Dermite irritative érythémateuse (érythème fessier du nourrisson)

<table border="1" cellpadding="5"><tbody><tr><th colspan="3">Diagnostic&nbsp;<strong>(<a href="https://www.ordotype.fr/liens-utiles/erytheme-fessier-image" target="_blank" rel="noopener">image</a>)</strong></th></tr><tr><td colspan="3"><ul><li>Principale cause d'&eacute;ryth&egrave;me fessier du nourrisson,</li><li>Irritation des fesses,</li><li>Localisation initiale aux zones convexes, <strong>&eacute;pargnant les plis</strong> (dont le sillon interfessier), en "W",</li><li>L&eacute;sions li&eacute;es &agrave; la mac&eacute;ration de la peau en contact prolong&eacute; ou fr&eacute;quent avec les couches souill&eacute;es.</li></ul></td></tr><tr><th colspan="3"><strong>Traitement (<a href="https://www.ordotype.fr/ordonnances-types/erytheme-fessier-simple" target="_blank" rel="noopener">ordonnance</a>)</strong></th></tr><tr><td colspan="3"><ul><li>&Eacute;ducation des parents (<a href="https://www.ordotype.fr/recommandations/erytheme-fessier-du-nourrisson" target="_blank" rel="noopener">version imprimable</a>),</li><li data-w-id="0a2524c7-874c-2e8f-e2a9-2f7482b50b99" data-wf-id="[&quot;0a2524c7-874c-2e8f-e2a9-2f7482b50b99&quot;]" data-automation-id="dyn-item-diagnostics-input">Hygi&egrave;ne du si&egrave;ge,</li><li data-w-id="94971969-9bbb-a215-9fd2-00a8b149d7bb" data-wf-id="[&quot;94971969-9bbb-a215-9fd2-00a8b149d7bb&quot;]" data-automation-id="dyn-item-diagnostics-input">Bonne utilisation des couches,</li><li data-w-id="6cd6ae19-dccb-8824-0bcf-0d82b54197c1" data-wf-id="[&quot;6cd6ae19-dccb-8824-0bcf-0d82b54197c1&quot;]" data-automation-id="dyn-item-diagnostics-input">Protection cutan&eacute;e.</li></ul>En cas de doute ou d'&eacute;chec du traitement : avis sp&eacute;cialis&eacute;.</td></tr><tr><th style="text-align: center;" colspan="3">&nbsp;<strong>Diagnostics diff&eacute;rentiels</strong></th></tr><tr><td style="background-color: #bef2d3; text-align: center;"><strong>Famille</strong></td><td style="background-color: #bef2d3; text-align: center;"><strong>Signes d'orientation</strong></td><td style="background-color: #bef2d3; text-align: center;"><strong>&Eacute;tiologies</strong></td></tr><tr><td style="text-align: center;"><strong>Dermites irritatives&nbsp;</strong></td><td style="text-align: center;">Atteinte initiale des zones convexes</td><td><ul><li data-w-id="9112e88e-889d-8097-cfa8-625d1099fc19" data-wf-id="[&quot;9112e88e-889d-8097-cfa8-625d1099fc19&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermite v&eacute;siculo-pustuleuse,</li><li data-w-id="32e09773-3e08-2872-6817-61ecd63ff1d7" data-wf-id="[&quot;32e09773-3e08-2872-6817-61ecd63ff1d7&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermite nodulaire.</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermites infectieuses&nbsp;</strong></td><td style="text-align: center;">Atteinte initiale des plis</td><td><ul><li data-w-id="8dfa9192-14fe-48bf-9afa-16ffba2be046" data-wf-id="[&quot;8dfa9192-14fe-48bf-9afa-16ffba2be046&quot;]" data-automation-id="dyn-item-diagnostics-input">Mycose du si&egrave;ge (intertrigo &agrave; <em data-w-id="1750b3d7-b58e-ef91-240a-e3c595e7f30b" data-wf-id="[&quot;1750b3d7-b58e-ef91-240a-e3c595e7f30b&quot;]" data-automation-id="dyn-item-diagnostics-input">C. albicans,</em>&nbsp;voir <a href="https://www.ordotype.fr/pathologies/intertrigos" target="_blank" rel="noopener">fiche</a>),</li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Anite streptococcique :<ul><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Atteinte p&eacute;ri-anale +&nbsp;<strong data-w-id="b86de023-1f70-75d1-6cc8-a31cf7349885" data-wf-id="[&quot;b86de023-1f70-75d1-6cc8-a31cf7349885&quot;]" data-automation-id="dyn-item-diagnostics-input">fi&egrave;vre</strong></li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">&Agrave; traiter comme une dermo-hypodermite (voir <a href="https://www.ordotype.fr/pathologies/erysipele" target="_blank" rel="noopener">fiche</a>),</li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Faire un pr&eacute;l&egrave;vement bact&eacute;riologique (streptocoque &beta;-h&eacute;molytique).