Home Smell from the mouth Skin diseases on the body of a child. Fungal skin diseases in children

Smell from the mouth

Skin diseases on the body of a child. Fungal skin diseases in children

Skin is the largest organ of the human body. Another feature of the skin is that diseases can not only be independent pathologies, but also a consequence of problems with other organs. In addition, they can be triggered by a variety of external stimuli.

A distinctive feature in children is also the fact that they do not proceed in the same way as in adults. For the most part, this is due to the immune system, which in children, especially the youngest ones, is not fully developed.

Types of skin diseases in children

Dermatitis is a skin lesion that is inflammatory in nature. There are several forms:

Atopic dermatitis

Atopy is a genetic predisposition to produce too much immunoglobulin E when exposed to certain environmental allergens. The term “atopy” itself has Greek origin and means foreign.

External manifestations of this feature of the body are a variety of allergic reactions. The word “allergy” itself is often used in diagnosing diseases that are provoked by the mediator immunoglobulin E, however, in some people suffering from allergic reactions, the level of this protein is normal.

Atopic dermatitis can be called one of the most common diseases of the epidermis in children. In the vast majority of cases, it occurs in the first six months of life and often occurs periodically in adulthood.

Most of the cases are infants under one year of age who have relatives suffering from similar problems. Atopic dermatitis is often accompanied by certain diseases, both allergic and related to the respiratory system.

Atopic dermatitis includes three variants of the course of dermatitis:

Infant, which occurs in children under two years of age. The infant form is characterized by localization of rashes on the face and bends of the limbs. Sometimes, but much less frequently, the disease affects the skin of the torso. The rash is characterized by dry skin and the appearance of crusts. Infantile atopic dermatitis also differs in that periods of its exacerbation may coincide with the time of teething.
Children's, common among children between two and thirteen years of age. The childhood form is characterized by the appearance of rashes mainly on the flexor surface of the limbs. Manifestations of the disease in this case are skin thickening, swelling, erosion, plaques, scratching and crusts.
Adult, which affects adolescents over thirteen years of age and adults.

As the name implies, it occurs due to direct contact with an allergen.

There are two types of this disease:

Acute form, when the disease makes itself felt immediately after contact with the allergen, all manifestations are also easily eliminated after determining the root cause and starting treatment measures.
Chronic form, when the disease manifests itself fully upon repeated contact with what causes the allergy. Exacerbations in this case are quite difficult, and treatment takes a lot of time.

Diaper dermatitis

It often affects the child’s torso and represents an inflammatory reaction to chemical, mechanical and microbial factors.

The cause of this disease may be the following factors:

violation of personal hygiene rules, as a result of which the child’s skin was in contact with urine and feces for too long;
skin infection by fungi;
increased temperature and humidity;
poor child nutrition.

The disease is expressed in the appearance of foci of inflammation, namely redness of the skin and increased sensitivity. To eliminate symptoms, it is necessary to determine the root cause of the disease and eliminate it.

Hives

This is a skin dermatitis that has allergic nature. This disease differs from others in the appearance of pink blisters. This manifestation quickly spreads over the skin and is accompanied by itching. The blisters are somewhat reminiscent of nettle burns, which gives the rash its name.

The appearance of this in children may be associated with the development of the endocrine and immune systems; the list of reasons may also include:

bacterial infections;
taking certain medications;
air and contact allergens;
viruses.

Prickly heat

This is a red rash that can sometimes be accompanied by whitish blisters. A similar rash can appear on a variety of parts of the body, however, it most often occurs on the bends of the limbs, as well as in other places where there are many sweat glands.

It does not pose a particular threat, however, the itching that accompanies it can cause anxiety for the child and, if the blisters are scratched, infection in the wounds.

Miliaria can occur on the skin of children in the following cases:

when wearing clothes that are too tight or too small;
when wearing clothes made of synthetic materials;
when using diapers;
using hygiene products of inadequate quality.

Pimples and boils

Acne is an inflammation that develops due to improper functioning of the sebaceous glands. Pimples can appear anywhere on the body. Boils are in most cases larger than pimples and painful. Inside such a formation there is pus, which is most often localized in the center of the boil. When pressure is applied to such inflammations, a light yellow substance is released. Here you can read more about purulent formations and see.

Common pimples and boils are the result of a microbial infection entering the deep layers of the skin. Despite the fact that acne most often occurs in teenagers, it can appear on the skin at any age, even at a very early age. In addition, it is worth considering that such manifestations may indicate serious diseases, for example, diabetes, or indicate a depressed state of the immune system.

Chicken pox

Chickenpox is an infectious disease of a viral nature. The root cause is a virus herpes simplex, which affects the mucous membranes and epidermal cells. Externally, the disease manifests itself in the form of a rash, and in especially severe cases it is accompanied by fever. This virus is transmitted by airborne droplets.

It is believed that the sooner a person gets chickenpox, the easier it will pass. Infants under six months of age rarely suffer from this disease, since mothers pass on their immunity.

Children under five years of age are most susceptible to chickenpox, however, the disease is relatively mild in them. Children who have reached the age of ten, and even adults, are less likely to get chickenpox, only if the immune system deteriorates, however, their course is the most severe.

Warts

Skin formations such as warts quite often appear in children when they have already begun to walk. This phenomenon is associated not only with infection with the human papillomavirus, but also with a decrease in immunity. Also, the appearance of warts can be caused by damage to the skin and poor hygiene. The method of removing warts depends on their location and number.

Dermatomycosis

Dermatomycosis includes a large number of varieties, since there are quite a few types of microscopic fungi that are the causative agents of this disease. However, it most often appears in the form of spots that are brighter pink than the rest of the skin. The spots may peel and affect the hairline.

Infection can occur in a variety of ways, from contact with soil to contact with animals or an infected person. Treatment will also be different and determined by the type of disease, the location of the spots and the individual characteristics of the patient’s body.

Psoriasis

A disease such as childhood psoriasis is a chronic non-infectious disease that affects the skin of children under ten years of age.

Sometimes the first signs of psoriasis can be found in infants in the first months of life. It is characterized by the appearance of inflammatory foci, the surface of which is covered with formations called papules, white.

Only a doctor can prescribe appropriate treatment. He can also diagnose correctly, since the manifestations of the disease may be similar to other dermatitis. It is worth noting that psoriasis is a chronic disease, so it cannot be cured forever.

Keloid

Keloid is a fibrous growth that occurs at the site of damage to the skin. Most often these are postoperative scars or scars that appear after the burn has healed. Sometimes keloid formation occurs as a result of healing closed injury. The reasons for the formation of keloid scars are still unknown.

Most experts believe that this is an individual tissue reaction to damage, as well as to the presence of a foreign body. Such a formation is distinguished by the fact that it is dense and non-extensible, and also does not grow with the growth of surrounding tissues.

This is especially dangerous in childhood because may cause tissue deformation. Especially with extensive damage to the skin. Keloid can be eliminated in a variety of ways. In the simplest cases, you can get by with special ointments. In the most severe cases, surgery is necessary.

Seborrheic dermatitis

The appearance of seborrheic dermatitis in children is accompanied by a mild inflammatory reaction of the epidermis, which occurs as a result of internal and external influence on the child's body. in young children is accompanied by the formation of gneiss in the head area, which is yellow scaly crusts.

This is what scares adults, however, there is no need to be afraid. Half of babies experience similar seborrhea; sometimes yellowish crusts can be found not only on the scalp, but also on the surface of the neck, face and even chest.

In this case, seborrheic dermatitis is not accompanied by pain or any other negative manifestations. The treatment prescribed by a specialist in the vast majority of cases is not long-lasting.

Dermatitis is a rash in the form of blisters, peeling, discomfort, itching, burning, etc. The reasons may be different, depending on which there are several types of dermatitis, for example, infectious, allergic, atopic, food, etc.

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Treatment of skin diseases in children

A general method for eliminating skin diseases in children has not been invented, since there are a very large number of varieties of these diseases. The rules of treatment are determined by the severity of the disease, the age group of the child, as well as the individual characteristics of his body.

Drug treatment may involve taking general medications. In some cases, doctors are limited to prescribing only external use. Sometimes, in general, no specific therapy is needed, just a general strengthening of the immune system is enough, which will suppress the root cause.

Prevention of skin diseases in children

Proper, completely balanced nutrition in accordance with the age-related needs of the body, which involves limiting, or even completely eliminating, foods containing allergens.
Compliance with basic rules of personal hygiene, as well as maintaining cleanliness in residential areas.
Eliminating the occurrence of stressful situations in the child’s daily life.
Wearing clothes only from natural materials, which ensure optimal air circulation.
Timely treatment of skin damage such as scratches, inflammation and abrasions.

Conclusion

In general, it is unlikely that you will be able to protect your child from skin diseases, if only because they are natural for the process of developing immunity. Parents can only prevent some of them and minimize the consequences of diseases. This requires prevention and timely treatment.

– a heterogeneous group of skin lesions, the causative agents of which are pathogenic microscopic fungi. Fungal skin diseases in children can manifest as peeling, itching, and cracked skin; thinning and hair loss, nail damage. Diagnosis of fungal skin diseases in children includes examination, fluorescent examination, microscopy and culture of scrapings for microflora. Complex treatment of fungal skin diseases in children is carried out using external and systemic antifungal agents, desensitizing and corticosteroid drugs, immunostimulants, and physiotherapy.

General information

Classification of fungal skin diseases in children

According to the depth of the lesion, fungal skin diseases in children are divided into keratomycosis (lichen versicolor), dermatophytosis (microsporia, trichophytosis, favus, epidermophytosis, rubromycosis); candidiasis; deep mycoses.

Keratomycosis is characterized by damage to the stratum corneum of the epidermis without the development of inflammatory reactions, damage to hair and nails. Dermatophytosis is accompanied by mild or severe inflammatory changes in the skin within the epidermis, damage to hair and nails. Dermatophytes (molds of the genera Trichophyton, Microsporum, Epidermophyton) are the main causative agents of fungal skin diseases in children. Superficial candidiasis, the second most frequently detected fungal skin disease in children, is caused by the pathogenic effects of yeast-like fungi of the genus Candida (usually C. albicans), affecting the skin and mucous membranes.

Causes of fungal skin diseases in children

The predominance of dermatomycosis among all fungal diseases is due to constant close contact of the skin with the environment. The causative agents of fungal skin diseases in children are widespread in nature, have great diversity and are highly resistant to external factors. Fungal skin diseases in children are usually observed in the form of sporadic cases; epidemic outbreaks are more typical for dermatophytosis of the scalp.

The source of anthropophilic dermatomycosis (trichophytia) is a sick person, zoophilic (microsporia) is a sick animal (stray cats and dogs, cows, horses), rare geophilic ones are soil. Infection occurs through direct contact of a child with the skin and hair of a patient or through household items contaminated with fungi and their spores (towels, washcloths, combs, toys, hats, shoes). Most often, children become infected with fungal skin diseases in swimming pools, showers and baths, on beaches, in hairdressers, and organized children's groups.

The characteristics of children's skin (hydrophilicity, increased vascularity, reduced bactericidal activity of sweat and sebaceous glands, easy vulnerability), immaturity of the immune system facilitate the penetration of the pathogen into the epidermis, contributing to the rapid development of fungal diseases in children.

A decrease in the child’s body’s defenses can be caused by bad environment, stress, vitamin deficiency, long-term use of antibiotics, dysbacteriosis, endocrinopathies and chronic infections. In case of immunodeficiency, opportunistic fungi that normally live on the skin of a child can transform into a pathogenic form and cause a fungal disease (for example, Malassezia furfur - the causative agent of pityriasis versicolor).

Symptoms of fungal skin diseases in children

The nature and severity of symptoms of fungal skin diseases in children depend on the type and virulence of the pathogen, the location and area of the lesion, and the reactivity of the body. Of the fungal skin diseases in children, the most common and contagious are microsporia and trichophytosis (ringworm), which predominantly affect smooth skin and the scalp.

Microsporia in most cases (99%) is caused by the zooanthropophilic fungus Microsporum canis, rarely by the anthropophilic M.ferrugeneum. It usually occurs in children of preschool and primary school age; occurs with the formation of a few, round, clearly defined lesions with hair broken off at a height of 4-5 mm from the skin level. Within the lesion, the skin is covered with small grayish-white scales. On smooth skin, microsporia manifests itself as concentric erythematous-squamous plaques surrounded by a ridge of small vesicles and serous crusts.

In young children, superficial trichophytosis of the scalp is more often observed, caused by anthropophilic trichophytons (Trichophyton tonsurans and T. violaceum), accompanied by loss of color, elasticity and shine of hair, breaking off at the skin level (stumps in the form of black dots), the formation of clear, rounded bald spots covered with small flaky elements. Clinical signs of trichophytosis on smooth skin resemble manifestations of microsporia. The infiltrative-suppurative form is characterized by perifolliculitis and deep follicular abscesses.

When infected with the fungus Achorion schonleini, a rare fungal skin disease develops in children - favus (scab), which usually manifests itself on the scalp with the formation of scutulae (favus scutes) - dry thick crusts of yellowish or light brown color with raised edges and a depressed center, emitting a stagnant unpleasant smell. Hair affected by the fungus becomes thinner, becomes like tow, and is pulled out along with the roots. Favus can result in patchy or continuous scar atrophy of the skin and death of hair follicles.

Rubromycosis, caused by the anthropophilic pathogen T. rubrum, occurs in children aged 7-15 years; manifested by dry skin of the feet and hands, clear pink-red, finely flaky lesions with a scalloped edge; nail damage.

With athlete's foot, slight redness, peeling, moderate weeping, cracks and blisters, hyperkeratosis, accompanied by itching, are observed in the interdigital folds and on the soles of the feet.

Microscopy of clinical material (hair, epidermal scales, horny masses from the nail bed) makes it possible to detect the presence of mycelium, hyphae or spores in it, confirm a fungal skin disease in children and determine its tissue form. Sowing scrapings on universal and selective media helps to isolate a pure culture of fungi and determine their drug sensitivity; bacterioscopy of culture smears and biochemical analysis– carry out phenotypic, species and intraspecific identification of the pathogen.

Physiotherapy for fungal skin diseases in children includes medicinal electrophoresis, pulsed magnetic therapy, darsonvalization, DMV therapy.

Treatment of fungal skin diseases in children is long-term and continues until clinical manifestations resolve and control tests for fungi are negative.

Forecast and prevention of fungal skin diseases in children

Many fungal skin diseases in children have a persistent course and require long-term systematic treatment, but if the recommendations are strictly followed, they have a favorable prognosis. Untreated fungal skin diseases in children acquire a chronic, relapsing form and can continue into adulthood.

Prevention of the spread of fungal skin diseases in children includes quarantine measures in children's institutions; disinfection of premises, household items, clothing, shoes, manicure and hairdressing supplies; avoiding contact of the child with stray animals, following the rules of personal hygiene, proper skin care, normalizing immunity.

