Erythema multiforme exudative in children

Introduction of exudative erythema multiforme in children Exudative erythema multiform erythematosus (erythemamultiformaexudativum), known as Steven-Johnson Syndrome, is an immune-related acute non-suppurative inflammation characterized by diverse skin and mucous membrane manifestations. basic knowledge The proportion of illness: 0.001% Susceptible people: children Mode of infection: non-infectious Complications: toxic shock syndrome myocarditis pneumonia atelectasis pleural effusion

Pediatric exudative erythema erythema

(1) Causes of the disease

The disease is an allergic disease, which occurs in children with allergies. The reaction may be mycoplasma, virus (mainly herpes simplex virus), bacteria, fungal infection, drugs (sulfa drugs, antibiotics, especially penicillin, erythromycin). , cephalosporins, anticonvulsants, sedatives, and food, etc., about half of the cases have a history of primary disease or a history of taking drugs 1 to 3 weeks before the onset of the disease, and the incubation period caused by the infection is longer than that of the drug.

(two) pathogenesis

Skin lesions mainly occur at the junction of epidermis and dermis, first vasodilation and local edema, obvious lymphocytic infiltration around the blood vessels, and then red blood cells exuded to the outside of the blood vessels, vacuolar formation and lymphocyte infiltration under the epidermis, severe cases Necrosis occurs in the epidermis, and mucosal lesions are similar to pathological changes in the skin. In severe cases, internal organs, heart, lungs, and brain may also be involved.

Pediatric exudative erythema erythema prevention

Prevention of erythema caused by drug allergies in children:

Children with allergies should be careful to use a variety of drugs, especially to avoid the abuse of antibiotics, to prevent the disease caused by drug allergy.

Prevention of erythema caused by food allergies in children:

From the beginning of the addition of complementary foods, parents should pay attention to the first time the amount of food should not be too much, in order to avoid allergic reactions, while paying close attention to the abnormal reaction of children after eating. Understand whether the child's allergy to the food is mild, moderate, or severe. If mild allergies, gradually increase the amount from the minimum dose to allow the child to slowly adapt to the food; if it is moderate or severe allergies, Try to avoid eating this food in your daily diet.

Pediatric exudative erythema erythema complications Complications toxic shock syndrome myocarditis pneumonia atelectasis pleural effusion

Severe cases are often accompanied by high fever, chills, toxic shock, acute myocarditis, heart enlargement, heart failure; pharyngitis can cause difficulty in breathing, pneumonia can occur in the lungs, atelectasis, pleural effusion. Urinary tract can be seen in the urinary tract, nephritis, a small number of renal failure can occur. Intestinal symptoms can be seen in diarrhea. Reactive arthritis can be seen in some cases.

Pediatric exudative erythema erythema symptoms common symptoms herpes sputum purulent secretions maculopapular edema bacterial infection high heat constipation photophobia low fever

Mostly acute onset, according to the degree of skin mucosal damage, systemic symptoms and visceral involvement, can be divided into light and heavy, rash can occur on the day of onset or within a few days after the disease.

1. Light type: visible low or moderate fever, may be accompanied by sore throat, headache, abdominal pain, diarrhea or constipation and other non-specific manifestations, the initial rash is irregular erythema, diameter 2mm ~ 2cm, can be scattered or fusion, after erythema enlargement The center pigment becomes lighter, or cyanosis gradually appears, and the surrounding skin is bright red. In addition, a variety of rashes such as macules, papules, urticaria, herpes, sometimes blistering in the center of the maculopapular rash, or diarrhea due to hemorrhage Spots, rashes can occur in various parts of the body, but with the back of the hands and feet, the extension of the arms and lower limbs, the face and neck are more common, mostly symmetrical, the rash starts from the distal end of the limbs, the palm and the sole of the foot, close to the heart End development, affecting the upper arm and thigh, after 1 to 2 weeks of regression, if there is herpes, ulceration can form after rupture, with severe pain and burning sensation, when the mucosa is damaged, it can cause difficulty in eating.

2. Severe type: Si-Qion syndrome, has a variety of names, such as malignant bullous polymorphic erythema, skin mucosal eye syndrome, Fuchs syndrome, etc., different from light polymorphic erythema, except for the skin Widely manifested, severely, there are extensive mucosal lesions and visceral involvement, severe skin lesions, large erythema, many herpes, wide range, large blebs, large skin exfoliation and hemorrhage, secondary bacterial infections can be red and swollen, whole body All parts can be seen, the trunk is more common, mucosal lesions are also very extensive, can be found in the mouth, nose, eyes, anus and external genitalia, especially lipitis and conjunctivitis are more common and serious, the lip and conjunctiva are also visible Herpes, bleeding, ulcers and gray-white pseudomembrane, purulent secretions, eyelid swelling, photophobia, corneal ulcers, severe cases can affect future vision, and occasionally full eyeball inflammation leading to blindness.

Examination of exudative erythema multiforme in children

No specific laboratory examination showed that the total number of peripheral white blood cells increased, neutrophils and eosinophils increased. In the absence of urinary tract infection, urine examination showed transient proteinuria, normal or rapid erythrocyte sedimentation rate, secondary Infected purulent secretions should be cultured in bacteria.

Do a chest X-ray, understand the heart and lungs, do an electrocardiogram and echocardiography, understand the heart damage, and other choices based on clinical needs.

Diagnosis and differentiation of exudative erythema multiforme in children

The clinical features of this disease are simultaneous damage to the skin and mucous membranes. Eyes and lips, genitals and anus are most susceptible; a variety of morphological rashes, mainly herpes, severe toxic shock and visceral damage, the above characteristics can help diagnose.

The disease must be identified with the following diseases:

1. Skin mucosal lymph node syndrome: This disease and polymorphic erythema can not be distinguished in the etiology, clinical manifestations also have many similarities, this disease rarely sees herpes, no ulcers, scarring, finger (toe) end redness, recovery In the period of seeing a large piece of peeling is characterized by coronary artery expansion, aneurysm.

2. erythema pemphigus: also known as Senear-Usher syndrome, the whole body see blisters, more common in the chest and back, still see erythema, scales, exudation, oily molting, similar to seborrheic dermatitis, there is a similar disk A lupus-like rash, the mucous membrane rarely invades.

3. Toxic epidermal necrolysis: Lyell disease, the disease is an allergic reaction, erythema and herpes are visible on the skin, and there is a large epithelial shedding, also see stomatitis and conjunctivitis, similar to the symptoms of Si-Jion syndrome. The course of disease progresses rapidly, the condition is serious, the symptoms of systemic poisoning are heavy, and the prognosis is poor.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.