-diaper areas. While streaks were highest for DD and lowest for non-diaper areas, flat regions were more frequent DD. Barrier integrity disruption or moisture accumulation rate was lower for normal dermatoglyphics than streaks or flat texture. DD severity decreased over 15 days. However, barrier properties of within diaper and non-diaper areas were not well-differentiated.

Thus, the incidence of streak texture in within diaper high magnification images was high despite appearing visually normal. These changes may predict skin damage and may be clinically useful for early detection and treatment.

Source: Skin Research and Technology. 2021 Mar;27(2):145-152. doi: 10.1111/srt.12925.