This is a skin disease that is caused by biological, chemical, physical or internal agents. In children, pathology develops mainly against the background of a hereditary tendency to allergic reactions. Often, skin inflammation in infants occurs in the first months of life. What is dermatitis in children after 4 years of age, mothers know much less often. The following groups are at risk:

children whose both parents suffer from any form of allergy;
frequent infectious diseases of the mother during pregnancy;
improper feeding;
prolonged stay in a heavily polluted environment (exhaust fumes, dyes, smoke).

Skin diseases in children are usually the result of disorders in the body. At the first manifestations of pathology, it is urgent to show the child to a doctor, since any omission can lead to unpredictable consequences. How to recognize infectious and non-infectious skin diseases in children in order to take the necessary actions?

Skin disease in children is a common phenomenon, since the delicate skin of children is an excellent target for the disease. Children get sick much more often than adults. Most cases are allergic in nature. Diseases should be treated only after an accurate diagnosis has been made and confirmed.

Every child has suffered from such an illness at least once in their life. Children's skin diseases are numerous, and each pathology manifests itself differently. Their reasons are also quite diverse, ranging from polluted ecology to contact with carriers of the infection.

All childhood skin diseases are divided into two large groups:

Infectious.
Non-infectious.

Each group includes many skin diseases with characteristic manifestations, causes, features, and treatment methods for each of them.

The presence of a specific disease can usually be determined by the first signs

Rashes of infectious origin

Infectious skin diseases in children can be divided into types that differ significantly from each other.

These include:

skin changes caused by viral infections;
pyoderma, or pustular lesions of the dermis, appear as a result of the ingestion of streptococci, staphylococci and others;
mycoses caused by the introduction of pathogenic fungi;
chronic infectious skin lesions caused by mycobacteria and borrelia.

We have previously written about the treatment of psoriasis in children and recommended bookmarking this article.

Today, science knows 44 species of dermatophytes - fungi that cause skin diseases

Exanthems

Skin rashes on the body due to many infectious diseases Doctors call them exanthemas. Infectious skin diseases in children with exanthemas include:

measles;
chicken pox;
scarlet fever;
rubella;
baby roseola.

The incubation period for these diseases is different, and the characteristic symptoms of skin diseases in children also differ, in particular, in the appearance of the rash. Thus, measles is characterized by large, merging papules, while rubella is characterized by rare and small rash. Chickenpox is accompanied by small blisters filled with liquid.

Scarlet fever stands out pinpoint rash mainly in the following places:

on the sides of the body;
on the face.

In infantile roseola, a maculopapular rash is observed. It is very similar to urticaria.

The virus of such a disease - measles - is transmitted from a patient to healthy child by airborne droplets

Pustular and viral diseases

Pustular changes (pyoderma) are quite common childhood skin diseases. The causative agents are staphylococci and streptococci, available:

in the air;
in house dust;
in the sandbox;
on clothes.

The most common manifestations of pyoderma:

Furunculosis.
Carbunculosis.
Impetigo.

Viral dermatoses include those skin diseases in children that are caused by various viruses. Among them:

Herpes simplex, characterized by changes in the mucous membrane and skin of the mouth and nose.
Warts, among which there are both regular and flat, as well as pointed ones. The disease is transmitted through skin contact, if there are microtraumas, and cellular immunity is reduced.

This is how the skin can react to pathologies of internal organs

Non-infectious skin lesions

pediculosis;
scabies;
demodicosis

It is possible to become infected through contact with a sick person.

Allergic skin diseases in children are a specific reaction of the body to an irritant (allergen). The most common of these is atopic dermatitis. The rash is accompanied by paroxysmal itching. The reasons for such a violation may be:

medicines;
food products;
cold.

Very young children often experience heat rash, which appears as a result of improper care, overheating or dysfunction of the sweat glands. This type of allergic skin disease in children is characterized by a pink-red rash (small spots and nodules), located:

in the upper chest;
on the neck;
on the stomach.

Daily hair care and frequent brushing will help protect against lice.

Prevention

According to the recommendations of doctors, the prevention of skin diseases in children should be carried out comprehensively. Health and psychological approaches are used here. It should be remembered that some skin diseases may be an external reflection of a serious internal pathology in the child’s body. Often skin lesions can be accompanied by problems:

central nervous system;
endocrine system;
many internal organs.

This is why prevention of skin diseases in children is necessary. The basic rules are:

wearing clothes made from natural fabrics - they should be chosen according to size, and should not irritate or injure the skin;
systematic ventilation of premises and wet cleaning;
increasing the immunity of children by hardening and organizing proper nutrition;
the use of various medicinal herbs that can prevent cracks and itching of the skin in young children.

Washing the skin in most cases prevents disease, as it removes dirt, germs, and sweat.

Treatment

Treatment of skin diseases in children should begin with a correct diagnosis. Such a diagnosis can only be made by an experienced specialist.

The fact is that each disease occurs differently and has its own characteristics. For example, some rashes should not be wetted, while others, on the contrary, should be kept clean and washed constantly.

In some cases, drug treatment is required, in others it is not.

In this case, parents must:

call a doctor at home;
protect the sick child from communicating with other children;
refrain from treating rashes with iodine, brilliant green or other solutions - this may complicate diagnosis.

Only an experienced doctor can external signs determine the disease

Medicines

A wide range of medications are used to treat skin diseases in children, which are used for a variety of painful changes in the dermis, such as:

acne;
warts;
fungus;
other inflammatory neoplasms.

Pharmaceutical products include:

ointments and creams;
sprays;
pharmaceutical talkers;
pills.

Effective medications include creams and ointments:

"Akriderm" (for the treatment of dermatitis, eczema, psoriasis).
"Candide B" (mycosis, fungal eczema).
"Laticort" (dermatitis, psoriasis).
“Skin cap” (seborrhea, dandruff) and many others.

For local therapy, the most commonly used effective means

Treatment should be carried out comprehensively - both pharmacy and folk remedies. We should not forget about skin cleanliness and hygiene.

Before meeting with a doctor, it is difficult to find out the nature of the trouble that has occurred, and in some cases, manifestations may be congenital or of a hereditary nature.

The older a child gets, the easier it is for him to have certain diseases, including skin ones. This is due to the body’s resistance: babies are extremely unstable to harmful influences from the outside, their skin is very sensitive, and the ability to resist harmful microbes is insignificant. At an early age, the baby’s nervous system has an insufficient regulatory effect, and the endocrine glands do not work at full strength. The wealth of children's skin in lymphatic and blood vessels promotes a greater intensity of reaction to external stimuli.

Believing that after a couple of days the inflammation will go away as suddenly as it appeared, parents make a mistake. Today, doctors know more than 100 types of skin diseases that can easily overcome a child. Unfortunately, no one is insured. Symptoms skin ailments varied, but many are not without similarities.

Immediate contact with a specialist is the first step towards a competent diagnosis of a skin disease and a speedy recovery for the baby!

How chickenpox begins: how the initial stage manifests itself in children

Chickenpox is called that way because it can be spread by the wind, that is, by airborne droplets. Let's figure out how chickenpox manifests itself in children. Someone sneezes contagiously next to you, you will already forget about this insignificant episode in your life. And after 1-3 weeks the temperature suddenly rises. This is the initial stage of chickenpox in children.

"Acyclovir" for chickenpox in children

In order to relieve chickenpox symptoms such as itching, you can ask your pediatrician to prescribe an antihistamine in a safe dosage. When the rash spreads to the eyes, you can use a special eye gel “Acyclovir” for chickenpox in children, which effectively fights against the herpes virus.

Many parents are absolutely sure that the treatment for chickenpox in children is to lubricate the blisters with brilliant green. Even now, walking down the street in this way, you can easily identify a child who has had chickenpox - by the characteristic “specks” of brilliant green. In fact, brilliant green does not treat the symptoms of chickenpox, but only performs a disinfecting function and protects against the penetration of bacterial infection into the wound.

This is especially important for a child. It is convenient for doctors to determine from these spots whether the child is contagious. That is, brilliant green is not a treatment for chickenpox in children, but serves to fix new rashes. This is very convenient, first of all, for doctors. In addition, brilliant green slightly reduces itching. In addition to brilliant green, rashes can simply be lubricated with a weak solution of manganese. This option is more suitable for an adult who does not want to walk around covered in brilliant green. Under no circumstances should you lubricate with alcohol.

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Causes and consequences

Since skin diseases are a heterogeneous group of pathologies, united only by the fact that they all affect the skin, it is impossible to identify common causes for them. After all, each type of skin disease has its own causes and characteristics of the development mechanism. Therefore, exact causative factors can only be given for each specific skin disease. And for the entire class of skin diseases, it is possible to identify only certain common factors that can play the role of causes of the development of pathologies.

The first and main causative factor of skin diseases is the failure of the liver, kidneys, intestines, spleen and lymphatic system completely remove all toxic substances present in the body. Toxic substances can be produced in the body during life, or can come from outside in the form of medicines, vegetables and fruits treated with pesticides, herbicides, etc.

If the liver and spleen do not have time to neutralize these toxic substances, and the intestines, lymphatic system and kidneys do not remove them, then they begin to be removed from the body through the skin. And this becomes the cause of the development of many skin diseases, such as dermatitis, dermatoses, psoriasis, eczema, etc.

The second very important causative factor of skin diseases are allergic reactions and irritation of the skin by chemicals, physical objects and other things present in the environment (bright sun, wind, low or high temperature, etc.).

The third most important causative factor of skin diseases is infections. Moreover, we are talking not only about infections of the skin itself, which develop when various pathogenic microorganisms, such as fungi, bacteria, viruses and others, come into contact with the skin, but also about infectious diseases of internal organs, for example, hepatitis, tonsillitis, sinusitis, etc. .

The fourth most important causative factor of skin diseases are “internal allergens,” which are protein substances produced by worms or opportunistic microorganisms, for example, staphylococci, streptococci, fungi of the genus Candida and others. These protein molecules are constantly present in the body and are a source of continuous irritation and stimulation of the immune system, which can be clinically expressed in provoking skin diseases in the form of rashes, blisters, etc.

The fifth most important causative factors of skin diseases are intestinal dysbiosis and stress.

Let's first figure out what skin diseases children have and what causes them.

For reasons, skin diseases in children are divided into the following groups:

Hereditary and psychosomatic diseases are not dangerous for others. But it is worth remembering that they are the rarest skin diseases in children. They appear more often in newborns and infants. As a rule, these rashes and irritations are a consequence of allergic reactions that are characteristic of the child’s parents and are transmitted through genes.

Children's skin diseases lead to significant consequences. Pustular rashes leave scars on the baby’s delicate skin, which then only become larger; Ignored skin symptoms of other diseases lead to serious consequences, including disability.

A decrease in the child’s body’s defenses can be caused by poor environment, stress, vitamin deficiency, long-term use of antibiotics, dysbiosis, endocrinopathies and chronic infections. In case of immunodeficiency, opportunistic fungi that normally live on a child’s skin can transform into a pathogenic form and cause a fungal disease (for example, Malassezia furfur, the causative agent of lichen versicolor).

Classification of fungal skin diseases in children

Currently

Skin abscess;
Acne;
Acrodermatitis atrophic;
Actinic granuloma;
Actinic keratosis;
Actinic reticuloid;
Skin amyloidosis;
Anhidrosis;
Kaposi's angioreticulosis;
Anyum;
Pasini-Pierini atrophoderma;
Atheroma;
Atopic dermatitis (including Bernier's pruritus);
Atrophic stripes (striae, stretch marks);
Basalioma;
Gougereau-Duppert disease;
Warts;
Epidermolysis bullosa;
Reiter's vasculitis;
Freckles ;
Wine stains;
Vitiligo;
Dermatitis herpetiformis (During's dermatitis);
Skin herpes;
Hidradenitis;
Hyperhidrosis;
Hyperkeratosis;
Granuloma annular;
Decubital ulcer;
Diaper dermatitis, allergic, seborrheic, contact, exfoliative, irritant contact, infectious, radiation;
Dermatomyositis;
Dyshidrosis (pompholyx);
Impetigo;
Ichthyosis;
Calcinosis of the skin;
Carbuncles;
Keloid scar;
The skin is rhombic in the occipital area;
Molluscum contagiosum;
Urticaria idiopathic, allergic, dermatographic, vibrational, contact, cholinergic, solar;
Lupus erythematosus;
Lichen planus;
Lichen monoliformis;
Xerosis;
Krauroz;
Lentigo;
Leprosy;
Livedoadenitis;
Lymphatoid papulosis;
Necrobiosis lipoidica of the skin;
Lipoma;
Lichen is shiny and linear;
Lichen atrophic;
Melanoma;
Mycoses (trichopytosis, microsporia, candidiasis of the skin, etc.);
Calluses and calluses;
Coin eczema;
Skin mucinosis;
Neurodermatitis;
Neurofibromatosis (Recklinghausen's disease);
Burns;
Frostbite;
Gottron's papules;
Parapsoriasis;
Paronychia;
Pilonidal cyst;
Flaming nevus;
Pigmented chronic purpura;
Pyoderma (streptoderma or staphyloderma);
Pityriasis white and pink;
Pemphigoid;
Perioral dermatitis;
Pint;
Poikiloderma Siwatt;
Polymorphic light rash;
Polymorphic dermal angiitis;
Miliaria deep, crystalline, red;
Pruritus;
Transient acantholytic dermatosis;
Lichen simplex chronicus;
Psoriasis;
Rocky Mountain Spotted Fever;
Pemphigus;
Skin cancer is squamous cell;
Reticulosis;
Rhinophyma;
Rosacea;
Stevens-Johnson syndrome;
Scleroderma;
Sclerema and scleredema;
Sunburn;
Senile skin atrophy;
Subcorneal pustular dermatitis;
Toxic epidermal necrolysis (Lyell's syndrome);
Lupus;
Acne;
Phlegmon;
Phototoxic drug reaction;
Photodermatosis;
Yaws;
Boils;
Cheilitis;
Chloasma;
Scabies;
Elastosis;
Eczema;
Wells eosinophilic cellulitis;
Erythema toxic, nodular, marginal, ring-shaped centrifugal, patterned, burn, septic, multiform bullous and non-bullous;
Erythematous diaper rash;
Erythrasma;
Erythrosis (Lane's disease);
Buruli ulcer.

The list includes most of the known and currently identified skin diseases, but rare diseases that are practically never encountered in the practice of a primary care dermatologist (a regular multidisciplinary clinic or private medical center) are not listed.

This list contains the official names of skin diseases as they are designated in the international classification of diseases (ICD-10). Next to some of the official names, others are listed in parentheses that were historically accepted and are still in use today.

Since there are quite a few skin diseases, and they differ in the causes of their occurrence, in the characteristics of their course, as well as in the type of pathological process that has a predominant influence in the development of clinical manifestations, they are divided into several large groups. Groups of skin diseases can be conditionally called types, since they are distinguished based on simultaneously three very important signs– the nature of the causative factor, the type of pathological process and the leading clinical symptom.

