Xlix.—dermatitis of the Diaper Region in Infants (Jacquet Dermatitis)

Etiology of Ovine Posthitis: Description of a Causal Organism

“…Zahorsky ( 19 15) and Brennemann (1921) described an ulceration of the external urinary meatus in circumcised male children which sometimes occurred in association with the ammoniacal diaper. Further reports on the etiology of ammonia dermatitis were published by Cooke (1926), Keith ( 1927) andFriend (1962). As in posthitis, it was recognized that diet could influence the course of the disease, being much more common in infants on liberal diets of formulated milk relatively high in protein and fat, than in breast fed babies.…”

Two Commonly Misunderstood Skin Conditions in Infancy

“…Locally tannic acid in alcohol, picric acid, and various antiseptic ointments have been prescribed. Cooke (1921Cooke ( , 1926 recommends soaking the napkins in 1 in 4,000 perchloride of mercury to discourage the growth of the Lirea-splitting organisms. Although this treatment is satisfactory if used by the more intelligent mothers, one hesitates to recommend it to the average mother seen in a clinic, not only because of the poisonous nature of the antiseptic but also because of the difficulty in ensuring that the concentration is correct.…”

“…However, there is no unanimity as to the origin of the ammonia. Cooke (1921Cooke ( , 1926 has gone very carefully into the problem, and has come to the conclusion that a Gram-positive bacillus derived from the faeces splits up the urea and causes the formation of ammonia. To inhibit the growth of the organism he recommends that the napkins be soaked in 1 in 4,000 perchloride of mercury.…”

Napkin (diaper) dermatitis and gastrointestinal carriage of Candida albicans

“…Microbial factors have long been viewed as important in all varieties of napkin dermatitis. The most entrenched view has been the belief that bacteria produce ammonia from urinary urea which then acts as a primary irritant in the napkin area (Cooke, 1921). Recently, we challenged this ancient dogma when we were unable to show any difference in either the amount of ammonia or the prevalence or density of ammonia producing organisms in infants with and without napkin rash (Leyden et al, 1977).…”