Napkin dermatitis refers to a collection of common disorders affecting the napkin area. Napkin dermatitis includes a range of conditions including irritant dermatitis, Candida napkin dermatitis, erosive napkin dermatitis and allergic contact dermatitis. Napkin area involvement may also be the presenting sign for napkin psoriasis or Kawasaki disease, and may rarely be an indicator of child abuse.

Primary irritant napkin or diaper dermatitis may over time evolve into secondary Candida napkin dermatitis or erosive napkin dermatitis. Allergic forms of contact dermatitis in the napkin area may be difficult to distinguish from irritant napkin dermatitis, although clinically allergic contact dermatitis is often pruritic rather than sore, and unusual patterns corresponding to specific components of the napkin may indicate an aetiology. Napkin psoriasis may be the presenting sign of psoriasis during infancy, and in older children is often the initial manifestation of Kawasaki disease.

This chapter focuses on a description of the clinical features, aetiology and treatment of napkin dermatitis.