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It is now established that a number of factors are considered important in the etiology of <jats:styled-content style=\"fixed-case\">IND<\/jats:styled-content>. The principal irritants are fecal enzymes, which damage infant skin and are further amplified by a number of factors, including skin maceration and friction, high <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>, the presence of urine, and the duration of contact with feces. In recent years, the decreasing incidence and severity of <jats:styled-content style=\"fixed-case\">IND<\/jats:styled-content> reflects improvements in the design and performance of diapers, diaper skin care products, and overall awareness about maintaining infant skin health.<\/jats:p>","DOI":"10.1111\/ijd.13334","type":"journal-article","created":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T05:03:41Z","timestamp":1466139821000},"page":"7-9","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Understanding irritant napkin dermatitis"],"prefix":"10.1111","volume":"55","author":[{"given":"David J.","family":"Atherton","sequence":"first","affiliation":[{"name":"Great Ormond Street Hospital for Children London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,17]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"493","article-title":"Getting to the bottom of nappy rash. 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