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A Novel Approach to Treating Moderate to Severe Incontinence-Associated Dermatitis and Intertriginous Dermatitis

A Case Series

Tammel, Karyl; Benike, Deborah; Sievers, Beth

Journal of Wound Ostomy & Continence Nursing: September/October 2019 - Volume 46 - Issue 5 - p 446–452
doi: 10.1097/WON.0000000000000564
Challenges in Practice

BACKGROUND: Patients with moderate to severe incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) often experience pain that negatively affects activities of daily living. While traditional treatments, such as skin protectants including ointment or cream-based products, cyanoacrylate-based monomers, and wicking agents, help some patients, those with moderate to severe cases require more aggressive treatments to accelerate healing.

CASE SERIES: This article describes a series of 4 hospitalized patients who presented with moderate to severe IAD and/or ITD with and without fungal infections. These patients were treated with therapies that went beyond routine skin care regimens, which included treatment with a combination of 0.25% acetic acid, a topical steroid agent, or a topical antifungal when necessary. The patients included a 74-year-old woman admitted with hypovolemic shock, an 82-year-old obese woman with pulmonary hypertension and heart failure, an 80-year-old woman with medically complicated obesity, and a 54-year-old morbidly obese woman admitted with sepsis.

CONCLUSION: The outcome achieved using this novel approach was successful in treating moderate to severe IAD and ITD in these cases.

Karyl Tammel, MS, APRN, CNS, Mayo Clinic, Rochester, Minnesota.

Deborah Benike, MS, APRN, CNS, Mayo Clinic, Rochester, Minnesota.

Beth Sievers, MS, APRN, CNS, CWCN, Mayo Clinic, Rochester, Minnesota.

Correspondence: Beth Sievers, MS, APRN, CNS, CWCN, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (

The authors declare no conflicts of interest and no funding was received during the execution of this project.

© 2019 by the Wound, Ostomy and Continence Nurses Society.