Which of the following skin complications is associated with ammonia exposure from incontinence in spina bifida?

• A. Ammonia Burns From Incontinence
• B. Frostbite
• C. Pressure Ulcers Only At Heels
• D. Sunburn

Answer: (A)

Ammonia exposure from incontinence causes a chemical irritation on the skin, leading to a burn-like dermatitis. In people with spina bifida, neurogenic bladder often results in incontinence, so urine can sit on the skin around the diaper area. Urea in urine is converted to ammonia by bacteria, raising the pH and creating a caustic environment that damages the outer skin layer. Moisture and friction from the diaper amplify this irritation, producing ammonia burns that appear as red, irritated, sometimes blistered skin.

The other options describe injuries from different causes: frostbite is from cold exposure, sunburn from UV light, and pressure ulcers arise from prolonged pressure, not chemical irritation from urine. Keeping skin clean and dry, changing diapers frequently, and using barrier creams or ointments helps protect against ammonia burns and skin breakdown.