{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:47:19Z","timestamp":1777513639429,"version":"3.51.4"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Atopic dermatitis (AD) is a chronic, inflammatory skin condition commonly affecting infants with notable sparing of the diaper region. Though sources anecdotally attribute this sparing to the physical barrier formed by the diaper and the subsequent retention of moisture, urine, sweat and feces, no studies have formally investigated the factors contributing to this sparing phenomenon. We performed a scoping literature review to investigate the factors involved in sparing of AD in the diaper region, namely humidity, scratching, urine, sweat, feces, and microbiome composition. A total of 130 papers met the inclusion criteria, and extracted data were analyzed in an iterative manner. Increased local humidity facilitates protective changes at the cellular level and offsets transepidermal water loss. Exposure to urea from both sweat and urine may contribute to improved moisturization of the skin through its natural humectant properties and ability to modulate gene expression. Introduction of flora in feces contributes to the generation of protective immune responses and outcompetes growth of pathogens such as Staphylococcus aureus. Finally, diapers physically prevent scratching, which directly interrupts the itch-scratch cycle classically implicated in AD. Our study reviews factors that may contribute to the sparing of AD in the diaper region in infants. A limitation to our findings is that the studies reviewed here explore the impacts of these factors on AD broadly, and not explicitly in the diaper region. Additional studies investigating this may further our understanding of AD pathogenesis and contribute to the development of effective therapeutics.<\/jats:p>","DOI":"10.1177\/12034754221088533","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T21:21:47Z","timestamp":1647984107000},"page":"398-403","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Potential Mechanisms of the Sparing of Atopic Dermatitis in the Diaper Region: A Scoping Review"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6478-6394","authenticated-orcid":false,"given":"Aria","family":"Jazdarehee","sequence":"first","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada"},{"name":"Kamloops Dermatology, Kamloops, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilya","family":"Mukovozov","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"bibr1-12034754221088533","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31286-1"},{"key":"bibr2-12034754221088533","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19580"},{"key":"bibr3-12034754221088533","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-64804-0_3"},{"key":"bibr4-12034754221088533","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2012.33.3553"},{"issue":"8","key":"bibr5-12034754221088533","first-page":"9.","volume":"23","author":"Avena-Woods C.","year":"2017","journal-title":"The American Journal of Managed Care"},{"key":"bibr6-12034754221088533","doi-asserted-by":"publisher","DOI":"10.3390\/jcm4050884"},{"key":"bibr7-12034754221088533","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13484"},{"key":"bibr8-12034754221088533","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-64804-0_4"},{"key":"bibr9-12034754221088533","volume-title":"Atopic Eczema in children: management of atopic Eczema in children from birth up to the age of 12 years","author":"National Collaborating Centre for Women\u2019s and Children\u2019s","year":"2007"},{"key":"bibr10-12034754221088533","unstructured":"Horii K. 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