Irritant Contact Dermatitis Due to Fecal, Urinary, or Dual Incontinence: It Is Time to Focus on Darkly Pigmented Skin

Irritant contact dermatitis due to fecal, urinary, or dual incontinence (ICD-FIUIDI) is a prevalent problem. Inspection of darkly pigmented skin may miss the signs of inflammation of ICD-FIUIDI, resulting in further skin damage and health disparities. In this article, the authors describe best practices for assessing ICD-FIUIDI in the context of diverse skin types using inspection, interview, health record review, and palpation to develop a plan of care; review ICD-FIUIDI prevention and treatment; and include case examples illustrating the application of these methods. The authors also summarize the epidemiology of ICD-FIUIDI and the basis of skin color and inflammation and discuss issues in practice related to the need to improve assessment of ICD-FIUIDI among patients with darkly pigmented skin. They make recommendations for current practice and future research.