Napkin psoriasis

Napkin psoriasis is characterised by persistent, well-defined, shiny, bright red plaques in the nappy area, which may then be followed by an explosive psoriasiform eruption on the face and trunk. The skin folds are often affected.

The condition may be preceded by a recent viral or bacterial infection (particularly streptococcal infection), and the nappy eruption may be triggered by a preceding skin injury from irritant dermatitis or candidal infection (known as the Köbner phenomenon). There is frequently a family history of psoriasis.

For plaques in the nappy area, treat as for irritant nappy rash.

For plaques on the face and trunk, apply a topical corticosteroid. Use:

If the rash and plaques persist for longer, refer to a dermatologist for assessment because this may indicate chronic psoriasis.