</li></ul></li><li data-w-id="09f5452a-3c6a-5f0f-1e22-322df8339da0" data-wf-id="[&quot;09f5452a-3c6a-5f0f-1e22-322df8339da0&quot;]" data-automation-id="dyn-item-diagnostics-input">Autres infections (pieds-mains-bouche...).</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermatoses inflammatoires</strong></td><td style="text-align: center;">Pr&eacute;sence de l&eacute;sions en dehors du si&egrave;ge</td><td><ul><li data-w-id="f882a355-bf86-02d4-8dc1-38fccbfceae1" data-wf-id="[&quot;f882a355-bf86-02d4-8dc1-38fccbfceae1&quot;]" data-automation-id="dyn-item-diagnostics-input">Psoriasis,</li><li data-w-id="f882a355-bf86-02d4-8dc1-38fccbfceae1" data-wf-id="[&quot;f882a355-bf86-02d4-8dc1-38fccbfceae1&quot;]" data-automation-id="dyn-item-diagnostics-input">Ecz&eacute;ma,</li><li data-w-id="c472be8f-e874-2995-fe9d-05391d0bc1c0" data-wf-id="[&quot;c472be8f-e874-2995-fe9d-05391d0bc1c0&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermatite s&eacute;borrh&eacute;ique du si&egrave;ge (squames grasses).</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermatites associ&eacute;es &agrave; une maladie g&eacute;n&eacute;rale&nbsp;</strong></td><td style="text-align: center;">Pr&eacute;sence d'autres sympt&ocirc;mes</td><td><ul><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Acrodermatite ent&eacute;ropathique :<ul><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">&Eacute;ruption &eacute;ryth&eacute;mato-squameuse autour du visage et du si&egrave;ge +/- diarrh&eacute;e +/- alop&eacute;cie,</li><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Apparition au sevrage en lait maternel,</li><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Li&eacute;e &agrave; une carence en zinc (&agrave; doser en cas de suspicion mais ne pas attendre les r&eacute;sultats pour d&eacute;buter une suppl&eacute;mentation).</li></ul></li><li data-w-id="244fc203-9da6-c4c9-fd96-544898ecd049" data-wf-id="[&quot;244fc203-9da6-c4c9-fd96-544898ecd049&quot;]" data-automation-id="dyn-item-diagnostics-input">Histiocytose langerhansienne (diagnostic &agrave; la biopsie).</li></ul></td></tr></tbody></table>‍

<table border="1" cellpadding="5"><tbody><tr><th colspan="3">Diagnostic&nbsp;<strong>(<a href="https://www.ordotype.fr/liens-utiles/erytheme-fessier-image" target="_blank" rel="noopener">image</a>)</strong></th></tr><tr><td colspan="3"><ul><li>Principale cause d'&eacute;ryth&egrave;me fessier du nourrisson,</li><li>Irritation des fesses,</li><li>Localisation initiale aux zones convexes, <strong>&eacute;pargnant les plis</strong> (dont le sillon interfessier), en "W",</li><li>L&eacute;sions li&eacute;es &agrave; la mac&eacute;ration de la peau en contact prolong&eacute; ou fr&eacute;quent avec les couches souill&eacute;es.</li></ul></td></tr><tr><th colspan="3"><strong>Traitement (<a href="https://www.ordotype.fr/ordonnances-types/erytheme-fessier-simple" target="_blank" rel="noopener">ordonnance</a>)</strong></th></tr><tr><td colspan="3"><ul><li>&Eacute;ducation des parents (<a href="https://www.ordotype.fr/recommandations/erytheme-fessier-du-nourrisson" target="_blank" rel="noopener">version imprimable</a>),</li><li data-w-id="0a2524c7-874c-2e8f-e2a9-2f7482b50b99" data-wf-id="[&quot;0a2524c7-874c-2e8f-e2a9-2f7482b50b99&quot;]" data-automation-id="dyn-item-diagnostics-input">Hygi&egrave;ne du si&egrave;ge,</li><li data-w-id="94971969-9bbb-a215-9fd2-00a8b149d7bb" data-wf-id="[&quot;94971969-9bbb-a215-9fd2-00a8b149d7bb&quot;]" data-automation-id="dyn-item-diagnostics-input">Bonne utilisation des couches,</li><li data-w-id="6cd6ae19-dccb-8824-0bcf-0d82b54197c1" data-wf-id="[&quot;6cd6ae19-dccb-8824-0bcf-0d82b54197c1&quot;]" data-automation-id="dyn-item-diagnostics-input">Protection cutan&eacute;e.</li></ul>En cas de doute ou d'&eacute;chec du traitement : avis sp&eacute;cialis&eacute;.</td></tr><tr><th style="text-align: center;" colspan="3">&nbsp;<strong>Diagnostics diff&eacute;rentiels</strong></th></tr><tr><td style="background-color: #bef2d3; text-align: center;"><strong>Famille</strong></td><td style="background-color: #bef2d3; text-align: center;"><strong>Signes d'orientation</strong></td><td style="background-color: #bef2d3; text-align: center;"><strong>&Eacute;tiologies</strong></td></tr><tr><td style="text-align: center;"><strong>Dermites irritatives&nbsp;</strong></td><td style="text-align: center;">Atteinte initiale des zones convexes</td><td><ul><li data-w-id="9112e88e-889d-8097-cfa8-625d1099fc19" data-wf-id="[&quot;9112e88e-889d-8097-cfa8-625d1099fc19&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermite v&eacute;siculo-pustuleuse,</li><li data-w-id="32e09773-3e08-2872-6817-61ecd63ff1d7" data-wf-id="[&quot;32e09773-3e08-2872-6817-61ecd63ff1d7&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermite nodulaire.