So, currently all skin diseases are divided into the following types: 1. Pyoderma (pustular skin diseases):

Streptoderma;
Staphyloderma;
Strepto-staphyloderma;
Pyoallergides.

Ringworm;
Pityriasis (multicolored) lichen;
Athlete's foot;
Rubromycosis;
Onychomycosis;
Skin candidiasis;
Favus.

Leprosy;
Tuberculosis;
Leishmaniasis;
Impetigo;
Furuncle;
Abscess;
Phlegmon;
Paronychia;
Pilonidal cyst;
Erythrasma;
Chicken pox ;
Smallpox, etc.

Herpes;
Warts;
Molluscum contagiosum.

Ichthyosis;
Xeroderma;
Congenital ichthyosoform Broca's erythroderma;
Pityriasis pilaris;
Epidermolysis bullosa simplex;
Dystrophic epidermolysis;
Weber-Cockayne syndrome;
Neurofibromatosis (Recklinghausen's disease).

Dermatomyositis;
Systemic lupus erythematosus;
Scleroderma;
Sclerema;
Scleredema;
Periarteritis nodosa;
Poikiloderma vascular atrophic;
Anyum.

Burns;
Frostbite;
Dyshidrosis (pompholyx);
Coin eczema;
Diaper dermatitis, allergic, seborrheic, contact, exfoliative, irritant contact, infectious, radiation;
Lyell's syndrome;
Erythematous diaper rash;
Pityriasis white.

Skin itching;
Pruritus;
Neurodermatitis;
Hives;
Simple chronic lichen.

Psoriasis;
Parapsoriasis;
Lichen planus;
Lichen;
Gianotti-Crosti syndrome.

True pemphigus;
Pemphigoid;
Transient acantholytic dermatosis (Grover's);
Acquired keratosis pilaris;
Epidermolysis bullosa;
Dermatitis herpetiformis (During's disease).

Gilbert's lichen (pityriasis rosea);
Multimorphic exudative erythema;
Erythema migrans of Afzelius-Lipschutz;
Stevens-Johnson syndrome;
Erythrosis (Lane's disease);
Septic erythema.

Dermal angiitis is polymorphic;
Purpura pigmentosa chronic;
Reiter's vasculitis;
Rosacea;
Livedoadenitis;
Periarteritis nodosa;
Malignant granuloma of the face;
Three-symptom Gougerot-Dupper disease.

Primary reticulosis;
Gottron's reticulosarcomatosis;
Kaposi's angioreticulosis;
Urticaria pigmentosa (mastocidosis, mast cell reticulosis).

Asteatosis (atheroma, steacytoma);
Acne;
Acne;
Rhinophyma;
Hyperhidrosis;
Anhidrosis;
Red grainy nose.

Vitiligo;
Chloasma;
Freckles;
Lentigo;
Wine stains;
Coffee stains;
Pigmentation incontinence (Bloch-Sulzberger syndrome);
Fusk line (Andersen-Verno-Hackstausen syndrome);
Buschke's warm melanosis;
Riehl's melanosis;
Toxic melasma of Hoffmann-Habermann;
Broca's erythrosis;
Poikiloderma Siwatt;
Photodermatosis.

Buruli ulcer;
Yaws;
Pint;
Rocky Mountain Spotted Fever.

Squamous cell skin cancer;
Melanoma;
Basalioma.

(lipoma, etc.).

Calcinosis;
Amyloidosis;
Necrobiosis lipoidica of the skin;
Vitamin deficiency.

Atrophic acrodermatitis;
Kraurosis of the vulva or penis;
Riehl's melanosis;
Anetoderma Schwenninger-Buzzi;
Anetoderma Jadassohn-Pellisari;
Pasini-Pierini atrophoderma;
Keratosis;
Keloid scar;
Granulomas.

(develop in people who come into contact with harmful chemicals and infectious agents or who constantly injure the skin by any physical factors):

Allergic dermatoses;
Chemical burns;
Epidermites;
Oily folliculitis;
Toxic melasma;
Skin ulcers;
Warts;
Occupational eczema;
Calluses and calluses;
Burns and frostbite;
Erysipiloid (pig erysipelas).

Hyperhidrosis;
Anhidrosis;
Hypertrichosis;
Change in hair color;
Epidermal, trichodermal cyst;
Atheroma;
Sweet's febrile neutrophilic dermatosis;
Wells eosinophilic cellulitis;
Mucinosis.

The division of skin diseases into the above types is used by dermatologists in clinical practice, since it allows us to combine pathologies with common clinical symptoms and the same development mechanism into one group. In turn, such a combination of pathologies with similar symptoms and development mechanisms into one group makes it possible to develop optimal approaches to the treatment of several skin diseases at once.

In addition to the above classification, there are several more options for dividing skin diseases into types, however, in the CIS countries they are used much less frequently. The main difference between other classifications and the one given is the smaller number of types of skin diseases, since similar varieties are combined into larger groups.

Allergic skin disease

During the first months of life, infants often experience exudative changes in the facial skin in the form of erythema, swelling, dryness and peeling of the cheeks. Subsequently, they may become more pronounced and form atopic dermatitis or childhood eczema with the appearance on the skin of the face (except for the area of the nasolabial triangle), body and extremities of erythematous itchy lesions with microvesicles that break open to form weeping, erosions and crusts.

On open parts body, a nodular itchy rash may appear - strophulus. After a few years, eczema can transform into neurodermatitis.
Urticaria often occurs in the form of itchy blisters, often merging into large areas of infiltration with jagged edges.
Quincke's edema is a rapidly developing limited allergic edema of the skin of the face, mucous membrane of the nose or oropharynx, and less commonly of the genitals.

Fungal skin diseases and dermatozoonoses

The most common types of fungal infections in children are trichophytosis, microsporia, favus and candidiasis. Dermatozoonoses are quite common in children:

with scabies, microvesicles appear on the skin, from which curved scabies ducts extend, severe itching occurs, especially in the evening and at night, traces of scratching are visible;
Lice bites are also accompanied by severe itching and lead to scratching on the scalp.

Childhood illnesses with skin rashes

It's chronic inflammatory disease caused by genetic characteristics. Therefore, the risk of developing this disease is higher in children whose close relatives suffer from atopy.

Factors that increase atopic dermatitis:

increased sensitivity of the skin to external factors;
disorders of the nervous system;
infectious skin diseases;
smoking tobacco in the presence of a child;
high content of dyes and flavor enhancers in the child’s food;
use of cosmetics that are unsuitable for child care;
bad ecology.

This dermatitis most often affects children under 12 years of age; at older ages, the disease appears extremely rarely. With atopy, children's skin becomes very dry, begins to peel and become covered with spots. Most often, the rash is localized on the neck, elbows, face, and knees. The disease has a wave-like course, periods of exacerbation are replaced by long remissions.

A childhood skin disease that causes severe itching, rashes, and blistering of the skin. Gradually, single blisters merge into one large lesion. The child may also experience fever and intestinal upset.

Factors that increase urticaria:

contact, food or other allergies;
viral and infectious diseases;
exposure to ultraviolet rays;
unsuitable temperature conditions;
insect bites.

Localization of the disease: lips, skin folds, eyelids, cheeks. Visually, the skin lesion resembles a nettle burn.

A disease of newborns that causes white rashes on the cheeks and chin. It may appear in the first six months of a child’s life. Occurs due to hormonal changes in the body and high levels of estrogen, as well as blockage of the sebaceous ducts.

Acne that appears in childhood does not require drug treatment. White or slightly yellowish papules disappear within two weeks, leaving no marks or scars. However, acne in children increases the risk of contracting skin infections and therefore requires monitoring. The presence of infection is indicated by redness and swelling of the skin around the acne.

most susceptible to infectious and allergic diseases skin, so they most often suffer from ringworm, erythema, impetigo, warts, herpes, urticaria and contact dermatitis. Also, children are characterized by skin irritation reactions that occur in the form

Itching and redness of individual areas or the entire skin. Other skin diseases rarely develop in children under 5–7 years of age, and upon reaching this age children become susceptible to the same skin pathologies the same as adults.

Only a few childhood diseases can provoke rashes on the dermis:

Among viral skin diseases, the most common infection in children is herpes infection. In newborns, this type of skin disease is often severe and takes on a generalized form.

Children of preschool age may be infected with the molluscum contagiosum virus. In this case, pale pink papules up to 5 - 7 mm in size appear on the skin with an indentation in the center and the release of a white pasty mass from it.

Bacterial skin diseases

Bacterial purulent skin diseases (pyoderma) in children are most often caused by staphylococci and streptococci, less often by pale spirochetes.

Staphyloderma in newborns. These types of skin diseases occur as:

vesiculopustulosis (inflammation of the mouth of the eccrine gland ducts),
pseudofurunculosis (formation of subcutaneous nodes followed by their opening and release of yellow-green, creamy pus),
epidemic pemphigus (formation of superficial blisters that break open to form erosions).

The most severe type of staphyloderma is exfoliative dermatitis with the formation of large, flabby, easily opened blisters. Symptoms of this type of skin disease: the epidermis also exfoliates in areas outside the boundaries of the blisters, often covering a significant area. Detachment of the epidermis in the form of ribbons occurs especially easily with oblique pressure (Nikolsky's symptom).

Streptoderma manifests itself in the form of impetigo (the appearance of soft blisters - phlyctene - followed by erosion and the formation of crusts), erysipelas, papuloerosive streptoderma, pemphigus, localized in the folds of the skin.

Syphilitic pemphigus develops not only on the skin of the body and face, but also on the palms and soles, where staphylococcal pyoderma rarely develops. In the contents of the bubbles special methods Treponema pallidum is detected.

In newborns during the first days of life, in some cases, omphalitis occurs - inflammation of the umbilical ring with its redness, infiltration and swelling, often with the release of serous fluid, blood or pus.

Hereditary dystrophic skin diseases primarily include various forms of congenital epidermolysis bullosa. With this disease, with any, even minor, injury, extensive blisters form on the skin due to detachment of the epidermis from the dermis, followed by secondary infection of the contents of the blisters.

The acquired form of epidermolysis bullosa is an autoimmune disease with the appearance of autoantibodies to type VII collagen.

Types of hereditary dystrophies include acrodermatitis, which is based on a sharp violation of zinc utilization. This type of disease manifests itself in the first year of a child’s life in the form of foci of hyperemia, blisters and blisters on the hands, feet, buttocks, in the perineum, around all natural openings. At the same time, hair and nail growth is disrupted, intestinal disorders, fever and exhaustion occur.

Skin diseases in the form of red spots

A rash has important diagnostic value in a number of cases non-communicable diseases. Thus, hemorrhagic rash is observed in thrombocytopenic purpura (Werlhof's disease), hemorrhagic vasculitis (Schönlein-Henoch disease), hypovitaminosis C (scurvy), aplastic and hypoplastic anemia, leukemia, diseases associated with disorders of the blood coagulation system.

It is much easier to cure dermatitis in an infant than in teenage girls and boys. The famous pediatrician Komarovsky claims that at the first signs of the disease, parents need to contact an experienced pediatrician to establish the correct diagnosis. To cure the pathology, you must strictly follow all the doctor’s instructions. WITH special attention you need to treat the baby’s nutrition - look at the body’s reaction to accepting any food, especially new ones.

Drug treatment of dermatitis in children includes the prescription of tablets, creams, ointments, and syrups. All drugs for external and internal action are divided into categories:

glucocosticosteroids, which reduce inflammation and reduce itching;
antihistamines, relieving allergic manifestations;
antiseptic, helping to destroy germs;
immunostimulants, which strengthen the immune system;
dexpanthenol, used to treat skin at any stage.

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Atopic dermatitis

Atopy is a genetic predisposition to produce too much immunoglobulin E when exposed to certain environmental allergens. The term “atopy” itself is of Greek origin and means foreign.

External manifestations of this feature of the body are a variety of allergic reactions. The word “allergy” itself is often used in diagnosing diseases that are provoked by the mediator immunoglobulin E, however, in some people suffering from allergic reactions, the level of this protein is normal.

Atopic dermatitis includes three variants of the course of dermatitis:

Infant, which occurs in children under two years of age. The infant form is characterized by the localization of rashes on the face and bends of the limbs. Sometimes, but much less frequently, the disease affects the skin of the torso. The rash is characterized by dry skin and the appearance of crusts. Infantile atopic dermatitis also differs in that periods of its exacerbation may coincide with the time of teething.
Childish, common among children from two to thirteen years old. The childhood form is characterized by the appearance of rashes mainly on the flexor surface of the limbs. Manifestations of the disease in this case are skin thickening, swelling, erosion, plaques, scratching and crusts.
Adult, which affects adolescents over thirteen years of age and adults.

Allergic contact dermatitis

As the name implies, it occurs due to direct contact with an allergen.

There are two types of this disease:

Acute form, when the disease makes itself felt immediately after contact with the allergen, all manifestations are also easily eliminated after determining the root cause and starting treatment measures.
Chronic form, when the disease manifests itself fully upon repeated contact with what causes the allergy. Exacerbations in this case are quite difficult, and treatment takes a lot of time.

Diaper dermatitis

Skin diseases - symptoms (signs)

Skin diseases are very diverse, but they are all united by a common feature - the presence of any change in the structure of the skin. These changes in skin structure can be represented by the following elements:

tubercles;
Vegetation;
blisters;
Lichenification;
Papules (nodules);
Petechiae;
Bubbles;
Bubbles;
Pustules (pustules);
spots;
The spots are hypermelanotic or hypomelanotic;
Telangiectasia;
Cracks;
Knot;
Scales;
Erosion;
Excoriation;
Ecchymoses;
Ulcers.

The listed elements are formed during skin diseases and determine clinical symptoms and signs of pathology. Moreover, each disease or type of pathology is characterized by certain pathological elements, thanks to which, based on their nature and properties, skin disease can be accurately diagnosed. Let us consider the characteristics of pathological elements that are symptoms of skin diseases.

The tubercle is a dense round formation that rises above the skin and does not have a cavity inside. The color, density and size of the tubercle may vary. In addition, closely spaced tubercles merge with each other, forming an infiltrate. After completion of the inflammatory process, an ulcer or scar is formed at the site of the tubercle.

This is what distinguishes a tubercle from a papule. The tubercles are characteristic of tuberculosis, leishmaniasis, leprosy, late stages of syphilis, chromomycosis. Vegetations are thickening of the skin that occurs in the area of papules and ulcers due to a long course of the chronic inflammatory process. Vegetations erode, bleed, and purulent infections can develop in them.

A blister is a round or oval formation that rises above the surface of the skin. The blisters are pink or white with a pink border. The size of the blister can vary from a few millimeters to centimeters in diameter. Blisters are typical for burns, insect bites, allergic reactions to medications, as well as bullous diseases (pemphigus, pemphigoid, etc.).

Lichenification is a growth of the deep layer of the epidermis and an increase in the number of processes of epithelial cells. Externally, lichenifications look like areas of dry, thickened skin with a changed pattern, covered with scales. Lichenification is characteristic of sunburn, scratching and chronic inflammatory processes.

