What is the cause of a 23-month-old female's erythematous (red), tender, and peeling perineal area, accompanied by a history of vomiting, diarrhea, cough, congestion, rhinorrhea, and recent fevers, with negative influenza (flu) and Coronavirus Disease 2019 (COVID-19) tests, and current use of Desitin (zinc oxide) cream and sensitive diapers?

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From the FDA Drug Label

Directions Change wet and soiled diapers promptly Cleanse the diaper area and allow to dry Apply ointment liberally as often as necessary. With each diaper change, especially at betime or anytime when exposure to wet diapers may be prolonged Uses Helps treat and prevent diaper rash Protects chafed skin due to diaper rash - helps protect skin from wetness Protects and dries the oozing and weeping of poison ivy, poison oak and poison sumac Helps prevent and temporarily protect chafed, chapped, cracked or windburned skin and lips

The recommended treatment for Olyvia's condition, which is likely a diaper rash, includes:

  • Frequent diaper changes to keep the area clean and dry
  • Gentle cleaning to avoid further irritation
  • Allowing the area to air dry as much as possible
  • Applying a thick layer of Desitin (zinc oxide) with each diaper change to create a barrier against further irritation from urine and stool 1 The zinc oxide in Desitin helps to treat and prevent diaper rash and protects chafed skin due to diaper rash 1.

From the Research

Olyvia's red, sore, peeling bottom is most likely diaper rash caused by her frequent diarrhea rather than an allergic reaction to Desitin or diapers. To treat this condition, change her diaper frequently to keep the area clean and dry. Clean the area gently to avoid further irritation. Allow her bottom to air dry when possible to promote healing. Apply a thick layer of Desitin with each diaper change to create a protective barrier against moisture from urine and stool. Don't completely remove the Desitin with each change as this can irritate the skin further. Use a loose diaper to reduce friction. The diaper rash is occurring because the acidic diarrhea combined with moisture creates an environment that damages the skin barrier. The Desitin contains zinc oxide which creates a physical barrier protecting the irritated skin from further contact with irritants, as supported by a study published in 2021 2. If the rash worsens, develops sores or blisters, spreads, or if Olyvia develops a fever, contact the clinic to schedule a same-day appointment for further evaluation.

Some key points to consider in the treatment of diaper rash include:

  • Frequent diaper changes to keep the area clean and dry
  • Gentle cleaning to avoid further irritation
  • Allowing the area to air dry when possible to promote healing
  • Applying a thick layer of Desitin with each diaper change to create a protective barrier
  • Using a loose diaper to reduce friction

It's also important to note that the use of zinc oxide in Desitin has been shown to be effective in treating diaper rash, as it creates a physical barrier that protects the skin from further irritation, as demonstrated in a study published in 2006 3. Additionally, a study published in 2014 4 highlights the importance of proper skin care practices, including gentle cleansing and the use of a barrier cream, in preventing and treating diaper rash. Overall, the treatment plan should prioritize keeping the area clean and dry, reducing friction, and protecting the skin with a barrier cream, as supported by the most recent and highest quality evidence 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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