</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermites infectieuses&nbsp;</strong></td><td style="text-align: center;">Atteinte initiale des plis</td><td><ul><li data-w-id="8dfa9192-14fe-48bf-9afa-16ffba2be046" data-wf-id="[&quot;8dfa9192-14fe-48bf-9afa-16ffba2be046&quot;]" data-automation-id="dyn-item-diagnostics-input">Mycose du si&egrave;ge (intertrigo &agrave; <em data-w-id="1750b3d7-b58e-ef91-240a-e3c595e7f30b" data-wf-id="[&quot;1750b3d7-b58e-ef91-240a-e3c595e7f30b&quot;]" data-automation-id="dyn-item-diagnostics-input">C. albicans,</em>&nbsp;voir <a href="https://www.ordotype.fr/pathologies/intertrigos" target="_blank" rel="noopener">fiche</a>),</li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Anite streptococcique :<ul><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Atteinte p&eacute;ri-anale +&nbsp;<strong data-w-id="b86de023-1f70-75d1-6cc8-a31cf7349885" data-wf-id="[&quot;b86de023-1f70-75d1-6cc8-a31cf7349885&quot;]" data-automation-id="dyn-item-diagnostics-input">fi&egrave;vre</strong></li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">&Agrave; traiter comme une dermo-hypodermite (voir <a href="https://www.ordotype.fr/pathologies/erysipele" target="_blank" rel="noopener">fiche</a>),</li><li data-w-id="7f99292d-5893-8cf6-a375-2a7a49f7ad49" data-wf-id="[&quot;7f99292d-5893-8cf6-a375-2a7a49f7ad49&quot;]" data-automation-id="dyn-item-diagnostics-input">Faire un pr&eacute;l&egrave;vement bact&eacute;riologique (streptocoque &beta;-h&eacute;molytique).</li></ul></li><li data-w-id="09f5452a-3c6a-5f0f-1e22-322df8339da0" data-wf-id="[&quot;09f5452a-3c6a-5f0f-1e22-322df8339da0&quot;]" data-automation-id="dyn-item-diagnostics-input">Autres infections (pieds-mains-bouche...).</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermatoses inflammatoires</strong></td><td style="text-align: center;">Pr&eacute;sence de l&eacute;sions en dehors du si&egrave;ge</td><td><ul><li data-w-id="f882a355-bf86-02d4-8dc1-38fccbfceae1" data-wf-id="[&quot;f882a355-bf86-02d4-8dc1-38fccbfceae1&quot;]" data-automation-id="dyn-item-diagnostics-input">Psoriasis,</li><li data-w-id="f882a355-bf86-02d4-8dc1-38fccbfceae1" data-wf-id="[&quot;f882a355-bf86-02d4-8dc1-38fccbfceae1&quot;]" data-automation-id="dyn-item-diagnostics-input">Ecz&eacute;ma,</li><li data-w-id="c472be8f-e874-2995-fe9d-05391d0bc1c0" data-wf-id="[&quot;c472be8f-e874-2995-fe9d-05391d0bc1c0&quot;]" data-automation-id="dyn-item-diagnostics-input">Dermatite s&eacute;borrh&eacute;ique du si&egrave;ge (squames grasses).</li></ul></td></tr><tr><td style="text-align: center;"><strong>Dermatites associ&eacute;es &agrave; une maladie g&eacute;n&eacute;rale&nbsp;</strong></td><td style="text-align: center;">Pr&eacute;sence d'autres sympt&ocirc;mes</td><td><ul><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Acrodermatite ent&eacute;ropathique :<ul><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">&Eacute;ruption &eacute;ryth&eacute;mato-squameuse autour du visage et du si&egrave;ge +/- diarrh&eacute;e +/- alop&eacute;cie,</li><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Apparition au sevrage en lait maternel,</li><li data-w-id="964fc46d-b3e4-ed1f-4531-0bec9cb79973" data-wf-id="[&quot;964fc46d-b3e4-ed1f-4531-0bec9cb79973&quot;]" data-automation-id="dyn-item-diagnostics-input">Li&eacute;e &agrave; une carence en zinc (&agrave; doser en cas de suspicion mais ne pas attendre les r&eacute;sultats pour d&eacute;buter une suppl&eacute;mentation).</li></ul></li><li data-w-id="244fc203-9da6-c4c9-fd96-544898ecd049" data-wf-id="[&quot;244fc203-9da6-c4c9-fd96-544898ecd049&quot;]" data-automation-id="dyn-item-diagnostics-input">Histiocytose langerhansienne (diagnostic &agrave; la biopsie).</li></ul></td></tr></tbody></table>‍