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Der Hautarzt

, Volume 71, Issue 1, pp 46–52 | Cite as

Inkontinenzassoziierte Dermatitis: ein Positionspapier

  • J. KottnerEmail author
  • N. Kolbig
  • A. Bültemann
  • J. Dissemond
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Zusammenfassung

Die inkontinenzassoziierte Dermatitis (IAD) beschreibt eine Schädigung der Haut, verursacht durch den wiederholten und länger andauernden Kontakt mit Urin und/oder Stuhl. Betroffen können Patienten in allen Altersgruppen sein; die Diagnose wird bevorzugt bei Erwachsenen und Jugendlichen verwendet. Die Prädilektionsstellen sind perineal, perianal, die Oberschenkelinnenseiten und die konvexen Areale des Gesäßes. Vermehrte Feuchtigkeit auf der Hautoberfläche, erhöhte pH-Werte, Okklusion, Verdauungsenzyme aus dem Stuhl und wiederholte Hautreinigungsprozeduren sind pathophysiologisch relevante Faktoren. Typische klinische Zeichen der IAD sind Erytheme, Erosionen, Exkoriationen und Schmerzen. Die Diagnostik gestaltet sich oft schwierig, da es viele relevante Differenzialdiagnosen gibt, die teils auch gemeinsam mit einer IAD auftreten können. Hier sind es insbesondere Dekubitus, Kontaktdermatitis und Intertrigo, die abgegrenzt und differenziert behandelt werden müssen. Wirksame Strategien der Prävention und Therapie der IAD sind Kontinenzmanagement, die Verwendung leistungsfähiger, aufsaugender Hilfsmittel sowie konsequenter Hautschutz und -pflege. Die IAD ist eine oft nicht oder falsch diagnostizierte Hauterkrankung, die möglichst frühzeitig, gemeinsam mit den verursachenden Faktoren wie Stuhl- und/oder Harninkontinenz therapiert werden sollte, da es ansonsten zu einer unnötig langen Dauer und Schwere der Beschwerden kommen kann.

Schlüsselwörter

Dekubitus Kontaktdermatitis Intertrigo Hautschutz Kontinenzmanagement 

Incontinence-associated dermatitis: a position paper

Abstract

Incontinence-associated dermatitis (IAD) describes damage to the skin caused by repeated and prolonged contact with urine and/or feces. Patients of all ages can be affected; the diagnosis is preferably used in adults and adolescents. The predilection sites are perineal, perianal, the inner thighs and the convex areas of the buttocks. Increased moisture on the skin surface, increased pH, occlusion, feces digestive enzymes and repeated skin cleansing procedures are pathophysiologically relevant factors. Typical clinical signs of IAD are erythema, erosions, excoriations and pain. Diagnosis is often difficult because there are many relevant differential diagnoses, some of which may occur together with an IAD. In particular, pressure ulcer, contact dermatitis and intertrigo need to be differentiated and treated. Effective strategies of prevention and therapy of IAD are continence management, the use of efficient, absorbent products as well as consistent skin protection and care. IAD is a skin disease that is often not or incorrectly diagnosed. It should be treated as early as possible, together with the causative factors such a fecal and/or urinary incontinence, as otherwise it can lead to an unnecessarily long duration and severity of the symptoms.

Keywords

Pressure ulcer Contact dermatitis Intertrigo Skin protection Continence management 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Kottner, N. Kolbig, A. Bültemann und J. Dissemond geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • J. Kottner
    • 1
    Email author
  • N. Kolbig
    • 2
  • A. Bültemann
    • 3
  • J. Dissemond
    • 4
  1. 1.Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin ScienceCharité Universitätsmedizin BerlinBerlinDeutschland
  2. 2.WundmanagementUniversitätsklinikum DüsseldorfDüsseldorfDeutschland
  3. 3.Abteilung für Gefäß- und endovaskuläre Chirurgie, WundcentrumAsklepios Klinikum Hamburg-HarburgHamburgDeutschland
  4. 4.Klinik für Dermatologie, Venerologie und AllergologieUniversitätsklinikum EssenEssenDeutschland

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