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In an inner city Birmingham district general hospital (Pediatric Dermatology 2007;24:483–8) 16% of children in nappies (diapers) had a nappy rash (diaper dermatitis). The survey included children on the paediatric wards (64%), in the outpatient clinics (17%), and on the neonatal unit (19%). Almost half (48%) of the children had never had a nappy rash. Among children aged 12–24 months 45% had had more than two episodes. Among the 19 neonates with a nappy rash 16 had a neonatal drug withdrawal syndrome because of maternal substance abuse. Current nappy rash was independently associated with oral thrush, number of previous episodes, infrequent nappy changes and diarrhoea. Recurrent episodes were associated with increasing age, non-use of barrier creams, current nappy rash and infrequent nappy changes. Almost all of the children had already been treated outside hospital.

It is anticipated that the large-scale use of human papilloma virus (HPV) vaccines may trigger public scares about vaccine safety when conditions, especially autoimmune diseases, are observed to occur in immunised adolescent girls and young women. Data from the Kaiser Permanente health maintenance organisation in California have been reported (The Pediatric Infectious Disease Journal 2007;26:979–84) in an attempt to forestall possible problems. The cohort study included 436 368 female adolescents and young adults in 2005. Immune-mediated conditions accounted for 10% of all emergency room …

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