A team of pediatricians writing in a leading journal this week suggest that a condition not seen for a long time in the US, toilet seat dermatitis, where skin irritations develop on the buttocks and posterior thighs from contact with toilet seats, could be making a comeback.
Writing in the 25 January online issue of Pediatrics, Dr Bernard Cohen from the Johns Hopkins Children’s Center in Baltimore, Maryland, and colleagues analyze 5 cases of toilet-seat dermatitis in children from the United States and India.
Cohen, who is director of pediatric dermatology at Hopkins Children’s, told the press that:
“Toilet seat dermatitis is one of those legendary conditions described in medical textbooks and seen in underdeveloped countries, but one that younger pediatricians have not come across in their daily practice.”
“If our small analysis is any indication of what’s happening, we need to make sure the condition is on every pediatrician’s radar,” said Cohen.
Cohen and colleagues wrote that in the past, toilet seat dermatitis came from exposure to wooden toilet seats and associated varnish, lacquers and paints. This caused an allergic contact dermatitis to develop on the buttocks and posterior thighs.
They suggest the re-emergence of the condition could be down to the same culprits, because wooden seats, especially those covered with varnishes and paints, appear to be gaining popularity as “exotic” bathroom décor; another cause however, could be harsh cleaning chemicals.
The condition is easily recognized and treated with topical steroids, wrote Cohen and colleagues, but few practitioners consider this diagnosis, resulting in delayed treatment and often a worsening of the skin eruption which spreads and causes painful itching and unnecessary misery for affected children and those caring for them.
Persistently irritated skin is vulnerable to bacteria and can result in more serious infections requiring oral antibiotics. In fact, delayed diagnoses were a hallmark of all 5 cases Cohen and colleagues described.
Lead researcher Dr Ivan Litvinov, of McGill University in Montreal, and a student of Cohen’s, said:
“Some of the children in our study suffered for years before the correct diagnosis was made.”
The researchers said you can prevent toilet seat dermatitis by:
- Using paper toilet seat covers in public facilities, including hospital and school toilets.
- Replacing wooden toilet seats with plastic ones.
- Cleaning toilet seats and bowls every day.
- Not using harsh store-brand cleaners, which often contain skin irritants like phenol or formaldehyde.
- Using rubbing alcohol and hydrogen peroxide instead, because these are still effective but gentler on the skin.
Cohen said children can start showing signs of irritation after several uses of a wooden seat or one that has been cleaned with harsh chemicals.
He and his team urge practitioners to ask about use of toilet seats and cleaners at home and at school when they see a young child or toddler with irritated skin around the buttocks or upper thighs.
“Recognizing and Treating Toilet-Seat Contact Dermatitis in Children.”
Ivan V. Litvinov, Paramoo Sugathan, and Bernard A. Cohen.
Pediatrics, Published online January 25, 2010.
Source: Johns Hopkins Children’s Center.
Written by: Catharine Paddock, PhD