Candida albicans and napkin dermatitis: relationship and lesion severity correlation

Abstract

Introduction: Napkin Dermatitis (ND) is a common problem in infancy that affects almost every child during the early months and years of their lifetime. It is a skin disease that becomes a challenge for both parents and physicians because of its frequency and difficulty in eliminating all of the causative factors in diapered infants. Usually Napkin dermatitis is self-limiting but when associated with Candida albicans (C. albicans) seems to be moderate to severe.

Aim: The aim of the present study was to determine the colonization of C. albicans in children with Napkin dermatitis and to correlate between intensity of C. albicans colonization and the severity of napkin rash.

Patients and Methods: This case-controlled study was conducted at Qassim University pediatric outpatient clinics, during the period from August 2014 to July 2015. Sixty patients with diaper dermatitis and 33 healthy controls were enrolled to this study. Sociodemographic and clinical data were obtained from the parents of each participant using questionnaires Paired (stool and skin) samples were collected from all cases and healthy control children. The samples were cultured on differential and selective chromogenic medium for isolation and initial identification of candida species. Identification confirmation of the isolates was determined by the Vitek 2 compact automated system.

Results: Diaper dermatitis shows significant outcome to washing diaper area (per day) (P = 0.001), History of diarrhea last 7 Days (P < 0.001), skin lab results (+/-) for Candida albicans, (P < 0.001), skin colony count, (P < 0.001), However, there is no correlation to age (P = 0.828), gender (P = 0.368) and feeding style (P = 0.401).

Conclusion: The severity score of napkin dermatitis was significantly observed among cases with diaper dermatitis (p-value < 0.001) and control children (p-value < 0.001) respectively.

Keywords:  Candida albicans, Napkin dermatitis, Diaper dermatitis, Vitek 2 compact system, Qassim