Clinical differential diagnosis between incontinence-associated dermatitis and pressure ulcers

Characteristic	IAD	Pressure ulcer
Color	Bright red in persons with lighter skin tones and subtle red in persons with darker skin tones	Deep red (maroon) to reddish or bluish purple in suspected deep tissue injury
Location	Perineal or perigenital skin, especially near anus, in skin folds or underneath absorptive incontinence product such as underpad or body-worn brief	Typically found over bony prominence
Lesions	One or more islands or erosion to extensive denudation of epidermis and dermis	Varies from partial thickness to full thickness wounds
Borders	Diffuse	Demarcated
Necrotic tissue	None	Black eschar or yellow slough may be present
Exudate	None or clear, serous exudate	Volume varies; high-volume purulent exudate seen in some cases
Symptoms	Burning pain, itching	Pain and itching, may be exacerbated by dressing change

IAD: incontinence-associated dermatitis.

From: Gray M, Beeckman D, Bliss DZ, et al. Incontinence-associated dermatitis: a comprehensive review and update. J Wound Ostomy Continence Nurs 2012; 39:61. DOI: 10.1097/WON.0b013e31823fe246. Copyright © 2012 Wound, Ostomy and Continence Nurses Society. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

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Clinical differential diagnosis between incontinence-associated dermatitis and pressure ulcers