Berg R W
Procter and Gamble Company, Miami Valley Laboratories, Cincinnati, Ohio.
Adv Dermatol. 1988;3:75-98.
Common diaper dermatitis is a group of skin disorders that result from attack of the skin by physical, chemical, enzymatic, and microbial factors in the diaper environment. The integrity of healthy skin is compromised by the very nature of the diaper environment, and normal intact skin therefore remains an elusive goal of current diapering practices. Moist occlusion promotes miliaria, and causes an increase in the coefficient of skin friction. Skin hydration and an increase in skin pH result in impaired barrier function, and fecal enzymes begin to attack the skin, further degrading its normal ability to cope with its environment. Skin in this weakened state is susceptible to a variety of biological, chemical, and physical insults that can cause or aggravate diaper dermatitis. These include attack of the skin by fecal enzymes and other irritants in urine and feces, mechanical abrasion, and infection by C. albicans. Diapering is unquestionably an effective and convenient way of localizing an infant's excreta. Unfortunately, infant skin was not designed to operate continuously in the resulting environment, and is frequently unable to weather this assault. However, by improving the inherently adverse relationship between diapers and diapered skin, one can have a significant effect on the incidence and severity of diaper dermatitis. A diaper that keeps skin drier will result in skin that is less permeable to irritants, supports less microbial growth, is less susceptible to chafing damage, and has less contact with irritants in urine and feces. A diaper that maintains the environment closer to the normal acidic pH of skin will promote skin that is less permeable to irritants, and reduce the irritancy of fecal enzymes. Finally, a diaper that limits the mixing and spreading of urine and feces will result in less potentiation of enzyme activity and less contact of the skin with fecal irritants. Diaper dermatitis, by definition, cannot exist in the absence of diapers. Moreover, diaper dermatitis will become less troublesome for the infant population to the degree that diapered skin can be provided an environment closer to that of undiapered skin.
常见尿布皮炎是一组皮肤疾病，由尿布环境中的物理、化学、酶和微生物因素对皮肤的侵袭所致。尿布环境的本质损害了健康皮肤的完整性，因此，保持正常的完整皮肤仍是当前尿布使用方法难以实现的目标。潮湿闭塞会引发痱子，并导致皮肤摩擦系数增加。皮肤水合作用及皮肤pH值升高会导致屏障功能受损，粪便中的酶开始侵蚀皮肤，进一步削弱其应对环境的正常能力。处于这种脆弱状态的皮肤易受各种生物、化学和物理侵害，从而引发或加重尿布皮炎。这些侵害包括粪便中的酶以及尿液和粪便中的其他刺激物对皮肤的侵蚀、机械摩擦和白色念珠菌感染。毫无疑问，使用尿布是一种有效且方便的方式，可将婴儿的排泄物局限在一定范围。不幸的是，婴儿的皮肤并非为在尿布环境中持续使用而设计，常常无法承受这种侵害。然而，通过改善尿布与裹尿布皮肤之间固有的不良关系，可对尿布皮炎的发生率和严重程度产生显著影响。能保持皮肤更干爽的尿布，可使皮肤对刺激物的渗透性降低，减少微生物生长，不易受到擦伤损害，且与尿液和粪便中的刺激物接触更少。能使皮肤环境更接近正常酸性pH值的尿布，可使皮肤对刺激物的渗透性降低，并降低粪便酶的刺激性。最后，能限制尿液和粪便混合及扩散的尿布，可减少酶活性的增强，降低皮肤与粪便刺激物的接触。根据定义，没有尿布就不会有尿布皮炎。此外，只要能为裹尿布的皮肤提供更接近未裹尿布时的环境，尿布皮炎对婴儿群体造成的麻烦就会减少。
