We read with great interest Dr. Adam's excellent overview of "Skin Care of the Diaper Area" (Ped Derm Vol 25 No 4 July/August 2008). The article presented a thorough review of the anatomy and physiology of the newborn diaper'^region. As well, an enlightening discussion of manufacturing and industry considerations in the formulation of disposable diapers was carried out. Dr. Adam used the diaper rash model espoused by Dr. Berg (1) as the basis for understanding the initiation and propagation of diaper dermatitis. The etiologic factors for this model, as listed in the article, include physical and infectious sources such as skin friction, fecal enzymes, chemical irritants, and yeast. As noted these significant factors can be enhanced bv excess skin wetness.
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