A papule (nodule) is a raised, dense formation from a changed area of skin, inside of which there is no cavity. Papules are formed when metabolic products are deposited in the dermis or when the size of the cells that form the skin structures increases. The shape of papules can be different - round, hemispherical, polygonal, flat, pointed.

Pink-red papules are characteristic of skin infections such as leprosy and tuberculosis. White-yellow papules are characteristic of xanthoma, pale pink - for secondary syphilis. Red papules in psoriasis and mycosis fungoides merge with each other, forming a plaque.

Petechiae and ecchymoses are spots on the skin of various shapes and sizes, which at the initial stages are colored red, but gradually change color to blue, and then successively to green and yellow. Spots less than 1 cm in diameter are called petechiae, and more - ecchymoses. A vesicle is a small round formation with a diameter of no more than 5 mm, rising above the skin and filled with liquid contents (bloody or serous).

As a rule, blisters form in large numbers in a limited area of the skin, forming clusters. If the bubble dries out, then a crust forms in its place, and if it opens, then erosion. Bubbles are characteristic of all types of herpes, smallpox, enterovirus infection, erysipiloid and fungal infection of the feet.

A bubble is a detachment of the upper layer of skin without violating its integrity and the formation of a kind of inflated bag. There is liquid inside the bubble. These elements are characteristic of pemphigus, pemphigoid, burns, and erythema multiforme.

A pustule (abscess) is a round, small (no more than 5 mm) formation that rises above the skin and is filled with white, green or yellow-green pus. Pustules can form from vesicles and blisters, and are also characteristic of pyoderma.

The spot is a change in skin color with intact structure in a limited round area. That is, the skin pattern of the spot remains normal, but only its color changes. If the blood vessels in the area of the spot are dilated, then it is pink or bright red. If there are venous vessels in the area of the spot, then it is colored dark red.

Multiple small red spots no more than 2 cm in diameter are called roseola, and the same, but larger spots are called erythema. Roseola spots are characteristic of infectious diseases (measles, rubella, typhoid fever, etc.) or allergic reactions. Erythema is characteristic of burns or erysipelas.

Hypermelanotic and hypomelanotic spots are areas of skin of various shapes and sizes, colored either dark or almost discolored. Hypermelanotic spots are colored dark colors. Moreover, if the pigment is in the epidermis, then the spots are brown, and if in the dermis, then they are gray-blue. Hypomelanotic spots are areas of skin with a light color, sometimes completely white.

Telangiectasias are red or bluish areas of skin with spider veins. Telangiectasia can be represented by single visible dilated vessels or their clusters. Most often, such elements develop with dermatomyositis, psoriasis, systemic scleroderma, discoid or systemic lupus erythematosus, and urticaria.

The node is a dense, large formation up to 5–10 cm in diameter, rising above the surface of the skin. Nodes are formed during inflammatory processes in the skin, therefore they are colored red or pink-red. After the disease resolves, the nodes may calcify, form ulcers or scars. Nodes are characteristic of erythema nodosum, syphilis and tuberculosis.

Scales are rejected horny plates of the epidermis. The scales can be small or large and are characteristic of ichthyosis, parakeratosis, hyperkeratosis, psoriasis and dermatophytosis ( fungal infection skin).

Erosion is a violation of the integrity of the epidermis and, as a rule, appears at the site of a opened bladder, vesicle or abscess, and can also form when blood flow is disrupted or the blood and lymphatic vessels of the skin are compressed. Erosion looks like a weeping, damp surface, painted pink-red.

Skin is the largest human organ. Her diseases may not be independent pathologies, but a consequence of damage to various internal organs and systems. But they can also be caused by the action of external irritants (infectious and non-infectious). In children, skin diseases occur differently than in adults. First of all, this is due to the insufficient development of the child’s immune system.

Classification of skin diseases in children

There are a large number of skin diseases that are classified according to different characteristics. Depending on the causative factors, three main groups of skin diseases can be distinguished. Let's look at them.

Infectious skin diseases in children

These diseases are associated with the penetration of infection through the surface of the skin (especially when it is damaged) or by other means (airborne, oral-fecal, transmission, etc.). Skin infections in children are divided into:

bacterial (furunculosis, folliculitis, carbunculosis, hidradenitis, impetigo, streptoderma, etc.);
viral (chickenpox, erythema infectiosum, sudden exanthema, rubella, warts, eczema herpeticum, etc.);
fungal (keratomycosis, dermatophytosis, candidiasis, trichophytosis, etc.).

Allergic skin diseases in children

Such pathologies arise due to interaction with various irritating factors. This may be a reaction of the body in response to:

food allergens (citrus fruits, dairy products, chocolate, honey, fish, etc.);
medicines;
household chemicals;
dust;
animal hair, etc.

IN this group include the following diseases:

toxic-allergic dermatitis;
diaper dermatitis;
eczema;
neurodermatitis;
pruritus, etc.

Symptoms of skin diseases in children

Skin diseases can have various external manifestations. As a rule, based on the type of skin rashes in children and their location, an experienced specialist can diagnose a particular pathology.

Skin rash in children can be represented by the following elements:

spots (macula) – not protruding above the surface of the skin of various shapes, sizes and colors (red, pink, brown, white, etc.);
papules (nodules) are dense formations that rise above the skin without cavities;
bubbles (vesicles and bullae) - elements filled with liquid contents;
pustules (ulcers) – formations with purulent contents inside;
urticaria – flat, dense, rounded formations that slightly rise above the surface of the skin (urticaria).

Other symptoms of skin diseases may include:

burning of the skin;
dryness;
peeling;
getting wet.

Other signs of illness may also appear:

high body temperature;
cough;
rhinitis;
abdominal pain, etc.

Treatment of skin diseases in children

There is no general tactics for treating skin diseases due to their diversity. Also, the principles of therapy depend on the severity of the disease, the age of the child, and his individual characteristics. Drug treatment may include drugs systemic action or be limited to external means. In some cases, no specific treatment is required at all.

Prevention of skin diseases in children

Properly balanced diet and limiting foods that can cause allergies.
Maintaining the rules of personal hygiene and cleanliness in the house.
Eliminating stressful situations in a child’s life.
Elimination of artificial materials in children's clothing.
Timely treatment of wounds and abrasions.

Chapter 4. INFECTIOUS SKIN DISEASES

4.1. BACTERIAL SKIN INFECTIONS (PIODERMA)

Pyoderma (pyodermiae)- pustular skin diseases that develop when pathogenic bacteria penetrate into it. With a general weakening of the body, pyoderma occurs due to the transformation of its own opportunistic flora.

Bacterial infections (pyoderma) are often encountered in the practice of dermatovenerologists (especially common in children), accounting for 30-40% of all visits. In countries with cold climates, the peak incidence occurs in the autumn-winter period. In hot countries with a humid climate, pyoderma occurs all year round, ranking second in frequency of occurrence after skin mycoses.

Etiology

The main pathogens are gram-positive cocci: in 80-90% - staphylococci (St. aureus, epidermidis); 10-15% - streptococci (S. pyogenes). In recent years, two pathogens can be detected simultaneously.

Pneumococci, Pseudomonas aeruginosa and Escherichia coli, Proteus vulgaris, etc. can also cause pyoderma.

The leading role in the occurrence of acute pyoderma belongs to staphylococci and streptococci, and with the development of deep chronic hospital pyoderma, a mixed infection with the addition of gram-negative flora comes to the fore.

Pathogenesis

Pyoccocci are very common in the environment, but not in all cases infectious agents are capable of causing the disease. The pathogenesis of pyoderma should be considered as an interaction microorganism + macroorganism + external environment.

Microorganisms

Staphylococcus morphologically they are gram-positive cocci, which are facultative anaerobes and do not form capsules or spores. The genus Staphylococcus is represented by 3 species:

Staphylococcus aureus (St. aureus) pathogenic for humans;

Staphylococcus epidermidis (St. epidermidus) may take part in pathological processes;

Saprophytic staphylococci (St. saprophyticus)- saprophytes, do not participate in inflammation.

Staphylococcus aureus is characterized by a number of properties that determine its pathogenicity. Among them, the most significant is the ability to coagulate plasma (a high degree of correlation is noted between the pathogenicity of staphylococci and their ability to form coagulase). Due to coagulase activity, when infected with staphylococcus, an early blockade of lymphatic vessels occurs, which leads to limiting the spread of infection, and is clinically manifested by the appearance of infiltrative-necrotic and suppurative inflammation. Staphylococcus aureus also produces hyaluronidase (a propagation factor that promotes the penetration of microorganisms into tissues), fibrinolysin, DNase, flocculent factor, etc.

Bullous staphyloderma is caused by staphylococci of the 2nd phage group, which produce an exfoliative toxin that damages the desmosomes of the spinous layer of the epidermis and causes stratification of the epidermis and the formation of cracks and blisters.

The association of staphylococci with mycoplasma causes more severe lesions than monoinfection. Pyoderma has a pronounced exudative component, often resulting in a fibro-necrotic process.

Streptococci morphologically they are gram-positive cocci, arranged in a chain, do not form spores, most of them are aerobes. According to the nature of growth on blood agar, streptococci are divided into hemolytic, viridian and non-hemolytic. β-hemolytic streptococcus is of greatest importance in the development of pyoderma.

The pathogenicity of streptococci is due to cellular substances (hyaluronic acid, which has antiphagocytic properties, and substance M), as well as extracellular toxins: streptolysin, streptokinase, erythrogenic toxins A and B, O-toxins, etc.

Exposure to these toxins sharply increases the permeability of the vascular wall and promotes the release of plasma into the interstitial space, which, in turn, leads to the formation of edema, and then blisters filled with serous exudate. Streptoderma is characterized by an exudative-serous type of inflammatory reaction.

Macroorganism

Natural defense mechanisms macroorganisms have a number of features.

The impermeability of the intact stratum corneum to microorganisms is created due to the tight fit of the horny plates to each other and their negative electric charge, repelling negatively charged bacteria. Also of great importance is the constant exfoliation of cells of the stratum corneum, with which a large number of microorganisms are removed.

The acidic environment on the surface of the skin is an unfavorable background for the proliferation of microorganisms.

Free fatty acids, which are part of sebum and the epidermal lipid barrier, have a bactericidal effect (especially against streptococci).

The antagonistic and antibiotic properties of normal skin microflora (saprophytic and opportunistic bacteria) have an inhibitory effect on the development of pathogenic microflora.

Immunological defense mechanisms are carried out with the help of Langerhans and Greenstein cells in the epidermis; basophils, tissue macrophages, T-lymphocytes - in the dermis.

Factors that reduce the resistance of the macroorganism:

Chronic diseases of internal organs: endocrinopathies (diabetes mellitus, Itsenko-Cushing syndrome, thyroid diseases, obesity), gastrointestinal diseases, liver diseases, hypovitaminosis, chronic intoxication (for example, alcoholism), etc.;

Chronic infectious diseases (tonsillitis, caries, infections of the urogenital tract, etc.);

Congenital or acquired immunodeficiency (primary immunodeficiency, HIV infection, etc.). Immunodeficiency conditions contribute to the long-term course of bacterial processes in the skin and the frequent development of relapses;

Long-term and irrational use (both general and external) antibacterial agents leads to disruption of skin biocenosis, and glucocorticoid and immunosuppressive drugs lead to a decrease in immunological protective mechanisms in the skin;

Age characteristics of patients (children, elderly). External environment

Towards negative factors external environment include the following.

Contamination and massive infection by pathogenic microorganisms in violation of the sanitary and hygienic regime.

Impact of physical factors:

High temperature and high humidity lead to maceration of the skin (violation of the integrity of the stratum corneum), expansion of the mouths of the sweat glands, as well as rapid spread infectious process hematogenously through dilated vessels;

- at low temperatures, the skin capillaries narrow, the speed decreases metabolic processes in the skin, and the dryness of the stratum corneum leads to a violation of its integrity.

Microtraumatization of the skin (injections, cuts, scratches, abrasions, burns, frostbite), as well as thinning of the stratum corneum - the “entry gate” for the coccal flora.

Thus, in the development of pyoderma, an important role is played by changes in the reactivity of the macroorganism, the pathogenicity of microorganisms and the adverse influence of the external environment.

In the pathogenesis of acute pyoderma, the most significant pathogenicity of the coccal flora and irritating environmental factors. These diseases are often contagious, especially for young children.

With the development of chronic recurrent pyoderma, the most important changes in the body's reactivity and the weakening of its protective properties. In most cases, the cause of these pyodermas is a mixed flora, often opportunistic. Such pyoderma is not contagious.

Classification

There is no uniform classification of pyoderma.

By etiology pyoderma is divided into staphylococcal (staphyloderma) and streptococcal (streptoderma), as well as mixed pyoderma.

By depth of damage The skin is divided into superficial and deep, paying attention to the possibility of scar formation when inflammation resolves.

By duration of flow pyoderma can be acute or chronic.

It is important to distinguish between pyoderma primary, occurring on unaltered skin, and secondary, developing as complications against the background of existing dermatoses (scabies, atopic dermatitis, Darier's disease, eczema, etc.).

Clinical picture

Staphylococcal pyoderma, usually associated with skin appendages (hair follicles, apocrine and eccrine sweat glands). Morphological element of staphyloderma - follicular pustule conical in shape, in the center of which a cavity filled with pus is formed. Along the periphery there is a zone of erythematous-edematous inflammatory skin with pronounced infiltration.

Streptococcal pyoderma most often develop on smooth skin around natural openings (oral cavity, nose). Morphological element of streptoderma - conflict(flat pustule) - a superficially located vesicle with a flabby covering and serous-purulent contents. Having thin walls, the lyktena quickly opens, and the contents dry out to form honey-yellow layered crusts. The process is prone to autoinoculation.

Staphylococcal pyoderma (staphyloderma)

Ostiofolliculitis (ostiofolliculitis)

Superficial pustules 1-3 mm in size appear, associated with the mouth of the hair follicle and penetrated by hair. The contents are purulent, the tire is tense, and there is an erythematous rim around the pustule. The rashes can be single or multiple, located in groups, but never merge. After 2-3 days, the hyperemia disappears, and the contents of the pustule dry out and a crust forms. There is no scar left. The most common localization is the scalp, torso, buttocks, and genitals. The evolution of osteofolliculitis occurs in 3-4 days.

Folliculitis

Folliculitis (folliculitis)- purulent inflammation of the hair follicle. In most patients, folliculitis develops from osteofolliculitis as a result of infection penetrating into the deep layers of the skin. Morphologically, it is a follicular pustule surrounded by a raised ridge of acute inflammatory infiltrate (Fig. 4-1, 4-2). If the upper part of the follicle is involved in the inflammatory process, then superficial folliculitis. When the entire follicle is affected, including the hair papilla, deep folliculitis.

