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Incontinence-associated dermatitis, previously and sometimes still referred to as moisture lesions or moisture damage, is a commonly seen contact dermatitis that is a reactive response of the skin to chronic contact to urine and faecal matter. Understanding the etiology is fundamental to creating a skin care plan and successfully prevention. Systemic reviews and studies have shown that the continued variability in management results from a combination of knowledge base, observation, diagnosis, and product selection. This article aims to improve clinicians' understanding of incontinence-associated dermatitis and its management. [ABSTRACT FROM AUTHOR]

The skin is one of the most important parts of the human body. It protects the underlying tissue from injury and is a valuable part of the homeostatic processes. The skin is delicate, and, therefore, dermatological intervention is an important part of patient care in the case of skin problems. Older people have more frail and aged skin, which must be treated correctly to avoid skin breaks, especially where there are any dermatological conditions present. Not only this, but where there is a wound, the dressing must be chosen and applied carefully, to treat the condition but also to avoid damage when it comes to removing the dressing, due to the risk of the skin tearing, which can be a common problem in older adults. Further, the thinner, drier skin of older people has moisture and barrier changes that lead to a higher susceptibility to eczema. This article provides an overview of the aetiological, diagnostic and treatment aspects of geriatric dermatology, with a focus on the common allergic skin conditions (dermatitis) seen in older adults. [ABSTRACT FROM AUTHOR]

The article discusses the prevention and management of incontinence-associated dermatitis (IAD) in older people. Topics covered include factors that make incontinence more prevalent in older people, the contribution of age to skin fragility, and skin care regime for the prevention and management of IAD.

Objective: Preventing moisture damage and breakdown of the skin can be a particular challenge for patients with incontinence. The level of protection offered by various skin protectant products can vary according to the chemical nature of the formulation and can decrease following wash procedures. The aim of this study was to compare five silicone-containing skin barrier creams indicated for use on incontinence-associated dermatitis (IAD) in terms of their resistance to a standardised wash cycle in healthy volunteer subjects. Method: A skin surface hygrometer (Skicon 200EX) evaluated skin surface conduction non-invasively on 36 non-patient subjects using a high-frequency (3.5MHz) electric current. This provided an index of the degree of protection given by barrier products after a single application and also any reduction in barrier properties after a repeated wash procedure. Results: Medi Derma-S barrier cream (MDS), Cavilon barrier cream (CBC) and LBF barrier cream (LBF) all demonstrated statistically significant differences (p<0.001) in the Skicon values following the first moisture challenge compared with Medihoney (MH), Remedy barrier cream (RBC) and the untreated control. All other comparisons were not significant (p>0.05). Statistical analysis following four moisture challenges reflected the results following the first, whereby Skicon values following treatment with MDS, CBC and LBF was significantly different compared with MH, RBC and the untreated control. Again, all other comparisons were not significant (p>0.05). When expressed as percentage barrier effectiveness, the results show a similar pattern to the absolute Skicon values. Conclusion: The results of this study show that there were differences between the barrier creams in terms of the initial moisture challenge and the resistance to wash-off following a repeated standardised wash procedure. It was concluded that MDS, CBC and LBF barrier cream all showed significant and equally effective moisture barrier protection and wash-off resistance. [ABSTRACT FROM AUTHOR]

Incontinence-associated dermatitis (IAD) is a common problem in patients with faecal and/or urinary incontinence. Urine alters the normal skin flora and increases permeability of the stratum corneum and faecal enzymes on the skin contribute to skin damage. Faecal bacteria can then penetrate the skin, increasing the risk of secondary infection. However, IAD can be prevented and healed with timely and appropriate skin cleansing and skin protection. This includes appropriate use of containment devices. This article also looks at HARTMANN incontinence pads that have been developed to absorb the fluids that cause IAD and maintain the skin’s acidic pH. The acidic pH of the skin contributes to its barrier function and defence against infection. Therefore, maintaining an acidic pH will help protect the skin from damage. [ABSTRACT FROM AUTHOR]

The article discusses incontinence-associated dermatitis (IAD) and its management. IAD is caused by damage to the skin due to prolonged exposure to urine and/or feces and means that a persons's continence needs must be addressed and that IAD must be looked for when the patient is clearly incontinent and in the presence of rash. Prevention and treatment goes together which include cleaning, moisturizing, and protecting the skin. Non-zinc based creams include Cavilon, Proshield Plus or Sorbaderm.

