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Incontinence-associated Dermatitis: A Consensus

Gray, Mikel; Bliss, Donna Z.; Doughty, Dorothy B.; Ermer-Seltun, JoAnn; Kennedy-Evans, Karen L.; Palmer, Mary H.

Section Editor(s): Doughty, Dorothy MN, RN, FNP, CWOCN, FAAN

Journal of Wound, Ostomy and Continence Nursing: January-February 2007 - Volume 34 - Issue 1 - p 45–54

Incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin. Little research has focused on IAD, resulting in significant gaps in our understanding of its epidemiology, natural history, etiology, and pathophysiology. A growing number of studies have examined clinical and economic outcomes associated with prevention strategies, but less research exists concerning the efficacy of various treatments. In the clinical and research settings, IAD is often combined with skin damage caused by pressure and shear or related factors, sometimes leading to confusion among clinicians concerning its etiology and diagnosis. This article reviews existing literature related to IAD, outlines strategies for assessing, preventing, and treating IAD, and provides suggestions for additional research needed to enhance our understanding and management of this common but under-reported and understudied skin disorder.

Mikel Gray, PhD, CUNP, CCCN, FAAN, Professor and Nurse Practitioner, Department of Urology, University of Virginia, Charlottesville.

Donna Z. Bliss, PhD, RN, CCRN, Professor, University of Minnesota, School of Nursing, Minneapolis.

Dorothy B. Doughty, MN, RN, CWOCN, FAAN, Director of the Wound, Ostomy Continence Nursing Education Center, Emory University, Atlanta, Ga.

JoAnn Ermer-Seltun, RN, MS, ARNP, CWOCN, Mercy Medical Center North Iowa, Women's Health Center—Continence Clinic, Forest Park Building, Mason City, Iowa.

Karen L. Kennedy-Evans, RN, CS, FNP, K. L. Kennedy Inc., Tucson, Ariz.

Mary H. Palmer, PhD, RN, FAAN, Helen W. & Thomas L. Umphlet Distinguished Professor in Aging, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC.

Corresponding author: Mikel Gray, PhD, CUNP, CCCN, FAAN, Department of Urology, University of Virginia, PO Box 800422, Charlottesville, VA 22908 (e-mail:

Copyright © 2007 by the Wound, Ostomy and Continence Nurses Society