Rythter's exfoliative dermatitis is essentially epidemic pemphigus in newborns. Some scientists distinguish it as a separate disease. Therefore, today we will choke about skin exfoliative dermatitis in children and adults, its symptoms, causes and treatment, let's see photos of patients.
Features of the disease
This severe form of infectious epithelium in newborns manifests itself in the form of reddening with the subsequent formation of "flaccid" blisters. After some time bubbles are transformed into erosion.
The disease initially affects the dermis area around the mouth, and then affects the entire skin of the baby. In addition to redness and blisters, the child's general condition is impaired. Redness, peeling covers up to 90% of the total area of the epithelium.
The diagnosis is quite easy to establish, given the typical clinic of the disease. When diagnosing, other dermatological diseases of the skin, which have similar symptoms, are usually excluded.
- In adults, this kind of dermatitis occurs at the age of more than 40 years.
- In this case, in the fair sex, the disease is observed more often than once in 4.
About exfoliative dermatitis will tell in detail the doctor in the video below:
Stages of
This type of dermatitis has three stages of development. Each of them has its own manifestations:
- Erythematous .There is redness of the skin, there is swelling, blisters are formed.
- Exfoliative .There is a peeling of the epithelium. This process is called Nikolsky's symptom. Flaking occurs due to the formation of fluid( exudate).Erosions increase in size, sometimes they merge. To external symptoms in children, symptoms of gastrointestinal disease are added.
- Regenerative .Discontinue diarrhea, vomiting, the temperature of the child decreases. On the skin there is a decrease in puffiness, redness, and erosion heal.
The disease is more severe in the youngest children( 2-6 days of life).
Causes of
In children, exfoliative dermatitis occurs due to exposure to Staphylococcus aureus. Sometimes his appearance provokes staphylococci in conjunction with streptococci.
In adults, exfoliative dermatitis occurs with the following factors:
- Complication of the underlying disease( contact dermatitis, seborrheic or atopic dermatitis, psoriasis).
- Reception of narcotic drugs.
- Taking certain medicines that cause an allergic reaction.
Symptoms of
The main symptoms of the disease include:
- redness, thickening of the skin;
- formation on the epithelium of crusts;
- itching;
- temperature increase;
- enlarged lymph nodes;
- release a large amount of fluid through the inflamed dermis. Symptoms of the stages:
- In newborns, this kind of dermatitis develops on the first weeks of life( 1-2).The first symptoms of the disease are redness, lamellar peeling on the epithelium around the mouth, near the navel. Then, at each stage of Ritter dermatitis, new signs are added.
- In the erythematous stage, redness quickly spreads. It affects the areas of large folds, genitals, anal. Then the redness covers the entire body. After reddening spreads and swelling. On the epidermis, large bubbles( not strained) are formed, they are opened very quickly. Appears symptom Nikolsky. In some cases, the mucous membranes of the nose, urogenital organs, and the edges around the lips can be affected.
- At the exfoliative stage, erosions are formed in the places of the opened bubbles. They increase, merge. By external signs, the disease at this stage of development resembles burns of the second degree. There is a violation of the general state of the person( the temperature rises to 400C, asthenia, diarrhea is noted).Children at this stage eat poorly( suck breast), rapidly lose weight.
- In the regenerative stage of puffiness, erythema decreases, epithelization of surfaces occurs after erosion.
Diagnostics of
If a suspicion arises of the occurrence of exfoliative dermatitis, you need to undergo an examination with an infectious disease specialist, a dermatologist. To establish an accurate diagnosis, a clinical picture of the disease, a manifestation of Nikolsky's symptom, is sufficient.
For diagnostics, bacterial culture of the contents of bubbles, erosion is carried out. In addition to the above diagnostic methods, the patient passes the analysis for syphilis( RPR test, PCR diagnostics).It is necessary to exclude early congenital syphilis.
