Incontinence-associated dermatitis (IAD), sometimes referred to as pcrineal dermatitis, is an inHam-
mation of the skin associated with exposure to urine or stool. Elderly adults, and especially those in long-
term care facilities, are at risk for urinary or fecal incontinence and IAD. Traditionally, IAD has received
little attention as a distinct disorder, and it is sometimes confused with stage I or II pressure ulcers. However.,
a modest but growing body of research is beginning to provide insights into the epidemiology, etiology, and
piithophysioiogy of IAD. In addition, recent changes in reimbursement policies from the US Center for
Medicare and Medicaid Services regarding pressure ulcer prevention has focused attention on the differ-
ential diagnosis of IAD versus pressure ulcer, and its influence on pressure ulcer risk. Color, location, depth,
and the presence or absence of necrotic tissue are visual indicators used to differentiate IAD from pressure-
related skin damage. Prevention is based on avoiding or minimizing exposure to stool or urine combined
with a structured skin-care program based on principles ofgentle cleansing, moisturimtion, preferably with
an emollient, and application of a skin protectant. Treatment of IAD focuses on three main goals: