Neonatal toxic erythema
Introduction
Introduction to neonatal toxic erythema Neonatal erythema (neonatalery thematoxicum), also known as neonatal urticaria (urticarianeonatorum), is a common disease in newborns, about 30% to 70% of newborns can develop this disease. It is an unexplained cause of transient skin disease characterized by erythema, papules and pustules within 2 weeks of birth. basic knowledge The proportion of illness: 0.04%-0.08% Susceptible people: infants and young children Mode of infection: non-infectious Complications: Mildew
Cause
Neonatal toxic erythema
Causes:
The cause is unknown. It may be a non-specific reaction caused by external stimuli after birth, or a toxic reaction from some allergic reactions or intestinal absorption substances caused by antigenic substances in the mother. It is also considered to be a viral infection, but none of them. Conclusion.
Pathogenesis
The pathogenesis is still unclear.
Prevention
Neonatal toxic erythema prevention
The disease is quite common in term newborns and is a temporary erythema. The cause is unknown and may not necessarily be related to the toxic effects of certain substances. Therefore, this disease cannot be directly prevented. Early detection, early diagnosis, and early treatment are important for indirect prevention of this disease. At the same time, attention should be paid to the health care during pregnancy and eating more vitamin-rich foods to reduce the infection of the virus.
Complication
Neonatal toxic erythema complications Complications
The disease mainly causes pustules on the skin. After the pustules are broken, the skin integrity is destroyed, so skin bacterial infection or fungal infection can be induced. Since the neonatal immune system has not established a mountain, the bacterial infection may have fever and skin. Swelling, rupture and purulent secretion flow out and other performances. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Neonatal toxic erythema symptoms Common symptoms Pustular papules edema Wind blush erythema (clear boundary
Most occur within 4 days after birth, a few births, at the latest about 2 weeks, skin lesions have erythema, papules, wheals and pustules, some may have diffuse erythema first, followed by a solid base with redness 1 ~ 3mm yellowish or white papules and pustules, scattered distribution, occasional fusion, in addition to palmar, can occur in any part, but occurs in the hip, back, shoulder and other pressure, the number is more or less The skin lesions can be withdrawn after a few hours, and soon re-issued, no other systemic symptoms, self-healing after 7 to 10 days.
Examine
Examination of neonatal toxic erythema
About 2/3 cases of blood eosinophils increased by 5% to 15%, pustule culture without bacterial growth, filled with a large number of eosinophils.
Histopathology: mild edema in the upper part of the erythema, a small amount of eosinophils around the blood vessels, infiltration of neutrophils and monocytes; significant edema of the dermis at the beginning of the papule, and eosinophils in the infiltrating cells; pustules are located Under the stratum corneum, or in the pores or sweat pores of the epidermis, which are a large number of eosinophils.
Diagnosis
Diagnosis and identification of neonatal toxic erythema
diagnosis
1. Most of them develop within 4 days after birth, and a few are born at the time of birth, and at least 2 weeks at the latest.
2. There are erythema, papules, wheal and pustules in the skin lesions, some may have diffuse erythema first, followed by a solid base with blushing 1-3mm yellow or white papules and pustules, scattered distribution, occasional fusion .
3. In addition to palmar, it can occur in any part, but it occurs in the buttocks, back, shoulders, etc., the number is more or less, the skin lesions can be receded in a few hours, and soon re-issued, no other body Symptoms, after 7 to 10 days of self-healing, recurrence is rare.
4. About 2/3 cases of blood eosinophils increased by 5% to 15%, pustule culture without bacterial growth, filled with a large number of eosinophils.
5. Histopathological examination, mild edema in the upper part of the erythema, a small amount of eosinophils around the blood vessels, infiltration of neutrophils and monocytes; significant edema of the dermis at the beginning of the papule, and eosinophils in the infiltrating cells; The pustules are located under the stratum corneum, or in the pores or sweat pores of the epidermis, which are a large number of eosinophils.
Differential diagnosis
It needs to be differentiated from staphylococcal or streptococcal pyoderma, and the latter is positive for blister culture; it is distinguished from red peony, which is mainly found in summer hot and humid environment, and the climate is cool and can naturally subside.
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