skin maceration

Introduction

Softening by contact with liquid, especially that of skin.

Etiology

• constant contact of skin with moisture
  • occlusive dressing
  • wet diapers

Clinical manifestations

• erythema
• excoriated skin
• blisters
• white & silvery patches
• can affect any skin in constant contact with moisture
  • skin folds
  • groin
  • buttocks

Management

• eliminate cause of moisture
  • toileting program for urinary incontinence
  • urinary catheter
    • condom catheter
    • reserve indwellng urinary catheter for refractory cases
  • remove & clean fecal incontinence
• protect skin from moisture
  • clean gently with mild soap & water after each episode of incontinence
  • apply a barrier cream (vaseline, zinc oxide)
  • use disposable diapers that wick moisture from the skin
  • use linen incontinence pads when disposable diapers worsen perineal dermatitis
• low-potency to low-medium potency glucocorticoids if barrier cream not effective
  • skin folds (genitals, gluteal cleft, & inguinal or axillary skin folds) are susceptible to atrophy from medium to high potency topical glucocorticoids
  • Desonide 0.05% (low potency)
  • Hydrocortisone butyrate 0.1% (lower-medium potency)
  • Hydrocortisone valerate 0.2% (lower-medium potency)
  • Fluocinolone acetonide 0.01% (low potency)

More general terms

• sign/symptom
• dermatitis