Rice. 4-1. Folliculitis, individual elements

Rice. 4-2. Common folliculitis

Localization - on any area of the skin where there are hair follicles, but more often on the back. The evolution of the element occurs in 5-10 days. After the element resolves, temporary post-inflammatory pigmentation remains. Deep folliculitis leaves a small scar and the hair follicle dies.

The appearance of osteofolliculitis and folliculitis on the skin is promoted by diseases of the gastrointestinal tract (gastritis, gastric ulcer, colitis, dysbiosis), as well as overheating, maceration, insufficient hygiene care, mechanical or chemical irritation of the skin.

Treatment osteofolliculitis and folliculitis consists of external use of alcohol solutions of aniline dyes (1% brilliant green, Castellani liquid, 1% methylene blue) 2-3 times a day on pustular elements, it is also recommended to wipe the skin around the rash with antiseptic solutions: chlorhexidine, miramistin *, sanguiritrin *, 1-2% chlorophyllipt*.

Furuncle

Furuncle furunculus)- acute purulent-necrotic lesion of the entire follicle and the surrounding subcutaneous fatty tissue. It begins acutely as deep folliculitis with a powerful perifollicular infiltrate and rapidly developing necrosis in the center (Fig. 4-3). Sometimes there is a gradual development - osteofolliculitis, folliculitis, then, with an increase in inflammatory phenomena in the connective tissue of the follicle, a boil is formed.

Rice. 4-3. Furuncle of the thigh

Clinical picture

The process occurs in 3 stages:

. Stage I(infiltration) is characterized by the formation of a painful acute inflammatory node the size of a hazelnut (diameter 1-4 cm). The skin above it becomes purplish-red.

. Stage II characterized by the development of suppuration and the formation of a necrotic core. A cone-shaped node protrudes above the surface of the skin, at the top of which a pustule forms. Subjectively, a burning sensation and severe pain are noted. As a result of necrosis, a softening of the node in the center occurs after a few days. After opening the pustule and separating the gray-green pus mixed with blood, the purulent-necrotic rod is gradually rejected. At the site of the opened boil, an ulcer is formed with uneven, undermined edges and a bottom covered with purulent-necrotic masses.

. Stage III- filling the defect with granulation tissue and scar formation. Depending on the depth of the inflammatory process, scars can be either barely noticeable or pronounced (retracted, irregular in shape).

The size of the infiltrate during a boil depends on the reactivity of the tissue. Particularly large infiltrates with deep and extensive necrosis develop in diabetes mellitus.

The boil is localized on any part of the skin, except palms and soles(where there are no hair follicles).

Localization of the boil on the face (nose area, upper lip) is dangerous - staphylococci may penetrate into the venous system of the brain with the development of sepsis and death.

In places with well-developed subcutaneous fatty tissue (buttocks, thighs, face), boils reach large sizes due to a powerful perifollicular infiltrate.

Significant pain is noted when boils are localized in places where there is almost no soft tissue (scalp, dorsum of fingers, anterior surface of the leg, external auditory canal, etc.), as well as in places where nerves and tendons pass.

A single boil is usually not accompanied by general symptoms; if several are present, body temperature may rise to 37.2-39 °C, weakness, and loss of appetite.

The evolution of the boil occurs within 7-10 days, but sometimes new boils appear, and the disease drags on for months.

If several boils occur simultaneously or with relapses of the inflammatory process, they speak of furunculosis. This condition is more common in adolescents and young people with severe sensitization to pyococci, as well as in persons with somatic pathology (diabetes mellitus, gastrointestinal diseases, chronic alcoholism), chronic itchy dermatoses (scabies, lice).

Treatment

For single elements, local therapy is possible, which consists of treating the boil with a 5% solution of potassium permanganate and applying pure ichthyol to the surface of the unopened pustule. After opening the element, apply lotions with hypertonic solutions, iodopirone*, proteolytic enzymes (trypsin, chymotrypsin), antibiotic ointments (levomekol*, levosin*, mupirocin, silver sulfathiazole, etc.), as well as 10-20% ichthyol ointment, Vishnevsky liniment *.

For furunculosis, as well as when boils are localized in painful or “dangerous” areas, antibacterial treatment is indicated. Broad-spectrum antibiotics are used (in case of furunculosis, the sensitivity of the microflora must be determined): benzylpenicillin 300,000 units 4 times a day, doxycycline 100-200 mg/day, lincomycin 500 mg 3-4 times a day, amoxicillin + clavulanic acid 500 mg 2 times a day, cefazolin 1 g 3 times a day, cefuroxime 500 mg 2 times a day, imipenem + cilastatin 500 mg 2 times a day, etc. within 7-10 days.

For furunculosis, specific immunotherapy is indicated: a vaccine for the treatment of staphylococcal infections, antistaphylococcal immunoglobulin, staphylococcal vaccine and toxoid, etc.

In case of a recurrent course of purulent infection, it is recommended to conduct a course of nonspecific immunotherapy with lycopid * (for children - 1 mg 2 times a day, for adults - 10 mg / day), a-glutamyl-tryptophan, etc. It is possible to prescribe ultraviolet radiation.

If necessary, surgical opening and drainage of boils is prescribed.

Carbuncle

Carbuncle (carbunculus)- a conglomerate of boils united by a common infiltrate (Fig. 4-4). It is rare in children. Occurs acutely as a result of simultaneous damage to many adjacent follicles, represents an acute inflammatory infiltrate

Rice. 4-4. Carbuncle

with many necrotic rods. The infiltrate involves the skin and subcutaneous tissue, accompanied by severe swelling, as well as a violation of the general condition of the body. The skin over the infiltrate is purplish-red with a bluish tint in the center. On the surface of the carbuncle, several pointed pustules or black centers of incipient necrosis are visible. The further course of the carbuncle is characterized by the formation of several perforations on its surface, from which thick pus mixed with blood is released. Soon, all the skin covering the carbuncle melts, and a deep ulcer is formed (sometimes reaching the fascia or muscles), the bottom of which is a solid necrotic mass of a dirty green color; around the ulcer long time the infiltrate remains. The defect is filled with granulations and heals with a deep retracted scar. Carbuncles are usually single.

Often carbuncles are localized on the back of the neck and back. When elements are localized along the spine, the vertebral bodies can be affected, when located behind the auricle - the mastoid process, in the occipital region - the bones of the skull. Complications in the form of phlebitis, thrombosis of the cerebral sinuses, and sepsis are possible.

In the pathogenesis of the disease, an important role is played by metabolic disorders (diabetes mellitus), immunodeficiency, exhaustion and weakening of the body due to malnutrition, chronic infection, intoxication (alcoholism), as well as massive contamination of the skin as a result of non-compliance with the hygienic regime and microtrauma.

Treatment carbuncles are treated in a hospital setting with broad-spectrum antibiotics, specific and nonspecific immunostimulation is prescribed (see. Treatment of boils). In some cases, surgical treatment is indicated.

Hidradenitis

Hidradenitis (hydradenitis)- deep purulent inflammation of the apocrine glands (Fig. 4-5). Occurs in adolescents and young patients. Children before puberty and the elderly do not suffer from hidradenitis, since in the former the apocrine glands have not yet developed, and in the latter the function of the glands fades away.

Hidradenitis is localized in armpits, on the genitals, in the perineum, on the pubis, around the nipple, navel.

Clinical picture

First, a slight itching appears, then pain in the area of the formation of an inflammatory focus in the subcutaneous tissue. Deep in the skin (dermis and subcutaneous fatty tissue) one or several nodes of small size, round shape, dense consistency, painful on palpation are formed. Soon hyperemia appears above the nodes, which later acquires a bluish-red color.

A fluctuation occurs in the center of the nodes, and soon they open with the release of thick yellowish-green pus. After that inflammatory phenomena decrease, and the infiltrate gradually resolves -

Rice. 4-5. Hidradenitis

Yes. There is no necrosis of skin tissue, as with a boil. At the height of the development of hidradenitis, the body temperature rises (subfebrile), and malaise occurs. The disease lasts 10-15 days. Hidradenitis often recurs.

Recurrent hidradenitis on the skin is characterized by the appearance of double or triple comedones (fistula tracts connected to several superficial openings), as well as the presence of scars resembling cords.

The disease is especially severe in obese people.

Treatment

Broad-spectrum antibiotics are used (for chronic hidradenitis - always taking into account the sensitivity of the microflora): benzylpenicillin 300,000 4 times a day, doxycycline 100-200 mg/day, lincomycin 500 mg 3-4 times a day, amoxicillin + clavulanic acid according to 500 mg 2 times a day, cefazolin 1 g 3 times a day, cefuroxime 500 mg 2 times a day, imipenem + cilastatin 500 mg 2 times a day, etc. within 7-10 days.

In chronic cases, specific and nonspecific immunotherapy is prescribed.

If necessary, surgical opening and drainage of hidradenitis is prescribed.

External treatment consists of applying pure ichthyol to the surface of an unopened pustule, and when opening the element, lotions with hypertonic solutions, iodopirone *, proteolytic enzymes (trypsin, chymotrypsin), antibiotic ointments (levomekol *, levosin *, mupirocin, silver sulfathiazole, etc.) are used. etc.), as well as 10-20% ichthyol ointment, Vishnevsky liniment*.

Sycosis

Sycosis (sycosis)- chronic purulent inflammation of the follicles in the growth area of bristly hair (Fig. 4-6). The follicles of the beard, mustache, eyebrows, and pubic area are affected. This disease occurs exclusively in men.

Several factors play a decisive role in the pathogenesis of sycosis: infection of the skin with Staphylococcus aureus; imbalance of sex hormones (only seborrheic areas on the face are affected) and allergic reactions that develop in response to inflammation.

Rice. 4-6. Sycosis

The disease begins with the appearance of osteofolliculitis on hyperemic skin. Subsequently, pronounced infiltration develops, against which pustules, superficial erosions, and serous-purulent crusts are visible. Hair in the affected area is easily pulled out. There are no scars left. Sycosis is often complicated by eczematization, as evidenced by increased acute inflammatory phenomena, the appearance of itching, weeping, and serous crusts.

This disease is characterized by a long course with periodic remissions and exacerbations (over many months and even years).

Treatment. Broad-spectrum antibiotics are used, taking into account the sensitivity of the microflora. Externally use alcohol solutions of aniline dyes (brilliant green, Castellani liquid, methylene blue) 2-3 times a day on pustular elements, antiseptic solutions (chlorhexidine, miramistin *, sanguiritrin *, 1-2% chlorophyllipt *), antibiotic ointments (levomekol *, levosin*, mupirocin, silver sulfathiazole, etc.), as well as 10-20% ichthammol ointment, Vishnevsky liniment *.

In case of chronic relapsing course, retinoids are prescribed (isotretinoin, vitamin E + retinol, topical creams with adapalene, azelaic acid).

For eczematization, antihistamines are recommended (desloratadine, loratadine, mebhydrolin, chloropyramine, etc.), and locally combined glucocorticoid drugs (hydrocortisone + oxytetracycline, betamethasone + gentamicin + clotrimazole, etc.).

Barley

Barley (hordeolum)- purulent folliculitis and perifolliculitis of the eyelid area (Fig. 4-7). There are external barley, which is an inflammation of the Zeiss or Mohl gland, and internal barley, the result of inflammation of the meibomian gland. Barley can have unilateral or bilateral localization. Often found in children.

Clinically, swelling and redness of the eyelid margin are characteristic, accompanied by severe pain. Subjective sensations disappear after the abscess breaks out. In most cases, spontaneous self-healing occurs, but sometimes the inflammation becomes chronic and the stye recurs.

External treatment: use of antibacterial drugs (tobramycin, chloramphenicol drops, tetracycline ointment, etc.) for 4-7 days 2-4 times a day.

Staphylococcal pyoderma in children infancy

Staphylococcal infection continues to occupy one of the leading positions in the structure of morbidity in young children. Staphyloderma is very common among infants, which is due to the anatomical features of their skin structure. Thus, the fragile connection of keratinocytes of the basal layer with each other, as well as with the basement membrane, leads to epidermolytic processes; neutral skin pH is more favorable for the development of bacteria than an acidic environment in adults; There are 12 times more eccrine sweat glands in children than in adults, sweating is increased, and the excretory ducts

Rice. 4-7. Barley

sweat glands are straight and dilated, which creates the preconditions for the development of infectious diseases of the sweat glands in young children.

These structural and functional features of the skin of infants have led to the formation of a separate group of staphylococcal pyoderma, characteristic only of small children.

Miliaria and vesiculopustulosis

Miliaria and vesiculopustulosis (vesiculopustulos)- 2 conditions that are closely related to each other and represent 2 stages of the development of the inflammatory process in the eccrine sweat glands with increased sweating against the background of overheating of the child (high ambient temperature, fever in common infectious diseases). They occur more often by the end of the 1st month of a child’s life, when the sweat glands begin to actively function, and stop by the age of 1.5-2 years, when the mechanisms of sweating and thermoregulation are formed in children.

Miliaria is considered a physiological condition associated with hyperfunction of the eccrine sweat glands. The condition is clinically characterized by the appearance on the skin of small reddish papules - dilated mouths of the ducts of the eccrine sweat glands. The rashes are located on the scalp, upper third of the chest, neck, and back.

Vesiculopustulosis is a purulent inflammation of the mouths of the eccrine sweat glands against the background of existing prickly heat and is manifested by superficial pustules-vesicles the size of millet grains, filled with milky-white contents and surrounded by a halo of hyperemia (Fig. 4-8).

With widespread vesiculopustulosis, low-grade fever and malaise of the child are noted. In place of the pustules, serous-purulent crusts appear, after rejection of which there are no scars or hyperpigmented spots left. The process lasts from 2 to 10 days. In premature babies, the process spreads deeper and multiple abscesses occur.

Treatment consists of adequate temperature conditions for the child, hygienic baths, the use of disinfectant solutions (1% potassium permanganate solution, nitrofural, 0.05% chlorhexidine solution, etc.), pustular elements are treated with aniline dyes 2 times a day.

Rice. 4-8. Vesiculopustulosis

Multiple abscesses in children

Multiple abscesses in children, or Finger's pseudofurunculosis (pseudofurunculosis Finger), occur primarily or as a continuation of the course of vesiculopustulosis.

This condition is characterized by staphylococcal infection of the entire excretory duct and even the glomeruli of eccrine sweat glands. In this case, large, sharply defined hemispherical nodules and nodes of various sizes (1-2 cm) appear. The skin over them is hyperemic, bluish-red in color, subsequently becomes thinner, the nodes open with the release of thick greenish-yellow pus, and upon healing a scar (or scar) is formed (Fig. 4-9). In contrast

Rice. 4-9. Finger's pseudofurunculosis

from a boil, there is no dense infiltrate around the node, it opens without a necrotic core. The most common localization is the scalp, buttocks, inner thighs, and back.

The disease occurs with a disturbance in the general condition of the child: an increase in body temperature to 37-39 °C, dyspepsia, and intoxication. The disease is often complicated by otitis media, sinusitis, and pneumonia.

Children suffering from malnutrition, rickets, excessive sweating, anemia, and hypovitaminosis are especially prone to this disease.

Treatment of children with Finger's pseudofurunculosis is carried out jointly with a pediatric surgeon to decide whether it is necessary to open the nodes. Antibiotics are prescribed (oxacillin, azithromycin, amoxicillin + clavulanic acid, etc.). Bandages with ointment levomekol*, levosin*, mupirocin, bacitracin + neomycin, etc. are applied to the exposed nodes. It is advisable to carry out physiotherapeutic treatment methods: ultraviolet irradiation, UHF, etc.

Epidemic pemphigus of newborns

Epidemic pemphigus of newborns (pemphigus epidemicus neonatorum)- widespread superficial purulent skin lesion. It is a contagious disease that most often occurs in the 1st week of a child’s life. The rashes are localized on the buttocks, thighs, around the navel, limbs, and extremely rarely on the palms and soles (unlike the localization of blisters in syphilitic pemphigus). Multiple blisters with cloudy serous or serous purulent contents, ranging in size from a pea to a walnut, appear on non-infiltrated, unchanged skin. Merging and opening, they form weeping red erosions with fragments of the epidermis. Nikolsky's symptom in severe cases of the process can be positive. No crust is formed on the surface of the elements. The bottom of the erosions is completely epithelialized within a few days, leaving pale pink spots. The rash occurs in waves, in groups, over 7-10 days. Each attack of the disease is accompanied by an increase in body temperature to 38-39 °C. Children are restless, dyspepsia and vomiting occur. Changes in peripheral blood are characteristic: leukocytosis, a shift in the leukocyte formula to the left, an increase in the erythrocyte sedimentation rate (ESR).

This disease can be abortive, manifesting itself in a benign form. Benign form characterized by single flaccid blisters with serous-purulent contents, dis-

placed on a hyperemic background. Nikolsky's symptom is negative. The blisters are quickly resolved by large-plate peeling. The condition of newborns is usually not impaired; body temperature may rise to subfebrile.

Pemphigus in newborns is considered a contagious disease, so the sick child is isolated in a separate room or transferred to the infectious diseases department.

Treatment. Antibiotics and infusion therapy are prescribed. The bubbles are punctured, preventing the contents from coming into contact with healthy skin; the tire and erosions are treated with 1% solutions of aniline dyes. UFO is used. To avoid the spread of the process, it is not recommended to bathe a sick child.

Ritter's exfoliative dermatitis of newborns

Ritter's exfoliative dermatitis of newborns (dermatitis exfoliativa), or staphylococcal scalded skin syndrome, is the most severe form of staphylococcal pyoderma, developing in children in the first days of life (Fig. 4-10). The severity of the disease directly depends on the age of the sick child: the younger the child, the more severe the disease. The development of the disease is also possible in older children (up to

2-3 years), in which it has a mild course and is not widespread.

Etiology - staphylococci of the 2nd phage group, producing exotoxin (exfoliatin A).

The disease begins with an inflammatory, bright, swollen erythema in the mouth or umbilical wound, which quickly spreads to the folds of the neck, abdomen, genitals and anus. Against this background, large flaccid blisters form, which quickly open, leaving extensive wet eroded surfaces. With minor trauma, the swollen, loosened epidermis peels off in places.

Rice. 4-10. Ritter's exfoliative dermatitis

Nikolsky's symptom is sharply positive. There are no scars left. In some cases, bullous rashes initially predominate, and then the disease takes on the character of erythroderma, in others it immediately begins with erythroderma for 2-3 days, covering almost the entire surface of the body. There are 3 stages of the disease: erythematous, exfoliative and regenerative.

IN erythematous Stages include diffuse redness of the skin, swelling and blistering. The exudate formed in the epidermis and under it contributes to the peeling of areas of the epidermis.

IN exfoliative stages, erosions appear very quickly with a tendency to peripheral growth and fusion. This is the most difficult period (outwardly the child resembles a patient with second-degree burns), accompanied by high body temperature up to 40-41°C, dyspeptic disorders, anemia, leukocytosis, eosinophilia, high ESR, decreased body weight, and asthenia.

IN regenerative stage, hyperemia and swelling of the skin decrease, epithelization of erosive surfaces occurs.

In mild forms of the disease, the stages of the course are not clearly expressed. Benign form localized (only on the face, chest, etc.) and is characterized by mild skin hyperemia and large-plate peeling. The general condition of the patients is satisfactory. This form occurs in older children. The prognosis is favorable.

In severe cases, the process proceeds septically, often in combination with complications (pneumonia, omphalitis, otitis, meningeal phenomena, acute enterocolitis, phlegmon), which can lead to death.

Treatment consists of maintaining the child’s normal body temperature and water-electrolyte balance, gentle skin care, and antibiotic therapy.

The child is placed in an incubator with regular temperature control or under a Sollux lamp. Antibiotics are administered parenterally (oxacillin, lincomycin). γ-globulin is used (2-6 injections), anti-staphylococcal plasma infusions of 5-8 ml per 1 kg of body weight. Infusion therapy with crystalloids is carried out.

If the child’s condition allows, then he is bathed in sterile water with the addition of potassium permanganate (pink). Areas of unaffected skin are lubricated with 0.5% aqueous solutions of aniline dyes.

calves, and compresses with Burov's fluid, sterile isotonic sodium chloride solution with the addition of 0.1% silver nitrate solution, and 0.5% potassium permanganate solution are applied to the affected areas. The remnants of the exfoliated epidermis are cut off with sterile scissors. For severe erosions, apply powder with zinc oxide and talc. For dry erosions, antibacterial ointments are prescribed (2% lincomycin, 1% erythromycin, containing fusidic acid, mupirocin, bacitracin + neomycin, sulfadiazine, silver sulfathiazole, etc.).

Streptococcal pyoderma ( streptodermia)

Streptococcal impetigo

Streptococcal impetigo (impetigo streptogenes)- the most common form of streptoderma in children, it is contagious. Morphological element - conflict- superficial epidermal pustule with a thin, flabby covering, lying almost at the level of the skin, filled with serous contents (Fig. 4-11). The phlyctena is surrounded by a zone of hyperemia (rim) and tends to grow peripherally (Fig. 4-12). Its contents quickly dry out into a straw-yellow crust, which, when removed, forms a moist, erosive surface. Around the primary conflict, new small, grouped conflicts appear, when opened, the hearth acquires a scalloped outline. The process ends in 1-2 weeks. Nai-

Rice. 4-11. Streptococcal impetigo

Rice. 4-12. Streptococcal impetigo on the face

more common localization: cheeks, lower jaw, around the mouth, less often on the skin of the body.

Children with streptococcal impetigo are restricted from attending schools and child care facilities.

There are several clinical varieties streptococcal impetigo.

Bullous impetigo

Bullous impetigo (impetigo bullosa) characterized by pustules and blisters located in areas of the skin with a pronounced stratum corneum or in the deeper layers of the epidermis. With bullous impetigo, the bladder cover is often tense, the contents are serous-purulent, sometimes with bloody contents (Fig. 4-13, 4-14). The disease often develops in young and middle-aged children and spreads to

Rice. 4-13. Bullous impetigo: a blister with bloody contents

Rice. 4-14. Bullous impetigo due to immunodeficiency

lower extremities, accompanied by a violation of the general condition, a rise in body temperature, and septic complications are possible.

Treatment is antibiotic therapy. Externally use 1% alcohol solutions of aniline dyes (brilliant green, Castellani liquid, methylene blue) 2-3 times a day.

Slit impetigo

Slit-like impetigo, seized (impetigo fissurica)- streptoderma of the corners of the mouth (Fig. 4-15). Often develops in middle-aged children and adolescents with the habit of licking their lips (dry lips in atopic dermatitis, actinic cheilitis, chronic eczema), as well as in patients with difficulty breathing through the nose (chronic tonsillitis) - excessive wetting of the corners occurs when sleeping with the mouth open mouth, which contributes to the development of inflammation. Phlyctena is localized in the corners of the mouth, quickly opens and is an erosion surrounded by a corolla

Rice. 4-15. Impetigo of the corners of the mouth (jamming)

exfoliated epidermis. In the center of the erosion in the corner of the mouth there is a radial crack, partially covered with honey-yellow crusts.

Treatment consists of the external use of antibacterial ointments (mupirocin, levomekol*, fusidic acid, erythromycin ointment, etc.), as well as aqueous solutions of aniline dyes (1% brilliant green, 1% methylene blue, etc.).

Superficial panaritium

Superficial panaritium (turnoe)- inflammation of the periungual ridges (Fig. 4-16). It often develops in children with hangnails, nail injuries, and onychophagia. The inflammation surrounds the legs in a horseshoe shape.

adhesive plate, accompanied by severe pain. In a chronic course, the skin of the nail fold is bluish-red in color, infiltrated, a fringe of exfoliating epidermis is located along the periphery, and a drop of pus is periodically released from under the nail fold. The nail plate becomes deformed, dull, and onycholysis may occur.

As inflammation spreads, deep forms of panaritium may develop, requiring surgical intervention.

Treatment. For localized forms, external treatment is prescribed - treatment of pustules with aniline dyes, 5% solution of potassium permanganate, apply

wipes with Vishnevsky liniment*, 10-12% ichthammol ointment, use antibacterial ointments.

In case of a widespread process, antibiotic therapy is prescribed. Consultation with a surgeon is recommended.

Intertriginous streptoderma, or streptococcal intertrigo (intertrigo streptogenes), occurs on contacting surfaces

Rice. 4-16. Superficial panaritium

skin folds in a child: inguinal-femoral and intergluteal, behind the ears, in the armpits, etc. (Fig. 4-17). The disease occurs mainly in children suffering from obesity, hyperhidrosis, atopic dermatitis, and diabetes mellitus.

Appearing in large numbers, phlyctenas merge and quickly open up, forming continuous eroded, wet surfaces of a bright pink color, with scalloped borders and a border of exfoliating epidermis along the periphery. Next to the main lesions, screenings are visible in the form of separately located pustular elements located on various stages development. Deep in the folds there are often painful cracks. The course is long and accompanied by pronounced subjective disturbances.

Treatment consists of treating pustular elements with 1% aqueous solutions of aniline dyes (brilliant green, methylene blue), a solution of chlorhexidine, miramistin*, external use of pastes containing antibacterial components, antibacterial ointments (bacitracin + neomycin, mupirocin, 2% lincomycin, 1% erythromycin ointments etc.). For preventive purposes, the folds are treated with powders (with clotrimazole) 3-4 times a day.

Post-erosive syphiloid

Post-erosive syphiloid, or syphiloid-like papular impetigo (syphiloides posterosives, impetigo papulosa syphiloides), occurs in children predominantly of infant age. Localization - skin of the buttocks, genitals, thighs. The disease begins with quickly opening-

Rice. 4-17. Intertriginous streptoderma

There are conflicts, which are based on infiltration, which makes these elements similar to papuloerosive syphilide. However, an acute inflammatory reaction is not typical for syphilitic infection. Poor hygienic care plays a role in the occurrence of this disease in children (another name for the disease is “diaper dermatitis”).

Treatment. Externally, the anogenital area is treated with antiseptic solutions (0.05% solutions of chlorhexidine, nitrofural, miramistin*, 0.5% potassium permanganate solution, etc.) 1-2 times a day, antibacterial pastes are used (2% lincomycin, 2% erythromycin ), antibacterial ointments (2% lincomycin, 1% erythromycin ointment, 3% tetracycline ointment, mupirocin, bacitracin + neomycin, etc.). For preventive purposes, the skin is treated 3-4 times (with each diaper or diaper change) with protective soft pastes (special creams for diapers, cream with zinc oxide, etc.), powders (with clotrimazole).

Ringworm simplex

Ringworm simplex (pityriasis simplex)- dry superficial streptoderma, caused by non-contagious forms of streptococcus. Inflammation develops in the stratum corneum of the epidermis and is keratopyoderma. Occurs especially often in children and adolescents.

The rashes are most often localized on the cheeks, chin, limbs, and less often on the torso. Lichen simplex often occurs in children with atopic dermatitis, as well as with xerosis of the skin. Clinically characterized by the formation of round, clearly demarcated pink lesions, abundantly covered with silvery scales (Fig. 4-18).

Rice. 4-18. Dry superficial streptoderma

The disease occurs without acute inflammatory manifestations, is long-lasting, and self-healing is possible. After the rash resolves, temporary depigmented spots remain on the skin (Fig. 4-19).

Treatment consists in the external use of antibacterial ointments (bacitracin + neomycin, mupirocin, 2% lincomycin, erythromycin ointments, etc.), in the presence of atopic dermatitis and xerosis of the skin, it is recommended to use combined glucocorticoid drugs (hydrocortisone ointment + oxytetracycline, hydrocortisone creams + natamycin + neomycin , hydrocortisone + fusidic

acid, etc.) and regularly apply moisturizing and softening creams (lipicar *, Dardia *, emoleum *, etc.).

Rice. 4-19. Dry superficial streptoderma (depigmented spots)

Ecthyma vulgaris

Ecthyma vulgaris (ecthyma vulgaris)- deep dermal pustule, which occurs more often in the shin area, usually in persons with reduced body resistance (exhaustion, chronic somatic diseases, vitamin deficiency, alcoholism), immunodeficiency, in case of non-compliance with sanitary and hygienic standards, against the background of chronic itchy dermatoses (Fig. 4-20 , 4-21). This disease is not typical for young children.

Distinguish pustular And ulcerative stage. The process begins with the appearance of an acutely inflammatory painful nodule in the thickness of the skin, on the surface of which a pustule appears with cloudy serous-purulent and then purulent contents. The pustule spreads inward and along the periphery due to the purulent melting of the infiltrate, which shrinks into a grayish-brown crust. In severe cases, the inflammation zone around the crust expands and a layered crust forms - rupee. When the crust is peeled away, a deep

Rice. 4-20. Ecthyma vulgaris

Rice. 4-21. Multiple ecthymas

an ulcer whose bottom is covered with purulent plaque. The edges of the ulcer are soft, inflamed, and rise above the surrounding skin.

At favorable course granulations appear under the crust and scarring occurs. The duration of the course is about 1 month. A retracted scar remains at the site of the rash.

Treatment. Broad-spectrum antibiotics are prescribed, preferably taking into account the sensitivity of the flora: benzylpenicillin 300,000 units 4 times a day, doxycycline 100-200 mg/day, lincomycin 500 mg 3-4 times a day, amoxicillin + clavulanic acid 500 mg

2 times a day, cefazolin 1 g 3 times a day, cefuroxime 500 mg 2 times a day, imipenem + cilastatin 500 mg 2 times a day, etc. within 7-10 days.

At the bottom of the ulcer, wipes with proteolytic enzymes (trypsin, chymotrypsin, collitin *, etc.), antibacterial ointments (levomekol *, levosin *, silver sulfathiazole, sulfadiazine, etc.) are applied, the edges of the ecthyma are treated with aqueous solutions of aniline dyes, 5% potassium permanganate solution.

Erysipelas

Erysipelas, or erysipelas (erysipelas),- acute damage to a limited area of skin and subcutaneous tissue, is caused by group A beta-hemolytic streptococcus.

The pathogenesis of erysipelas is quite complex. Great importance give to allergic restructuring of the body. Erysipelas is a peculiar reaction of the body to streptococcal infection, characterized by trophic disorders of the skin, associated with damage to the vessels of the lymphatic system (the development of lymphangitis).

The “entry gate” of infection is often microtraumas of the skin: in adults - small cracks on the feet and in interdigital folds, in children - macerated skin of the anogenital area, in newborns - umbilical wound. If the patient has foci of chronic infection, streptococcus enters the skin through the lymphogenous or hematogenous route.

The incubation period for erysipelas lasts from several hours to 2 days.

In most cases, the disease develops acutely: there is a sharp rise in body temperature to 38-40 ° C, malaise, chills, nausea, and vomiting. Skin rashes are preceded by local soreness, pink-red erythema soon appears, dense and hot to the touch, then the skin becomes swollen, bright red. The boundaries of the lesion are clear, often with a bizarre pattern in the form of flames, painful on palpation, regional lymph nodes are enlarged. The listed symptoms are typical for erythematous form erysipelas (Fig. 4-22).

At bullous form as a result of detachment of the epidermis with exudate, vesicles and bullae of various sizes are formed (Fig. 4-23). The contents of the blisters contain a large number of streptococci; when they rupture, the pathogen may spread and new lesions may appear.

Rice. 4-22. Erysipelas in a baby

Rice. 4-23. Erysipelas. Bullous form

In weakened patients, it is possible to develop phlegmonous And necrotic forms erysipelas. Treatment of these patients should be carried out in surgical hospitals.

The average duration of the disease is 1-2 weeks. In some cases, a recurrent course of erysipelas develops, especially often localized on the extremities, which leads to pronounced trophic disorders (lymphostasis, fibrosis, elephantiasis). Recurrent erysipelas is not typical for children; it is more often observed in adult patients with chronic somatic diseases, obesity, after radiation therapy or surgical treatment of cancer.

Complications of erysipelas - phlebitis, phlegmon, otitis, meningitis, sepsis, etc.

Treatment. Penicillin antibiotics are prescribed (benzylpenicillin 300,000 units intramuscularly 4 times a day, amoxicillin 500 mg 2 times a day). Antibiotic therapy is carried out for 1-2 weeks. In case of intolerance to penicillins, antibiotics of other groups are prescribed: azithromycin 250-500 mg once a day for 5 days, clarithromycin 250-500 mg 2 times a day for 10 days.

Infusion detoxification therapy is carried out [hemodez*, dextran (average molecular weight 35000-45000), trisol*].

Externally, lotions with antiseptic solutions (1% potassium permanganate solution, iodopyrone *, 0.05% chlorhexidine solution, etc.), antibacterial ointments (2% lincomycin, 1% erythromycin ointment, mupirocin, bacitracin + neomycin, etc.) are used for rashes. .d.), combined glucocorticoid agents (hydrocortisone + fusidic acid, betamethasone + fusidic acid, hydrocortisone + oxytetracycline, etc.).

Mixed streptostaphylococcal pyoderma (streptostaphylodermia)

Streptostaphylococcal impetigo, or vulgar impetigo (impetigo streptostaphylogenes),- superficial contagious streptostaphylococcal pyoderma (Fig. 4-24).

The disease begins as a streptococcal process, which is joined by a staphylococcal infection. Serous contents

Rice. 4-24. Streptostaphylococcal impetigo

the pustule becomes purulent. Next, powerful yellowish-green crusts form in the outbreak. The duration of the disease is about 1 week, ending with the formation of temporary post-inflammatory pigmentation. Rashes often appear on the face and upper extremities. Widespread pyoderma may be accompanied by low-grade fever and lymphadenopathy. Often occurs in children, less often in adults.

Treatment. For widespread inflammatory processes, broad-spectrum antibiotics are prescribed (cephalexin 0.5-1.0 3 times a day, amoxicillin + clavulanic acid 500 mg/125 mg 3 times a day, clindamycin 300 mg 4 times a day).

For limited damage, only external treatment is recommended. Apply 1% aqueous solutions aniline dyes (diamond green, methylene blue), antibacterial ointments (with fusidic acid, bacitracin + neomycin, mupirocin, 2% lincomycin, 1% erythromycin, etc.), as well as pastes containing antibiotics (2% lincomycin, etc. )

Children with streptostaphyloderma are restricted from attending schools and child care institutions.

Chronic ulcerative and ulcerative-vegetative pyoderma

Chronic ulcerative and ulcerative-vegetative pyoderma (pyodermitis chronica exulcerans et vegetans)- a group of chronic pyoderma, characterized by a long and persistent course, in the pathogenesis of which the main role belongs to immunity disorders

(Figure 4-25).

Rice. 4-25. Chronic ulcerative pyoderma

The causative agents of the disease are staphylococci, streptococci, pneumococci, as well as gram-negative flora.

Purulent ulcers are localized mainly on the lower legs. Most often they are preceded by a boil or ecthyma. Acute inflammatory phenomena subside, but the disease becomes chronic. A deep infiltrate is formed, subjected to purulent melting, with the formation of extensive ulcerations, fistula tracts with the release of pus. Over time, the bottom of the ulcers becomes covered with flaccid granulations, the congestively hyperemic edges become infiltrated, and their palpation is painful. Formed chronic ulcerative pyoderma.

At chronic ulcerative-vegetative pyoderma the bottom of the ulcer is covered with papillomatous growths and cortical layers, when squeezed, drops of thick pus are released from the interpapillary fissures. There is a tendency to serping. Foci of ulcerative-vegetative pyoderma are most often localized on the dorsum of the hands and feet, in the ankles, on the scalp, pubis, etc.

Chronic pyoderma lasts for months, years. Healing proceeds through rough scarring, as a result of which areas of healthy skin are also enclosed in scar tissue. The prognosis is serious.

This course of pyoderma is typical for adult patients and older children with severe immune deficiency, severe somatic and oncological diseases, alcoholism, etc.

Treatment. Assign combination therapy, including antibiotics, always taking into account the sensitivity of the wound microflora, and glucocorticoid drugs (prednisolone 20-40 mg/day).

It is possible to use specific immunotherapy: a vaccine for the treatment of staphylococcal infections, anti-staphylococcal immunoglobulin, staphylococcal vaccine and toxoid, etc.

A course of nonspecific immunotherapy is prescribed: lycopid * (for children - 1 mg 2 times a day, for adults - 10 mg / day), a-glutamyltryptophan, thymus extract, etc. Physiotherapy (Ural irradiation, laser therapy) may be prescribed.

Proteolytic enzymes that help cleanse the ulcer (trypsin, chymotrypsin, etc.), wound wipes with antiseptic agents (voskopran*, parapran*, etc.), antibacterial ointments (levomekol*, levosin*, silver sulfathiazole, sulfadiazine, etc.) are used externally etc.).

In case of ulcerative-vegetative pyoderma, destruction of papillomatous growths at the bottom of the ulcer is carried out (cryo-, laser-, electrodestruction).

Chancriform pyoderma

Chancriform pyoderma (pyodermia chancriformis)- a deep form of mixed pyoderma, clinically similar to syphilitic chancre (Fig. 4-26).

Rice. 4-26. Chancriform pyoderma

The causative agent of the disease is Staphylococcus aureus, sometimes in combination with streptococcus.

Chancriform pyoderma develops in both adults and children.

In most patients, the rashes are localized in the genital area: on the glans penis, foreskin, labia minora and labia majora. In 10% of cases, an extragenital location of the rash is possible (on the face, lips, eyelids, tongue).

The occurrence of the disease is facilitated by poor skin care, long foreskin with a narrow opening (phimosis), resulting in an accumulation of smegma, which irritates the glans and foreskin.

The development of chancriform pyoderma begins with a single pustule, which quickly turns into erosion or a superficial ulcer of regularly round or oval shape, with dense, roller-like raised edges and an infiltrated bottom of a meat-red color, covered with a slight fibrinous-purulent coating. The size of the ulcer is 1 cm in diameter. The discharge from the ulcer is scanty, serous or serous-purulent; upon examination, coccal flora is detected. There are no subjective sensations. Ulcers are usually single, rarely multiple. The similarity with syphilitic chancroid is aggravated by the presence at the base of the ulcer of more or less

less pronounced compaction, low pain of the ulcer, moderate compaction and enlargement of regional lymph nodes to the size of a cherry or hazelnut.

The course of chancriform pyoderma can last up to 2-3 months and ends with the formation of a scar.

Other bacterial processes

Pyogenic granuloma

Pyogenic granuloma, or botryomycomoma, or telangiectatic granuloma (granulomapyogenicum, botryomycoma), traditionally belongs to the group of pyoderma, although in fact it is a special form of hemangioma, the development of which is provoked by coccal flora (Fig. 4-27).

Often observed in young and middle-aged children (Fig. 4-28).

Clinically, pyogenic granuloma is a rapidly growing tumor-like formation on a stalk, consisting of capillaries, ranging in size from a pea to a hazelnut. The surface of pyogenic granuloma is uneven, often with bleeding bluish-red erosions, covered with purulent-hemorrhagic crusts. Sometimes ulceration, necrotization, and in some cases keratinization occur.

The favorite localization of pyogenic granuloma is the face and upper extremities. In most cases, it develops at sites of injury, insect bites, and long-term non-healing wounds.

Treatment is destruction of the element (diathermocoagulation, laser destruction, etc.).

Rice. 4-27. Pyogenic granuloma

Rice. 4-28. Pyogenic granuloma in a child

Erythrasma

Erythrasma (erytrasma)- chronic bacterial skin lesions (Fig. 4-29, 4-30). Pathogen - Corynebacterium fluorescens erytrasmae, multiplying only in the stratum corneum of the skin. The most common localization of rashes is large folds (inguinal, axillary, under the mammary glands, perianal area). Predisposing factors for the development of erythrasma: increased sweating, high temperature, humidity. The contagiousness of erythrasma is low. The disease is typical for patients with excess body weight, diabetes mellitus and other metabolic diseases. In young children, the disease occurs extremely rarely; it is more common in adolescents with endocrinological diseases.

The rashes are represented by non-inflammatory scaly spots of brownish-red color, with sharp boundaries, prone to peripheral growth and fusion. The spots are sharply demarcated from the surrounding skin. Usually they rarely extend beyond the contacting areas of the skin. In the hot season, increased redness, swelling of the skin, and often vesiculation and weeping are observed. Lesions in the rays of a Wood's lamp have a characteristic coral-red glow.

Treatment includes treatment of lesions with 5% erythromycin ointment 2 times a day for 7 days. For inflammation - diflucortolone cream + isoconazole 2 times a day, then isoconazole, course of treatment - 14 days.

Rice. 4-29. Erythrasma

Rice. 4-30. Erythrasma and residual manifestations of furunculosis in a patient with diabetes mellitus

Econazole ointment and 1% clotrimazole solution are effective. In case of a widespread process, erythromycin 250 mg is prescribed every 6 hours for 14 days or clarithromycin 1.0 g once.

Prevention of the disease - combating sweating, maintaining good hygiene, using acidic powders.

Features of the course of pyoderma in children

In children, especially newborns and infants, the main reason for the development of pyoderma is poor hygienic care.

In young children, contagious forms of pyoderma (pemphigus of newborns, impetigo, etc.) often occur. For these diseases, it is necessary to isolate sick children from children's groups.

In childhood, acute superficial forms of pyoderma are more typical than deep chronic forms.

Hidradenitis develops only in adolescents during puberty.

Pathomimia characteristic of childhood and adolescence (artificial dermatitis, excoriated acne, onychophagia, etc.) is often accompanied by the addition of pyoderma.

The development of chronic ulcerative and ulcerative-vegetative pyoderma, carbuncles, and sycosis is not typical for childhood.

Consulting patients with pyoderma

Patients need to be explained the infectious nature of pyoderma. In some cases, it is necessary to exclude children from attending schools and preschool institutions. For all types of pyoderma, water procedures are contraindicated, especially those associated with prolonged exposure to water, high temperatures, and rubbing the skin with a washcloth. For pyoderma, therapeutic massages are contraindicated; in the acute period, all types of physical therapy are contraindicated. In order to prevent secondary infection, it is recommended to boil and iron the clothes and bedding of children, especially those suffering from streptoderma, with a hot iron.

In case of deep and chronic pyoderma, a thorough examination of patients is necessary, identifying chronic diseases that contribute to the development of pyoderma.

Scabies (scabies)

Etiology

The life cycle of a tick begins with the contact of a fertilized female on human skin, which immediately penetrates deep into the skin (to the granular layer of the epidermis). Moving forward along the scabies course, the female feeds on the cells of the granular layer. In the mite, digestion of food occurs outside the intestine with the help of a secretion secreted into the scabies tract, which contains a large amount of proteolytic enzymes. The daily fertility of a female is 2-3 eggs. 3-4 days after laying the eggs, the larvae hatch from them, leave the passage through the “ventilation holes” and re-emerge into the skin. After 4-6 days, adult sexually mature individuals are formed from the larvae. And the cycle begins again. The lifespan of a female is 1-2 months.

Scabies mites are characterized by a strict daily rhythm of activity. During the day, the female is at rest. In the evening and in the first half of the night, she gnaws 1 or 2 egg knees at an angle to the main direction of the passage and lays an egg in each of them, having previously deepened the bottom of the passage and made a “ventilation hole” in the “roof” for the larvae. The second half of the night it gnaws in a straight line, feeding intensively, and during the day it stops and freezes. The daily program is carried out by all females synchronously, which explains the appearance of itching in the evening, the predominance straight path infections in bed at night, the effectiveness of applying acaricidal drugs in the evening and at night.

Epidemiology

Seasonality - the disease is more often registered in the autumn-winter season, which is associated with the highest fertility of females at this time of year. Transmission routes:

. straight the path (directly from person to person) is most common. Scabies is a disease of close bodily contact. The main circumstance under which infection occurs is sexual contact (in more than 60% of cases), which was the basis for including scabies in the group of STIs. Infection also occurs while sleeping in the same bed, while caring for a child, etc. In a family, if there is 1 patient with widespread scabies, almost all family members become infected;

. indirect, or mediated, the path (through objects used by the patient) is much less common. The pathogen is transmitted through shared use of bedding, linen, clothing, gloves, washcloths, toys, etc. In children's groups, indirect transmission occurs much more often than in adults, which is associated with the exchange of clothing, toys, writing materials, etc.

The invasive stages of the mite are the young female scabies mite and the larva. It is at these stages that the tick is able to move from a host to another person and exist in the external environment for some time.

The most favorable conditions for a tick to live outside its “host” are fabrics made from natural materials (cotton, wool, leather), as well as house dust and wooden surfaces.

