Candidal diaper dermatitis is an erythematous plaque with a scalloped border and a sharply demarcated edge that is studded by satellite lesions. It usually occurs in the moist, occluded diaper area and intertriginous zones and usually results from the action of organisms harbored in the gastrointestinal tract. Treatment consists of a topical anticandidal agent with each diaper change or four times daily. Protection of the area with zinc oxide paste overlying the cream will prevent friction, and local treatment with Nystatin cream will prevent spread of the infection. In addition, an oral course of Nystatin is usually warranted to prevent colonization of the gut ( Table
Oral lesions are white and flaky, covering the tongue, lips, gingiva, and mucous membranes. These lesions are common in debilitated infants and in those on antibiotics. Oral lesions may affect oral intake because of pain and discomfort. Treatment of ill infants consists of treating the underlying pathology, oral antifungal therapy, and an anesthetic gel prior to feeding. Cool liquids may prevent discomfort and pain. 4 50
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