If there are symptoms of exfoliative dermatitis in newborns, differential diagnosis should be made to exclude such diseases:
- contact dermatitis;
- bullous dermatitis;
- herpes simplex;
- dermatitis of Dühring;
- syphilitic pemphigus.
Next we will tell you how to treat exfoliative dermatitis.
Treatment of exfoliative dermatitis
If a patient is diagnosed with a severe form of exfoliative dermatitis, he is hospitalized. On inpatient treatment, specialists are determined with the choice of therapeutic methods.
Therapeutic method
Patient is assigned:
- symptomatic,
- keratolytic anti-inflammatory therapy.
To exclude the development of dehydration, baths with emollients are recommended. If suspected of psoriasis prescribe phototherapy.
Now it's worth talking about ointments and creams to treat this type of dermatitis.
Drug medication
Treatment with medication involves the use of antibiotics, corticosteroids( "Prednisolone").For the treatment of severe disease use of glucocorticoids( "Prednisone").This drug is taken for 10 days for 1 tablet.
Effective for topical treatment are ointments, creams, which contain hormonal substances.
Newborns are treated in a cuvette.
- They inject antibiotics of the cephalosporin series( "Kefzol", "Tseporin").
- Also parenterally injected with antistaphylococcal plasma, "Timalin", antistaphylococcal gamma globulin.
- To avoid dehydration, a newborn is given an infusion therapy with "Gemodeza", "Polyglukin".
- To avoid the occurrence of dysbacteriosis, probiotics are used( Lactobacterin, Bifidumbacterin).
- For the treatment of healthy areas apply fucarcine, salicylic alcohol. The resulting bubbles are opened.
- Treatment of affected areas with ointments, aerosols with antibiotics, zinc oil, naphthalene liniment, dusting with xerophore is carried out.
Babies must change their clothes daily, perform baths with potassium permanganate. Since the disease is contagious, the patients are placed in separate boxes. Quarantine measures are mandatory.
Folk methods
For the treatment of exfoliative dermatitis in adults, you can also take the recipes of traditional medicine. To proceed to such treatment is desirable after a meeting with a specialist. He can adjust the therapy according to the individual characteristics of the patient.
Of folk remedies,
- compresses are considered effective;
- bathing;
- flocks;
- lotion.
In treatment, baths are used from broths of broccoli, celandine or chamomile. To prepare the broths you need to take 300 grams of grass. They pour two liters of water, boil for 15 minutes. Before adding the resulting broth to the bath, it is worth filtering.
Decoctions for drinking are prepared from marigold, chamomile. To prepare a decoction for drinking, take 2 tablespoons of herbs, pour two cups of boiling water. Broth insist for 30 minutes, filter. Take a decoction preferably half a cup 4 times / day.
Prevention of disease
Preventive measures in adults are to implement such recommendations:
- Avoid allergens that can trigger the appearance of this type of dermatitis.
- Maintain a healthy lifestyle.
- Proceed in time to treat this disease, so that a complicated form of dermatitis does not appear.
- Stick to the power mode.
Preventive measures to prevent the occurrence of this type of dermatitis in newborns is:
- Regular inspection of staff of maternity hospitals for the presence of a carrier of the disease.
- Maternity tests for caries( Staphylococcus aureus).
- Regular quartz waxing of maternity wards, maternity wards.
- Use by doctors, nurses of gauze dressings when contacting newborns.
- Observance of hygiene in the place of stay of the baby after discharge from the hospital.
Complications of
Exfoliative dermatitis can cause the following complications:
- peritonitis;
- otitis media;
- phlegmon;
- acute enterocolitis;
- pneumonia;
- meningitis.
Forecast
- With timely treatment in adults, the disease has a favorable prognosis. It can be cured in just 2 weeks.
- If you start this kind of dermatitis, the above complications may occur. In case of severe exfoliative dermatitis in newborns, fatal outcomes are possible.
On dermatitis in babies will tell this video: