Persistent diaper dermatitis linked to food allergy in children

Persistent diaper dermatitis lasting longer than a month may be associated with food allergy, according to a study published in Pediatric Dermatology.

Mehmet Halil Celiksoy and associates conducted a retrospective chart review to determine the relationship between persistent diaper dermatitis and food allergy.

Diaper dermatitis is not generally considered a manifestation of food allergy but food allergy may be suspected in children with persistent diaper dermatitis lasting longer than 1 month.

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According to NIH Guidelines for the Diagnosis and Management of Food Allergy, food allergy is defined not as a positive skin prick test or specific-IgE test, but as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food.

The study included pediatric patients with a diagnosis of persistent diaper dermatitis between August 2015 and November 2017. A total of 157 patients diagnosed with persistent diaper dermatitis (67 male, 72 female; median age: 13 months)participated in the study.

The investigators found that Diaper dermatitis was more common and included the whole perineum in children who had multiple food allergies. In children with multiple food allergies, the course of diaper dermatitis was more severe, and the condition did not respond to topical treatment.

However, a longer elimination diet was required for patients with Type I reactions and persistent diaper dermatitis. In patients with Type II and mixed reactions, diaper dermatitis was more diffuse and covered the whole perineum. In patients with Type II and mixed reactions, diaper dermatitis was more severe and did not respond to topical treatment.

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“The diaper rash may also be the only indicator of the food allergy. Elimination of the responsible food may allow these patients to recover from persistent diaper dermatitis, write the authors.”

Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food‐allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema.