Skin diphtheria

Introduction The cutaneous diphtheria is a diphtheria bacillus that invades a skin wound or is infected by the diphtheria of the nose, pharynx, and throat. Acute patients often have diphtheria in the throat or other areas, while chronic patients generally have only skin symptoms. The clinical manifestation is the appearance of an ulcer with a grayish white pseudomembrane on the skin. It occurs mostly in children, occasionally in adults, and generally does not cause systemic symptoms, but can have severe systemic symptoms in infants. Preventing the infection of diphtheria bacilli in advance is an important measure to prevent the occurrence of this disease, including controlling the source of infection, cutting off the transmission route, and improving the immunity of the body.

Cause

(1) Causes of the disease: Corynebacterium diphtheriae is a Gram-positive bacterium belonging to the genus Corynebacterium. The main source of infection is diphtheria patients and carriers, causing illness by droplets, contaminated germs or food brought into the nose or mouth. However, skin diphtheria is often infected by invasive skin. Some are self-infections caused by diphtheria in the nose, throat and throat.

(2) Pathogenesis: It is caused by droplets, contaminated germs or food brought into the nose or mouth. However, skin diphtheria is often infected by invasive skin. Some are self-infections caused by diphtheria in the nose, throat and throat.

an examination

Related inspection

Methylene blue immunopathological examination

Skin diphtheria is rare in China, mostly in children, occasionally seen in adults, generally does not cause systemic symptoms, but can have severe systemic symptoms in infants. If the patient has diphtheria in the nose, throat and throat, the corresponding parts may have adhesive and hemorrhagic scarring. After the skin lesion is infected, the edge of the ulcer is gradually formed, and the surface is tightly attached with a gray-white pseudomembrane. Forcibly torn off, causing surface bleeding; the ulcer has black necrotic tissue and early self-conscious pain. Skin lesions can also be eczema-like, dermatitis-like, and a few can also have acne-like or purplish-like changes, but the surface has gray-white pseudomembrane.

According to the clinical manifestations, diphtheria bacilli can be found by staining with the blue after taking the specimen for smear. It can also grow on Loffler medium. Histopathology: thickened epithelial cells in the edge of the ulcer, acute inflammatory cell infiltration in the dermis, necrotic cells, fibrin and neutrophils on the surface of the ulcer. There is a large amount of diphtheria in the necrotic layer. You can diagnose.

Differential diagnosis

Adhesive leukoplakia: symptoms of clinical manifestations of chronic cutaneous mucosal candidiasis. Chronic mucocutaneous candidiasis is a bacterial immunodeficiency disease of persistent Candida infections of the skin, mucous membranes, hair and nails. This disease, unlike other cellular immunodeficiency diseases, only responds to Candida albicans and a small number of antigen-related fungi, but is immune to viruses, bacteria and other microorganisms. This disease is a syndrome of some diseases, which can be combined with various endocrine organ dysfunction, tumors and other chronic debilitating diseases, and can also occur during the application of immunosuppressive agents.

Subcutaneous fat granules: Fat granules are small white mites that grow on the skin and are about the size of a needle. They look like a small white sesame, usually on the face, especially in the eyes of women. The fat granules are caused by tiny wounds on the skin, and in the process of self-repair of the skin, a small white cyst is formed. It is also possible that sebum is covered by keratin and cannot be properly discharged to the epidermis, thereby accumulating white particles formed in the skin.

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