A 60-year-old postmenopausal female presented with multiple, itchy lesions, and painful ulcers on buttocks and perineum since 1 year. She gave a history of urinary incontinence and frequent diaper use. Clinical examination revealed multiple well-defined plaques with friable, grey, edematous, elevated borders, and circumscribed, superficial ulcers symmetrically on a background of lichenification involving the genital, perineal, and perianal areas [Figure 1]. The lesions were arranged linearly on the convexities of vulvae, and spared the folds. She had received antiviral medications empirically and had provisionally been diagnosed as a case of syphilis from outside. Tzanck smear and serological tests for syphilis (VDRL and TPHA) and herpes simplex virus yielded negative results. A clinical diagnosis of Jacquet's erosive diaper dermatitis was made. She was advised topical zinc oxide cream application and oral antihistamines. The patient reported modest improvement at next follow-up.
Figure 1.
Well-defined plaques with friable, grey, edematous, elevated borders, and circumscribed, superficial ulcers present symmetrically on a background of lichenification involving the genital, perineal, and perianal areas
Jacquet's erosive diaper dermatitis is an entity that occurs mainly in children but can also be seen in adults.[1] Characteristic morphology and distribution of lesions with a history of urinary incontinence are useful pointers. Diagnosis is primarily clinical, and treatment comprises barrier agents (e.g., zinc oxide ointment), local hygiene, and management of underlying factor (e.g., urinary incontinence).
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Reference
- 1.Van L, Harting M, Rosen T. Jacquet erosive diaper dermatitis: A complication of adult urinary incontinence. Cutis. 2008;82:72–4. [PubMed] [Google Scholar]