What are the other Names for this Condition? (Also known as/Synonyms)

• Fecal Incontinence-Associated Dermatitis
• Urinary Incontinence-Associated Dermatitis

What is Incontinence-Associated Dermatitis? (Definition/Background Information)

• Incontinence-Associated Dermatitis is described as a form of irritant contact dermatitis that affects individuals who have urinary incontinence or fecal incontinence or both
• An incontinence describes a lack of control over urination or defecation that occurs from several causes. Irritant contact dermatitis is a skin condition in which the skin gets damaged and inflamed due to exposure to substances that irritate the outer protective layer of skin
• Incontinence-Associated Dermatitis develops from regular contact of skin to urine and/or to feces. The condition is often noted in older adults. The cause involves a combination of multiple factors such as constant wetness in the region, skin friction, constant presence of urine or feces, and microorganisms that are present in the environment
• The treatment of Incontinence-Associated Dermatitis involves the use of topical creams and lotions, and medications for bacterial or fungal infections. In general, the prognosis is good with appropriate treatment. However, the condition may recur, especially if urinary or fecal incontinence is not addressed suitably

Who gets Incontinence-Associated Dermatitis? (Age and Sex Distribution)

• Incontinence-Associated Dermatitis is typically seen in individuals with urinary and/or fecal incontinence. The incidence of the condition varies from 3.4% to 25% in individuals with incontinence
• It is reported that nearly 33% of the individuals with fecal incontinence may develop Fecal Incontinence-Associated Dermatitis
• Individuals of any age category may be affected, but a greater number of cases are reported in elderly adults
• Both men and women are equally affected
• No racial, ethnic, or geographical predominance is observed

What are the Risk Factors for Incontinence-Associated Dermatitis? (Predisposing Factors)

• The primary risk factor for Incontinence-Associated Dermatitis is fecal and/or urinary incontinence
• Elderly adults who are bedridden or have certain neurological conditions, are highly vulnerable to Incontinence-Associated Dermatitis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Incontinence-Associated Dermatitis? (Etiology)

Incontinence-Associated Dermatitis is a type of contact dermatitis that arises from regular exposure of the skin to urine and/or feces. The condition occurs when the skin gets damaged due to exposure to substances that irritate the outer protective layer of the skin. The factors involved in the condition include:

• Trapped urine and feces that combine to increase the pH value, which may be speeded up or aggravated by diarrhea and/or increased urination
• The outermost protective layer of skin gets softened or eroded, which leads to deeper skin layers being affected
• Prolonged mechanical friction due to rubbing of clothes/fabric/diapers or fecal matter on skin
• Presence of microorganisms that grow and thrive in the region

What are the Signs and Symptoms of Incontinence-Associated Dermatitis?

The signs and symptoms of Incontinence-Associated Dermatitis can be mild or severe and may vary from one individual to another. It may include:

• The skin area involved is mostly the genital and anal region
• Presence of red rashes
• Erosion and ulceration of the skin surface is generally noted
• The skin rashes may be symmetrical or asymmetrical in presentation
• Pain, burning sensation, and tenderness in the affected area
• Over a period of time, the skin may dry, peel, and crack
• If a secondary infection develops, such as bacterial or fungal infection, the area of involvement may spread to the non-contact areas too

How is Incontinence-Associated Dermatitis Diagnosed?

A diagnosis of Incontinence-Associated Dermatitis would include:

• A complete evaluation of one’s medical history and a thorough physical examination to observe the signs and symptoms; a history of urinary or bowel incontinence is important for diagnosing the condition
• Culture studies through skin swabs to detect any bacterial or fungal infection

Note: A skin biopsy is usually not necessary for a diagnosis of Incontinence-Associated Dermatitis; however, it can be performed to eliminate other skin conditions.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Incontinence-Associated Dermatitis?

Incontinence-Associated Dermatitis could lead to the following complications namely:

• Severe discomfort and emotional stress
• Secondary bacterial and fungal infection
• Reduced quality of life
• Recurrence of the condition

How is Incontinence-Associated Dermatitis Treated?

Incontinence-Associated Dermatitis may be treated using the following measures:

• Appropriate management of fecal/urinary incontinence
• Use of topical applications and barrier creams; petroleum jelly and creams containing zinc oxide
• Use of mild topical steroidal creams, for short terms
• Administration of antifungal or antibiotic medication, if required, for secondary infections
• In case of severe symptoms, systemic therapy may be necessary

How can Incontinence-Associated Dermatitis be Prevented?

The following measures may be adopted to minimize the risk for Incontinence-Associated Dermatitis:

• Undertake steps to control incontinence, such as by treating the underlying causative condition
• Good skin care:
  • Wash the skin area regularly and keep dry
  • Use barrier creams and moisturizers, as applicable
• Minimize the use of diapers, where possible

What is the Prognosis of Incontinence-Associated Dermatitis? (Outcomes/Resolutions)

The prognosis of Incontinence-Associated Dermatitis depends upon several factors. However, with adequate care and treatment, the prognosis can be good.

Additional and Relevant Useful Information for Incontinence-Associated Dermatitis:

The following article link will help you understand contact dermatitis:

http://www.dovemed.com/diseases-conditions/contact-dermatitis/