{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:52:54Z","timestamp":1790099574468,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004357","name":"Procter and Gamble","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004357","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare prevalence and severity of diaper dermatitis (DD) in infants and toddlers (babies) across three countries (China, USA, and Germany), including diapered skin measures and caregiver practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study of 1791 babies (~600 from each country) was recruited at each clinical site. Based on regional toilet\u2010training habits, exclusively diaper\u2010wearing infants were recruited between ages 2\u20108\u00a0months in China and 2\u201018\u00a0months in the USA and Germany. DD was measured, as well as skin pH, transepidermal water loss (TEWL), and relative humidity (RH) in the diapered region. Caregiver habits were collected via a questionnaire and included information on hygienic practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Diaper dermatitis was highest in the perianal area, followed by the intertriginous, genital, and buttock regions. In general, DD was significantly lower in babies in China, highest in Germany, and intermediate in the USA. This rank ordering of DD by geography was also observed in baby age 2\u20108\u00a0months. The lower DD observed in China was associated with lower skin pH and TEWL on diapered skin and decreased RH in the diaper. Chinese caregivers had the highest rate of prophylactic topical product usage, the most robust cleaning of the diapered area, lack of cleansing after urine\u2010only diaper changes, and Chinese infants spent the least time in an overnight diaper.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data suggest caregiver behaviors including prophylactic use of topical products, thorough cleaning after stooling and reduced time in an overnight diaper are associated with less DD, lower superficial skin pH, and enhanced skin barrier.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pde.14047","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T21:07:01Z","timestamp":1575320821000},"page":"130-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-8033","authenticated-orcid":false,"given":"Andrew N.","family":"Carr","sequence":"first","affiliation":[{"name":"Procter &amp; Gamble Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Cork","sequence":"additional","affiliation":[{"name":"Sheffield Children\u2019s Hospital and University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-0474","authenticated-orcid":false,"given":"Lawrence F.","family":"Eichenfield","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"F\u00f6lster\u2010Holst","sequence":"additional","affiliation":[{"name":"University of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hohl","sequence":"additional","affiliation":[{"name":"Beaumont Hospital CHUV\u2010UNIL Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred T.","family":"Lane","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Paller","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine Evanston IL USA"},{"name":"Ann and Robert H. Lurie Children\u2019s Hospital Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Pickering","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-8608","authenticated-orcid":false,"given":"Alain","family":"Taieb","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao Y.","family":"Cui","sequence":"additional","affiliation":[{"name":"Beijing United Family Hospital and Clinics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-1854","authenticated-orcid":false,"given":"Zi G.","family":"Xu","sequence":"additional","affiliation":[{"name":"Beijing Children\u2019s Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xeumin","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Skin Disease Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Brink","sequence":"additional","affiliation":[{"name":"Procter &amp; Gamble Schwalbach Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeuqing","family":"Niu","sequence":"additional","affiliation":[{"name":"Procter &amp; Gamble Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Ogle","sequence":"additional","affiliation":[{"name":"Procter &amp; Gamble Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Odio","sequence":"additional","affiliation":[{"name":"Procter &amp; Gamble Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Gibb","sequence":"additional","affiliation":[{"name":"Procter &amp; Gamble Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12245"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2008.00725.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.154.9.943"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1986.tb00513.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2007.00499.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13495"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1994.tb00696.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1986.tb00499.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1986.tb00498.x"},{"key":"e_1_2_7_11_1","first-page":"75","article-title":"Etiology and pathophysiology of diaper dermatitis","volume":"3","author":"Berg RW","year":"1988","journal-title":"Adv Dermatol"},{"key":"e_1_2_7_12_1","first-page":"s27","article-title":"Etiological factors in diaper dermatitis: a model for development of improved diapers","volume":"14","author":"Berg RW","year":"1987","journal-title":"Pediatrician"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13372"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12348"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079904125003575"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2001.tb01519.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000018366"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0926-9959.2001.00002.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2011.08.016"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.13329"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2011.01308.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489515"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489522"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-2494.2006.00344.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1470.2001.01929.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13691"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12819"},{"key":"e_1_2_7_28_1","unstructured":"Prevent and treat diaper rash with tips from dermatologists. American Academy of Dermatology News Release.https:\/\/www.aad.org\/media\/news-releases\/prevent-and-treat-diaper-rash-with-tips-from-dermatologistsPublished December 09 2014 (online). Accessed September 27 2019."}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpde.14047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.14047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.14047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.14047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T22:23:00Z","timestamp":1693347780000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.14047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,2]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1111\/pde.14047"],"URL":"https:\/\/doi.org\/10.1111\/pde.14047","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,2]]},"assertion":[{"value":"2019-12-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}