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Etiologic factors in diaper dermatitis: the role of feces
Insights
Diaper dermatitis in infants involves skin irritation from fecal enzymes like proteases and lipases. Bile salts worsen this damage, increasing skin permeability and susceptibility to other diaper irritants.
Area of Science:
- Dermatology
- Pediatrics
- Biochemistry
Background:
- Diaper dermatitis is a common infant skin condition.
- Its etiology is multifactorial, involving skin exposure to urine and feces.
Purpose of the Study:
- To identify key irritants in infant feces contributing to diaper dermatitis.
- To understand the role of fecal enzymes and bile salts in skin barrier disruption.
Main Methods:
- Analysis of infant feces to identify specific enzymes.
- In vitro testing to assess the effects of fecal components on skin.
Main Results:
- Proteases and lipases identified as primary fecal irritants.
- Bile salts were found to enhance the damaging effects of fecal enzymes on infant skin.
- Fecal enzymes increased skin permeability, predisposing it to further irritation.
Conclusions:
- Fecal enzymes and bile salts are significant contributors to diaper dermatitis.
- Increased skin permeability due to fecal enzymes exacerbates the condition.
Abstract:
While the etiology of diaper dermatitis in infants is complex, it is generally believed to involve an interaction between skin and irritants in feces and urine. Proteases and lipases were identified as the major irritants in the feces of infants, and bile salts were found to potentiate the damage produced by the action of fecal enzymes on skin. Fecal enzymes also increased the permeability of skin, thereby increasing potential susceptibility to other irritants in the diaper environment.