The efficacy of topical camphorated oil in long-term care of residents with incontinence-associated dermatitis

Candida albicans is the most prevalent human fungal commensal organism and is reported to be the most frequent aetiological agent of incontinence-associated dermatitis (IAD). However, it remains unclear whether incontinence predisposes a patient to increased Candida colonisation or whether incontinence acts as a trigger for Candida infection in those already colonised. For this reason, understanding the epidemiology of IAD and accurately estimating Candida colonisation is necessary [1]. Candida infection commonly presents with a central maculopapular rash, characteristic satellite lesions at the margins, non-specific confluent papules, erythematous, and scaly plaques with maceration and oedema, sometimes with pustules and erosion in severe cases [1, 2].
In most cases, laboratory investigations are not necessary, except for mycological cultures of swabs [3]. Superinfection or infection by Candida albicans seem to be so frequent that it may be reasonable to propose a biopsy only when antifungal treatment and routine skin care fail. Biopsy and histopathological examinations are often nonspecific, even in cases of psoriasis or eczema [4].
Treatment goals include protecting the skin from further exposure to irritants, establishing a healing environment, and eradicating any cutaneous infections [5]. The general characteristics of the ideal product for the prevention and management of IAD were formulated in 2015 by the Global IAD Expert Panel. Such a product should be clinically effective and cost effective, have low irritant potential, be compatible with other products used, transparent, and easily removed for skin inspection [6]. After searching for a topical product that would have the impact in the prevention and management of IAD, an official Camphorated oil was proposed for use.
This study aimed at investigating the efficacy of camphorated oil in the skin care of long-term care residents with IAD.
This prospective, observational study included 134 consecutive adult patients who were hospitalised in long-term care units between July 2014 and March 2017 and were diagnosed with IAD. The mean age was 77 years (range 36–92). The cohort included 83 (61.9%) women. All patients had urinary incontinence, while 48 residents (35.8%) had double urinary and faecal incontinence.
Patients with IAD were randomly divided into a study group (n = 104) and a control group (n = 30). In patients from the study group, local application of...


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