Incontinence associated dermatitis

Incontinence associated dermatitis (IAD) is characterized by skin damage (inflammation with or without erosion of the epidermis and dermis) following exposure to urine or stool (Gray et al. 2007). Previously referred to as perineal dermatitis, the term IAD was decided on by a consensus conference of clinical experts because it labels the condition as a form of irritant dermatitis that occurs when the skin is exposed to irritating substances (urine and/or stool) and because it acknowledges clinical observations that IAD often extends far beyond the perineum into the perigenital area, perianal area and upper thighs. Cutaneous infections also may occur with IAD. Junkin and Selekof (2007) found that 18% of a group of 263 hospitalized patients with IAD had secondary cutaneous candidiasis.
Little is known about the natural history of IAD; clinical experience suggests that skin damage tends to originate as inflammation of the skin, seen as bright (redness) erythema in persons with lighter skin tones and more subtle redness in persons with darker skin tones (Gray et al., 2012). Erosion of the skin is thought to begin as isolated islands that may lead to epidermal and dermal denudation in severe cases. Nevertheless, when skin is exposed to severely irritating incontinence, such as that seen with high volume infectious diarrhea, erosion may occur as rapidly as inflammation. Erosion tends to result in a partial thickness (erosion through the epidermis but not the dermas) wound; full thickness (erosion through epidermis and dermas) wounds are usually associated with ischemic skin damage caused by pressure or shear forces (Doughty et al., 2012).
Moisture Barrier of the Skin

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Inkontinensia terkait dermatitis (IAD) ditandai dengan kerusakan kulit (peradangan dengan atau tanpa erosi epidermis dan dermis) setelah terekspos terhadap urin atau tinja (abu-abu et al. 2007). Sebelumnya disebut sebagai dermatitis n. perineum, istilah IAD diputuskan pada oleh konsensus konferensi ahli klinis karena itu label kondisi sebagai bentuk dermatitis iritan yang terjadi ketika kulit terkena menjengkelkan zat (air kencing dan/atau tinja) dan karena itu mengakui pengamatan klinis IAD yang seringkali jauh melampaui perineum ke daerah perigenital , perianal area, dan bagian atas paha. Kulit infeksi juga dapat terjadi dengan IAD. JUNKIN dan Selekof (2007) menemukan bahwa 18% dari sekelompok 263 pasien yang dirawat dengan IAD kandidiasis kulit sekunder.Little is known about the natural history of IAD; clinical experience suggests that skin damage tends to originate as inflammation of the skin, seen as bright (redness) erythema in persons with lighter skin tones and more subtle redness in persons with darker skin tones (Gray et al., 2012). Erosion of the skin is thought to begin as isolated islands that may lead to epidermal and dermal denudation in severe cases. Nevertheless, when skin is exposed to severely irritating incontinence, such as that seen with high volume infectious diarrhea, erosion may occur as rapidly as inflammation. Erosion tends to result in a partial thickness (erosion through the epidermis but not the dermas) wound; full thickness (erosion through epidermis and dermas) wounds are usually associated with ischemic skin damage caused by pressure or shear forces (Doughty et al., 2012).Moisture Barrier of the Skin