A peculiar napkin dermatitis: when excessive washing is harmful

Key words: Napkin dermatitis, Irritant dermatitis, Detergents

The case of a 3-month-old boy that was visited because of a brownish, hyperkeratotic and slightly desquamative dermatitis of the inguinal folds, perineum and perianal area is reported. The patient was healthy, asymptomatic and the remaining physical examination was normal. Anamnesis revealed frequent and thorough washings of the diaper area with a synthetic pH acid detergent. A diagnosis of pigmented and hyperkeratotic napkin dermatitis was made. Complete healing was obtained within 5 days using a delicate detergent instead of the previous one and using a moisturizing cream containing omega 3 and omega 6 fatty acids. Pigmented and hyperkeratotic napkin dermatitis is a peculiar, under-reported type of irritant contact dermatitis that falls within differential diagnosis with many other dermatitis of the diaper area.