Kottner Jan, Dissemond Joachim
Institute of Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany.
Drugs Aging. 2025 Jul 4. doi: 10.1007/s40266-025-01227-z.
Prolonged and repeated exposure of the skin to urine and/or faeces may lead to incontinence-associated dermatitis (IAD). IAD is an irritant contact dermatitis characterised by pain, erythema, maceration, erosion, scaling and very often associated with secondary infection. Older adults who are incontinent are at high IAD risk. Several differential diagnoses must be separated from IAD, with allergic contact dermatitis being the most common in older people. The main prevention and treatment principles are to reduce or to avoid the exposure of the skin to urine and stool. The type of incontinence should be assessed first and strategies to enhance continence implemented. Especially in older adults, high absorbency incontinence products should be used and changed regularly to reduce overhydration of the epidermis. Protective skin care products and mild cleansing should be applied. Weeping erosions, excoriations or infection should be treated with appropriate topical products. The short-term and controlled use of corticosteroids or external urine or stool collection devices or indwelling urinary catheters might be considered in severe cases. Owing to demographic changes, the management of incontinence and associated IAD will become more important. This will be especially relevant in primary care for older adults.
皮肤长期反复接触尿液和/或粪便可能导致失禁相关性皮炎（IAD）。IAD是一种刺激性接触性皮炎，其特征为疼痛、红斑、浸渍、糜烂、脱屑，且常伴有继发感染。失禁的老年人患IAD的风险很高。必须将几种鉴别诊断与IAD区分开来，其中过敏性接触性皮炎在老年人中最为常见。主要的预防和治疗原则是减少或避免皮肤接触尿液和粪便。应首先评估失禁类型并实施增强控尿能力的策略。特别是对于老年人，应使用高吸收性失禁产品并定期更换，以减少表皮过度水化。应使用保护性皮肤护理产品并进行温和清洁。对于有渗液的糜烂、擦伤或感染，应使用适当的外用产品进行治疗。在严重病例中，可考虑短期、有控制地使用皮质类固醇或外部尿液或粪便收集装置或留置导尿管。由于人口结构的变化，失禁及相关IAD的管理将变得更加重要。这在老年人的初级保健中尤为重要。
