Newborn skin thin

Introduction The skin barrier of neonatal impetigo, due to the thin and tender skin of newborns, the secretory function has not yet fully developed, and the "resident flora" of epidermal parasitism has not yet fully formed. Therefore, local immune function is low and it is easy to be infected. After infection, it is easy to spread the whole body by inoculation, or it is infected with each other, resulting in prevalence in the neonatal room. Newborns are particularly sensitive to bacteria because of their delicate skin and impaired immune function. In particular, malnutrition, climate hot and humid, excessive warmth, skin sweating and other factors can induce the disease. It is often transmitted by infected medical staff or mothers.

Cause

(1) Causes of the disease

Induced by coagulase-positive, Staphylococcus aureus and/or hemolytic streptococcus. Newborns are particularly sensitive to bacteria because of their delicate skin and impaired immune function. In particular, malnutrition, climate hot and humid, excessive warmth, skin sweating and other factors can induce the disease. It is often transmitted by infected medical staff or mothers.

(two) pathogenesis

1. Weak skin barrier: The newborn's skin is thin and tender, the secretory function is not fully developed, and the "resident flora" of epidermal parasitism has not yet fully formed. Therefore, local immune function is low and it is easy to be infected. After infection, it is easy to spread the whole body by inoculation, or it is infected with each other, resulting in prevalence in the neonatal room.

2. Weak humoral immunity: The IgG of neonatal serum is lower than normal, and the maternal IgG through the placenta also lacks natural immunity. Therefore, it is difficult for children to resist bacterial infection and reinfection, especially in premature infants and malnutrition. Newborn.

3. Various toxins of Staphylococcus aureus: Among them, epidermal exfoliation toxins are the first, which can loosen the connection between epidermal cells and make other toxins more invasive. Some toxins can cause chills, fever, and even S. aureus scalded skin syndrome (SSSS) after entering the blood circulation.

4. Abnormal allergies

(1) Type II allergic reaction: From the children with impetigo secondary to acute nephritis, the isolated pathogenic strain and the glomerular basement membrane have a common antigen, and the corresponding antibody and glomerular basement membrane produced by the body Binding causes type II allergies to cause immune damage to the kidneys.

(2) Type III allergic reaction: The antigen-antibody complex formed by the M protein of the pathogenic strain is deposited on the glomerular basement membrane to cause immunological damage. It is a blister under the cornea, which contains a lot of neutrophils, cocci, and fibrin. The basal spine cell sponge forms, or a small amount of acanthosis cells are released, and neutrophils infiltrate into the spine cells. The upper part of the dermis is dilated and hyperemic, with moderate neutrophils and lymphocytic infiltration.

an examination

Related inspection

Physical examination of skin diseases Skin elasticity Check skin color

More than 4 to 10 days after birth. Blisters suddenly appear on the face, trunk and limbs, ranging from peas to walnuts, varying in size. The blister fluid is initially pale yellow and clear. After 1 to 2 days, part of the blister fluid becomes cloudy, and the blister begins with a half moon. Phenomenon, after the pus gradually increased, but the entire bullae is not fully purulent, and thus the characteristics of water pustules. There is no redness around the blister, the wall is thin, easy to rupture, and after the break, the bright red moist smashed surface is exposed, and the thin yellow sputum is attached. The temporary brown rash is left after the sable peels off, leaving no trace after disappearing. The lesion develops rapidly, and most of the skin is affected in a few hours and 1-2 days, and the mucosa can also be damaged. There is no systemic symptoms at first, and there may be fever and diarrhea in the future.

Differential diagnosis

According to the characteristics, location, contact infection, rapid spread of pustules, etc., it is easier to diagnose.

Chickenpox

The basic damage is scattered and centripetal distribution of mung bean to soybean big blisters, surrounded by blush, some blisters may have umbilical concavity, pus and scab is very light, can invade the mucosa, some children have fever and other systemic symptoms.

2. Acute systemic rash impetigo

For transient aseptic pustulosis, the child has a history of medication or infection. The basic damage is dense superficial pustules on the basis of systemic erythema. The blister fluid is sparse and appears in batches. It may appear as exfoliative dermatitis in the late stage. It may have fever of 3839°C, but the disease course is short and the condition is self-limiting. It can be cured naturally after symptomatic treatment.

The disease should be differentiated from bullous epidermolysis and neonatal exfoliative dermatitis.

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