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Napkin (diaper) dermatitis and gastrointestinal carriage of Candida albicans
Insights
Candida albicans recovery from skin and feces correlates with diaper dermatitis severity. Absence of this yeast indicates other conditions, while skin detection can be unreliable due to inflammation.
Area of Science:
- Mycology
- Pediatrics
- Dermatology
Background:
- Napkin (diaper) dermatitis is common in infants.
- The role of Candida albicans in various types of diaper dermatitis requires clarification.
Purpose of the Study:
- To investigate the correlation between Candida albicans recovery and distinct clinical presentations of napkin dermatitis in infants.
- To assess the reliability of skin versus fecal sampling for C. albicans detection.
Main Methods:
- Culturing Candida albicans from skin, rectum, and feces of infants in four distinct clinical groups.
- Correlating yeast recovery with clinical diagnosis and severity of napkin dermatitis.
Main Results:
- Candida albicans was consistently found on skin and in feces of infants with overt candidiasis.
- C. albicans was absent in infants with simple chafing or atopic dermatitis.
- Fecal C. albicans presence correlated with severity in unclassifiable dermatitis.
- Skin recovery failure can occur due to inflammatory host response.
Conclusions:
- Candida albicans presence is a strong indicator of candidiasis in napkin dermatitis.
- Absence of C. albicans suggests alternative diagnoses like chafing or atopic dermatitis.
- Fecal sampling is a reliable indicator, while skin sampling can be misleading due to host inflammatory responses.
Abstract:
The correlation of recovery of Candida albicans from the skin, rectum and faeces of four clinically distinct groups of infants with napkin (diaper) dermatitis has been studied. We found that: (I) C. albicans is largely and constantly present both on the skin and in faeces of subjects with clinically overt Candidiasis of the napkin area; (2) C. albicans is lacking from both the skin and faeces of subjects with chafing or atopic dermatitis; (3) C. albicans can be found in faeces of subjects with unclassifiable napkin dermatitis in a direct relationship with its clinical severity; (4) failure to recover C. albicans from the skin can be due to the inhibitory effect of the inflammatory host reaction and therefore can be misleading.