The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinenceassociated dermatitis (IAD). IAD is skin breakdown related to faecal and/ or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage. [ABSTRACT FROM AUTHOR]

Incontinence-associated dermatitis (IAD) is a common skin disorder seen in patients with incontinence. Typically IAD presents as inflammation of the skin surface characterised by redness, and in extreme cases, swelling and blister formation. If untreated this usually rapidly leads to excoriation and skin breakdown, which may subsequently become infected by the skin flora. While this is a common condition encountered in all areas of nursing practice, gaps remain in our understanding of the many contributing factors. A lack of standardised definitions of IAD, differences in terminology, and a bewildering increase in products available to prevent and manage IAD, makes it difficult for nurses to deliver evidence-based care. However, it is an area where nursing research has made a considerable contribution over the past few years. This article explores the current thinking on IAD and the implications for nursing practice. [ABSTRACT FROM AUTHOR]

Flea allergic dermatitis is a common cause of allergic skin disease in cats and dogs. A diagnosis can best be achieved by taking a full clinical history and making a thorough examination of the animal. The institution of a rigorous flea control programme is important in achieving control. [ABSTRACT FROM AUTHOR]

Individuals who suffer with incontinence, especially in relation to faeces, will often be at risk of skin breakdown and develop incontinence-associated dermatitis (IAD) which, if left untreated, can lead to pressure ulcer formation (Gray, 2004). IAD is caused by increased, unrelieved moisture against the skin, usually from liquid faeces and urine, which can then weaken the skin integrity. The integrity of the skin in this area is also at risk of pressure ulcers caused by shear or friction (Beeckman et al, 2010a). Treatment and prevention of IAD lesions involves a three-step process used in postincontinence episodes, which includes cleansing, moisturisation and protection of the skin (Beeckman et al, 2011a). Using a wipe covers all of these steps immediately following incontinence episodes (Rönner et al, 2010). This reduces the need to gather a number of different items required for post-incontinence skin care, which usually includes a dry wipe to be soaked in soapy water to wash the skin, a moisturiser to replace lost moisture and a skin protectant to prevent moisture from direct contact with the skin (Foxley and Baadjies, 2009). This article will give some examples of the use of a particular continence and cleansing wipe in clinical practice. [ABSTRACT FROM AUTHOR]

Incontinence-associated dermatitis (IAD) is a common problem in older people. However, it is frequently misdiagnosed and poorly treated. There is often uncertainty about -which product to use to prevent and treat IAD; the different types, brands and how to apply them. This literature review looks specifically at the use of barrier products in the prevention and treatment of IAD. A systematic search found six primary research papers that analysed the effectiveness of various barrier products; they will be compared and contrasted in this review. There is a lack of evidence to recommend any one barrier product over another for use in a standardised skin care protocol such as the regimen suggested by Gray et al (2012). More research needs to be conducted to establish the most effective barrier products on the market. More research is also needed on the efficacy of barrier products in the prevention and treatment solely of IAD rather than combined studies looking at IAD with pressure ulcers. [ABSTRACT FROM AUTHOR]

Abstract: Nappy rash is a general definition used to describe a range of inflammatory reactions of the skin in the nappy area, often it is a mild condition that affects most babies at some time. There appear to be key times when infants become more prone to nappy rash. This article describes these trigger points from a parents prospective and provides skin care advice to help manage and treat the condition. [ABSTRACT FROM AUTHOR]

Breakdown of the skin barrier is the first event in the development of atopic eczema (atopic dermatitis). Research over the past five years has indicated that this arises as a result of the interaction of environmental agents such as soap and other detergents with the products of changes in several genes. These genetic changes predispose to the breakdown of the skin barrier, which allows the penetration of allergens, triggering a flare of atopic eczema. This new understanding of how breakdown of the skin barrier is the first event in the development of atopic eczema provides a rationale for a renaissance in the use of a complete emollient therapy regimen in atopic eczema and related skin barrier breakdown diseases, such as asteatotic eczema and irritant contact dermatitis. [ABSTRACT FROM AUTHOR]