Irritant Contact Dermatitis Due to Fecal, Urinary, or Dual Incontinence: It Is Time to Focus on Darkly Pigmented Skin

Adv Skin Wound Care. 2024 Nov-Dec;37(11&12):579-593. doi: 10.1097/ASW.0000000000000238.

Abstract

General purpose: To review best practices related to the assessment of irritant contact dermatitis due to fecal, urinary, or dual incontinence (ICD-FIUIDI) among patients with darkly pigmented skin.

Target audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

Learning objectives/outcomes: After participating in this educational activity, the participant will:1. Identify risk factors for the development of ICD-FIUIDI.2. Describe clinical features and manifestations of ICD-FIUIDI.3. Propose recommendations to improve care related to ICD-FIUIDI.

Plain language summary

Irritant contact dermatitis due to fecal, urinary, or dual incontinence (ICD-FIUIDI) is a prevalent problem. Inspection of darkly pigmented skin may miss the signs of inflammation of ICD-FIUIDI, resulting in further skin damage and health disparities. In this article, the authors describe best practices for assessing ICD-FIUIDI in the context of diverse skin types using inspection, interview, health record review, and palpation to develop a plan of care; review ICD-FIUIDI prevention and treatment; and include case examples illustrating the application of these methods. The authors also summarize the epidemiology of ICD-FIUIDI and the basis of skin color and inflammation and discuss issues in practice related to the need to improve assessment of ICD-FIUIDI among patients with darkly pigmented skin. They make recommendations for current practice and future research.

Publication types

  • Review

MeSH terms

  • Dermatitis, Contact / diagnosis
  • Dermatitis, Contact / etiology
  • Dermatitis, Irritant* / diagnosis
  • Dermatitis, Irritant* / etiology
  • Fecal Incontinence*
  • Female
  • Humans
  • Male
  • Risk Factors
  • Skin Pigmentation
  • Urinary Incontinence*