{ "schema_version": 1, "kind": "condition", "id": "nappy-rash", "name": "Nappy Rash (Diaper dermatitis)", "category": "chronic", "sources": "NICE Clinical Knowledge Summaries Nappy Rash 2021 · No labelled dose - barrier preparation applied to intact skin, to effect · Egyptian National Drug Formulary, antimicrobial 2023, nystatin monograph, topical mucocutaneous candidiasis · Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) · Diaper Dermatitis - StatPearls - NCBI Bookshelf (NBK559067), with the form and indication from Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph)", "review_status": "reviewed", "verified_against": "No labelled dose - barrier preparation applied to intact skin, to effect · Egyptian National Drug Formulary, antimicrobial 2023, nystatin monograph, topical mucocutaneous candidiasis · Nappy Rash (Diaper dermatitis) - disease-level clinical article (nappy-rash-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1241, "generic": "Zinc oxide", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply barrier paste thickly at every diaper change after cleaning", "adult_duration": "until skin heals", "dose_source": "No labelled dose - barrier preparation applied to intact skin, to effect", "rationale": "Barrier protectant applied to shield irritated skin from the moisture and friction of nappies; first-line management for uncomplicated nappy rash.", "cautions": [ "First line management is frequent nappy changes, nappy-free time, and gentle cleansing with water.", "Avoid alcohol wipes and scented soaps.", "If satellite lesions or persistent rash >3 days, suspect secondary Candida infection." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply thickly at every nappy change after washing and thorough drying", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NAPI-CARE OINT.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 2.35, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENTADIAPER 20% TOPICAL CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA > PENTA PHARMA", "price_egp": 3.5, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BABY RASH FREE 30% OINT.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA > MILLENIUM PHARMA-EGYPT", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EVA BABY CARE CREAM 50 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 9.75, "pack_count": null, "unit_price": null, "strength_mg": 50000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BALMIX 10% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 14.4, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NONOPENT CREAM 75 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> PENTA PHARMA", "price_egp": 100.0, "pack_count": null, "unit_price": null, "strength_mg": 75000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NINO SERENO CREAM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE > GMCKS", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nappy-rash" }, { "id": 1242, "generic": "Nystatin", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply 100,000 units/g cream to the affected area twice daily", "adult_duration": "7-14 days (continue 48 hrs after rash resolves)", "dose_source": "Egyptian National Drug Formulary, antimicrobial 2023, nystatin monograph, topical mucocutaneous candidiasis", "rationale": "Topical polyene antifungal that binds fungal cell membrane sterols, used when nappy rash develops the beefy red, satellite-pustule appearance of secondary candidal infection.", "cautions": [ "Indicated for candidal diaper dermatitis (beefy red rash, involvement of skin folds, satellite pustules).", "Apply antifungal first, then barrier paste over it.", "Exclude oral thrush which may re-infect digestive tract." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply the 100,000 units/g cream twice daily under a barrier cream for candidal nappy rash, 7-14 days, continuing 48 hours past the rash clearing.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NOCANDIDA 10 M.I.U. CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.25, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nappy-rash" }, { "id": 1244, "generic": "Clotrimazole", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply the 1% cream or solution thinly to the affected skin twice a day", "adult_duration": "7 to 10 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) - verbatim: \"Cutaneous candidiasis: Topical: Cream, solution: Apply to affected area twice daily; if no improvement occurs after 4 weeks of therapy, re-evaluate diagnosis.\"; the 7 to 10 day course is from Diaper Dermatitis - StatPearls - NCBI Bookshelf (NBK559067)", "rationale": "Candida colonises broken nappy skin, and the article says to move to an azole when nystatin has not helped within a few days. Clotrimazole is the cheapest and most widely stocked plain azole cream in Egypt.", "cautions": [ "Reconsider the diagnosis if the rash has not improved by the end of the course - a persisting nappy rash may be psoriasis, seborrhoeic dermatitis, scabies or bacterial infection rather than candida.", "Do not use if the child has reacted to a topical azole before.", "Prescribe the plain cream, not a betamethasone-clotrimazole combination - a potent steroid under an occlusive nappy thins the skin." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The child is the patient here. Same twice-daily application for 7 to 10 days; apply thinly and leave the area open to air where you can.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "CANEMAZOLE 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 1% TOPICAL CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ARAB DRUG COMPANY (ADCO)", "price_egp": 7.25, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMATIN 1% TOP. CREAM 14 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 14000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANESTEN 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > BAYER HEALTHCARE", "price_egp": 29.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 29.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 1% TOPICAL CREAM 40 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ARAB DRUG COMPANY (ADCO)", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 40000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nappy-rash" }, { "id": 1245, "generic": "Miconazole", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply the 2% cream thinly to the affected skin twice a day", "adult_duration": "7 to 10 days", "dose_source": "Diaper Dermatitis - StatPearls - NCBI Bookshelf (NBK559067), with the form and indication from Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph)", "rationale": "Interchangeable with clotrimazole for candida nappy rash and just as cheap in Egypt. Useful when a breastfed pair is already using miconazole in the mouth, since the same 2% strength treats the skin.", "cautions": [ "Reconsider the diagnosis if the rash has not settled by the end of the course.", "Do not use if the child has reacted to a topical azole before.", "Prescribe plain miconazole cream rather than the hydrocortisone-miconazole combination for occluded nappy skin." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The child is the patient. Twice-daily application for 7 to 10 days. Use the skin cream on the nappy area, not the oral gel.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "MICONOL 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERMOZOL 2% GEL 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 6.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICO ORAL 2% ORAL GEL 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 6.25, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUCCAZOLE 2% ORAL GEL 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICONAZ 2% ORAL GEL 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 23.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DAKTARIN 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > JANSSEN CILAG", "price_egp": 28.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DAKTARIN 2% ORAL GEL 40 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JANSSEN CILAG > SOFICOPHARM", "price_egp": 53.5, "pack_count": null, "unit_price": null, "strength_mg": 40000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOZOLE 2% TOPICAL CR. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 7.25, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nappy-rash" }, { "id": 1243, "generic": "Hydrocortisone", "line": 2, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Hydrocortisone 0.5% 2 times a day for one week", "adult_duration": "1 week", "dose_source": "Nappy Rash (Diaper dermatitis) - disease-level clinical article (nappy-rash-clinical.txt)", "rationale": "Short course of low-potency topical corticosteroid to reduce inflammation in moderate-to-severe diaper dermatitis or when non-pharmacologic barrier measures fail after 2-3 days.", "cautions": [ "Use low-potency formulations (e.g. 0.5%) for a short duration (maximum 7 days) to avoid skin atrophy and systemic absorption.", "Do not use under tight-fitting diapers or occlusive dressings without medical supervision." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply Hydrocortisone 0.5% 2 times a day for 1 week for moderate-to-severe diaper dermatitis or when barrier measures fail after 2-3 days.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NOVACORTIN 1% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVACORTIN 1% OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICORT 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 12.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYDROCORTISONE 1% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nappy-rash" } ] }