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2010

“Poop” Dermatitis Linked To Fashionable Toilet Seats, Harsh Chemicals

MEDIA CONTACT: Ekaterina Pesheva
EMAIL: epeshev1@jhmi.edu
PHONE: (410) 502-9433

January 25, 2010
BernardCohen

Bernard Cohen, M.D.

Considered a dermatological nuisance that was long gone, skin irritations caused by toilet seats appear to be making a comeback in pediatricians’ offices, according to research led by Johns Hopkins Children’s Center investigator Bernard Cohen, M.D.

“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,” says Cohen, director of pediatric dermatology at Hopkins Children’s. “If our small analysis is any indication of what’s happening, we need to make sure the condition is on every pediatrician’s radar.”

Analyzing five cases from the United States and India in the February issue of the journal Pediatrics, Cohen and colleagues said the culprits responsible for the reemergence of the condition are harsh cleaning chemicals and exotic wooden toilet seats — making a comeback as bathroom décor —especially seats covered with varnishes and paints.

Cohen says children can develop irritation after several uses of a wooden seat or repeated exposure to residue from harsh cleaning chemicals. He urges pediatricians to inquire about toilet seats and cleaners used both at home and at school any time they see a toddler or a young child with skin irritation around the buttocks or upper thighs.

The researchers say most cases are fairly benign and easy to treat with topical steroids, but because many pediatricians don’t suspect the cause and don’t treat it properly, the inflammation can persist and spread further, causing painful and itchy skin eruptions and unnecessary misery for both children and parents. Persistently irritated skin is vulnerable to bacteria and may lead to more serious infections requiring oral antibiotics.

Indeed, missed and delayed diagnoses were a hallmark of every single case described in the review.

“Some of the children in our study suffered for years before the correct diagnosis was made,” says lead researcher Ivan Litvinov, Ph.D., of McGill University in Montreal, and a student of Cohen’s.

To prevent toilet-seat dermatitis, Cohen and colleagues recommend:

  • Use of paper toilet seat covers in public restrooms, including hospital and school restrooms
  • Replacing wooden toilet seats with plastic ones
  • Cleaning toilet seats and bowls daily
  • Avoiding harsh store-brand cleaners, which often contain skin irritants like phenol or formaldehyde. Rubbing alcohol and hydrogen peroxide, effective and gentler on the skin, could be used instead.

Dermatologist Paramoo Sugathan, M.D., of Baby Memorial Hospital, Calicut, Kerala, India, was co-investigator in the study.


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Founded in 1912 as the children's hospital of the Johns Hopkins Medicine, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Johns Hopkins Children Center is consistently ranked among the top children's hospitals in the nation by U.S. News & World Report. It is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, visit www.hopkinschildrens.org.