The spread of scabies is facilitated by poor sanitation and hygiene, migration, overcrowding, and diagnostic errors, late diagnosis, atypical unrecognized forms of the disease.

Clinical picture

The incubation period ranges from 1-2 days to 1.5 months, which depends on the number of mites caught on the skin, the stage in which these mites are located, the tendency to allergic reactions, as well as the cleanliness of the person.

The main clinical symptoms of scabies: itching at night, the presence of scabies, polymorphism of rashes and characteristic localization.

Itching

The main complaint in patients with scabies is itching, which gets worse in the evening and at night.

Several factors are noted in the pathogenesis of itching with scabies. The main cause of itching is mechanical irritation of the nerve endings when the female moves, which explains the nocturnal nature of the itching. Reflex itching may occur.

Also important in the formation of itching are allergic reactions that occur when the body is sensitized to the mite itself and its waste products (saliva, excrement, egg shells, etc.). Among allergic reactions when infected with scabies highest value has a type 4 delayed hypersensitivity reaction. An immune response, manifested by increased itching, develops 2-3 weeks after infection. At re-infection itching appears after a few hours.

Scabies move

Scabies is the main diagnostic sign of scabies, distinguishing it from other itchy dermatoses. The course looks like a slightly raised line of dirty gray color, curved or straight, 5-7 mm long. Sézary's symptom is detected - palpation detection of scabies in the form of a slight elevation. The itch ends in a raised blind end with the female. Scabies can be detected with the naked eye; if necessary, use a magnifying glass or dermatoscope.

If scabies are detected, you can use ink test. A suspicious area of skin is treated with ink or a solution of any aniline dye, and after a few seconds the remaining paint is wiped off with an alcohol swab. Uneven coloring of the skin above the scabies occurs due to paint getting into the “ventilation holes”.

Polymorphism of rashes

The polymorphism of rashes is characterized by various morphological elements that appear on the skin during scabies.

The most common are papules, vesicles measuring 1-3 mm, pustules, erosions, scratches, purulent and hemorrhagic crusts, post-inflammatory pigmentation spots (Fig. 4-31, 4-32). Seropapules, or papules-vesicles, are formed at the site where the larvae penetrate the skin. Pustular elements appear with the addition of a secondary infection, hemispherical itchy papules - with lymphoplasia.

The largest number of scabies are found on the hands, wrists, and in young men - on the genitals (Fig. 4-33).

The polymorphism of scabies rashes is often determined Ardi-Gorchakov's symptom- presence of pustules, purulent and hemorrhagic

Rice. 4-31. Scabies. Abdominal skin

Rice. 4-32. Scabies. Skin of the forearm

Rice. 4-33. Scabies. Genital skin

crusts on the extensor surfaces of the elbow joints (Fig. 4-34) and Michaelis sign- the presence of impetiginous rashes and hemorrhagic crusts in the intergluteal fold with transition to the sacrum

(Figure 4-35).

Localization

The typical localization of scabies rashes is the interdigital folds of the fingers, the area of the wrist joints, the flexor surface of the forearms, in women - the area of the nipples of the mammary glands and abdomen, and in men - the genitals.

Rice. 4-34. Scabies. Ardi-Gorchakov's symptom

Rice. 4-35. Scabies. Michaelis symptom

Damage to the hands is most significant in case of scabies, since it is here that the main number of scabies burrows are localized and the bulk of larvae are formed, which are passively spread throughout the body by hand.

In adults, scabies does not affect the face, scalp, upper third of the chest and back.

The localization of scabies rashes in children depends on the age of the child and differs significantly from skin lesions in adults.

Complications

Complications often change the clinical picture and significantly complicate diagnosis.

Pyoderma is the most common complication, and with widespread scabies it always accompanies the disease (Fig. 4-36, 4-37). The most common developments are folliculitis, impetiginous elements, boils, ecthyma, and the development of phlegmon, phlebitis, and sepsis is possible.

Dermatitis is characterized by a mild course, clinically manifested by foci of erythema with unclear boundaries. Often localized in the folds of the abdomen.

Eczema develops with long-standing widespread scabies and is characterized by a torpid course. Microbial eczema most often develops. The lesions have clear boundaries, numerous vesicles, oozing, and serous-purulent crusts appear. The rashes are localized on the hands (possible

Rice. 4-36. Scabies complicated by pyoderma

Rice. 4-37. Common scabies complicated by pyoderma

and bullous elements), feet, in women - in the circumference of the nipples, and in men - on the inner surface of the thighs.

Hives.

Nail lesions are detected only in infants; Thickening and clouding of the nail plate are characteristic.

Features of the course of scabies in children

Clinical manifestations of scabies in children depend on the age of the child. Features of scabies in infants

The process is generalized, rashes are localized throughout the skin (Fig. 4-38). Rashes pre-

are formed by small papular elements of bright pink color and erythematous-squamous foci (Fig. 4-39).

The pathognomonic symptom of scabies in infants is symmetrical vesicular-pustular elements on the palms and soles (Fig. 4-40, 4-41).

No excoriation or hemorrhagic crusts.

The addition of a secondary infection, manifested by focal erythematous-squamous foci covered with purulent crusts.

Rice. 4-38. Common scabies

Rice. 4-39. Common scabies in infants

Rice. 4-40.Scabies in a child. Brushes

Rice. 4-41.Scabies in a child. Feet

In most infants, scabies becomes more complicated allergic dermatitis, torpid to antiallergic therapy.

When examining mothers of sick children or those providing primary care for the child, typical manifestations of scabies are identified.

Features of scabies in young children

. The rash is similar to that seen in adults. Excoriations and hemorrhagic crusts are characteristic.

The favorite localization of rashes is the “panty area”: the stomach, buttocks, and in boys the genitals. In some cases, vesicular-pustular elements remain on the palms and soles, which are complicated by eczematous rashes. The face and scalp are not affected.

A frequent complication of scabies is common pyoderma: folliculitis, furunculosis, ecthyma, etc.

Severe night itching can cause sleep disturbances in children, irritability, and decreased performance at school.

In adolescents, the clinical picture of scabies resembles scabies in adults. The frequent addition of a secondary infection with the development of common forms of pyoderma is noted.

Clinical types of scabiesTypical shape

The typical form described includes fresh scabies and widespread scabies.

Fresh scabies is the initial stage of the disease with an incomplete clinical picture of the disease. It is characterized by the absence of scabies on the skin, and the rashes are represented by follicular papules and seropapules. The diagnosis is made by examining persons who have been in contact with a person with scabies.

The diagnosis of widespread scabies is made with a long course and complete clinical picture diseases (itching, scabies, polymorphism of rashes with typical localization).

Low-symptomatic scabies

Scabies is asymptomatic, or “erased,” and is characterized by moderate skin rashes and mild itching. The reasons for the development of this form of scabies may be the following:

Careful adherence by the patient to the rules of hygiene, frequent washing with a washcloth, which helps to “wash off” ticks, especially in the evening;

Skin care, which consists of regular use of moisturizing body creams, covering the ventilation holes and disrupting the vital activity of the mite;

Occupational hazards consisting of contact of substances with acaricidal activity (motor oils, gasoline, kerosene, diesel fuel, household chemicals, etc.) on the patient’s skin, which leads to a change in the clinical picture (lack of

rashes on the hands and open areas of the skin, but significant lesions on the skin of the torso).

Norwegian scabies

Norwegian (crusted, crustose) scabies is a rare and particularly contagious form of scabies. It is characterized by the predominance of massive cortical layers in typical places, the rejection of which exposes erosive surfaces. Typical scabies even appear on the face and neck. This form of scabies is accompanied by a disturbance in the general condition of the patient: increased body temperature, lymphadenopathy, leukocytosis in the blood. Develops in individuals with disorders skin sensitivity, mental disorders, immunodeficiency (Down's disease, senile dementia, syringymyelia, HIV infection, etc.).

Scabies "incognito"

“Incognito” scabies, or unrecognized scabies, develops against the background of drug treatment with drugs that suppress inflammatory and allergic reactions and have an antipruritic and hypnotic effect. Glucocorticoids, antihistamines, neurotropic drugs and other agents suppress itching and scratching in patients, which creates favorable conditions for the mite to spread over the skin. The clinical picture is dominated by scabies, excoriation is absent. Such patients are very contagious to others.

Postscabiosis lymphoplasia

Postscabiosis lymphoplasia is a condition after treatment of scabies, characterized by the appearance on the patient’s skin of hemispherical nodules the size of a pea, bluish-pink or brownish in color, with a smooth surface, dense consistency and accompanied by severe itching. This disease is often observed in infants and young children (Fig. 4-42).

Postscabiosis lymphoplasia is a reactive hyperplasia of lymphoid tissue in the areas of its greatest accumulation. Favorite localization is the perineum, scrotum, inner thighs, and axillary fossae. The number of elements is from 1 to 10-15. The course of the disease is long, from several weeks to several months. Anti-scabies therapy is ineffective. Spontaneous regression of elements is possible.

Rice. 4-42. Postscabiosis lymphoplasia

Diagnostics

The diagnosis of scabies is established on the basis of a combination of clinical manifestations, epidemic data, results laboratory research and trial treatment.

The most important to confirm the diagnosis are the results of laboratory diagnostics with the detection of the female, larvae, eggs, and empty egg membranes under a microscope.

There are several methods for detecting ticks. The simplest is the layer-by-layer scraping method, which is carried out on a suspicious area of skin with a scalpel or scarifier until pinpoint bleeding appears (with this method,

In the wild, the scraping is treated with alkali) or with a sharp spoon after first applying a 40% lactic acid solution. The resulting scraping is examined under a microscope.

Differential diagnosis

Scabies is differentiated from atopic dermatitis, prurigo, pyoderma, etc.

Treatment

Treatment is aimed at destroying the pathogen with acaricidal drugs. External preparations are mainly used.

The general principles of treatment of patients with scabies, the choice of medications, and the timing of clinical examination are determined by the “Protocol for the management of patients. Scabies" (order of the Ministry of Health of the Russian Federation No. 162 of April 24, 2003).

General rules for prescribing anti-scabies drugs:

Use the drug in the evening, preferably before bedtime;

The patient should take a shower and change his underwear and bed linen before starting treatment and at the end;

The drug must be applied to all areas of the skin, with the exception of the face and scalp;

The drug should be applied only by hand (not with a swab or napkin), which is due to the high number of scabies on the hands;

It is necessary to avoid contact of the drug with the mucous membrane of the eyes, nasal passages, oral cavity, as well as genitals; in case of contact with mucous membranes, rinse them with running water;

Exposure of the drug applied to the skin should be at least 12 hours;

The drug should be rubbed in the direction of vellus hair growth (which reduces the possibility of developing contact dermatitis and folliculitis);

After treatment, do not wash your hands for 3 hours, then rub the drug into the skin of your hands after each wash;

You should not use anti-scabies drugs an excessive number of times (exceeding the recommended regimens), since the toxic effect of the drugs will increase, but the anti-scabies activity will remain the same;

Treatment of patients identified in one outbreak (for example, in a family) is carried out simultaneously to avoid reinfection.

The most effective anti-scabies drugs: benzyl benzoate, 5% permethrin solution, piperonyl butoxide + esbiol, sulfur ointment.

.Benzyl benzoate water-soap emulsion(20% - for adults, 10% - for children or in the form of 10% ointment) is used according to following diagram: treatment with the drug is prescribed twice - on the 1st and 4th days of treatment. Before use, the suspension is thoroughly shaken, then thoroughly applied to the skin twice with a 10-minute break. Side effects of the drug include the possible development of contact dermatitis and dry skin.

A 5% solution of permethrin is approved for use in infants and pregnant women. Side effects with its use are rare. Treatment with the drug is carried out three times: on the 1st, 2nd and 3rd days. Before each treatment, it is necessary to prepare a fresh aqueous emulsion of the drug, for which 1/3 of the contents of the bottle (8 ml of a 5% solution) is mixed with 100 ml boiled water room temperature.

Piperonyl butoxide + esbiol in the form of an aerosol is a low-toxic drug, approved for the treatment of infants and pregnant women. The aerosol is applied to the skin from a distance of 20-30 cm from its surface in the direction from top to bottom. In infants it is also treated scalp heads and face. The mouth, nose and eyes are first covered with cotton swabs. According to the manufacturer's recommendation, treatment is carried out once, but from experience it is known that with widespread scabies, 2-3 times the drug is required (1, 5 and 10 days) and only with fresh scabies, a single use of this drug leads to a complete cure of patients.

Sulfur ointment (33% ointment is used in adults, 10% in children). Common side effects include contact dermatitis. Apply for 5-7 days in a row.

Particular attention is paid to the treatment of complications, which is carried out in parallel with anti-scabies treatment. For pyoderma, antibiotic therapy is prescribed (if necessary), aniline dyes and antibacterial ointments are used externally. For dermatitis, antihistamines, desensitizing therapy, and externally combined glucocorticoid drugs with antibiotics (hydrocortisone + oxytetracycline, hydrocortisone + natamycin + neomycin, hydrocortisone + oxytetracycline, etc.) are prescribed. For insomnia, sedatives are prescribed (tinctures of valerian, motherwort, persen*, etc.).

Postscabiosis itching after complete therapy is not an indication for an additional course of specific treatment. Itching is regarded as the body's reaction to a killed tick. To eliminate it, antihistamines, glucocorticoid ointments and 5-10% aminophylline ointment are prescribed.

The patient is invited for a second appointment 3 days after the end of treatment for scabies, and then every 10 days for 1.5 months.

Postscabiosis lymphoplasia does not require anti-scabies therapy. They use antihistamines, indomethacin, glucocorticoid ointments under an occlusive dressing, and laser therapy.

Features of the treatment of scabies in children

Anti-scabies are rubbed into the baby's skin by the mother or other caregiver.

The drug must be applied to all areas of the skin, even in cases of limited damage, including the skin of the face and scalp.

To avoid getting the drug into the eyes when touching them with your hands, small children wear a vest (shirt) with protective sleeves or mittens (mittens); You can apply the drug while the child is sleeping.

Features of the treatment of scabies in pregnant and lactating women

The drugs of choice are benzyl benzoate, permethrin and piperonyl butoxide + esbiol, which have been proven safe for use during pregnancy and lactation.

Clinical examination

An appointment (examination, consultation) with a patient’s dermatovenereologist for the treatment of scabies is carried out five times: 1st time - on the day of application, diagnosis and treatment; 2nd - 3 days after the end of treatment; 3, 4, 5th - every 10 days. The total period of clinical observation is 1.5 months.

When diagnosing scabies, it is necessary to identify the source of infection and contact persons subject to preventive treatment (family members and people living in the same room with the patient).

Members of organized groups (preschool institutions, educational institutions, classes) are examined by health workers on site. If scabies is detected, schoolchildren and children are suspended from visiting a child care facility for the duration of treatment. The issue of treatment of contact persons is decided individually (if new cases of scabies are detected, all contact persons are treated).

- In organized groups where preventive treatment of contact persons was not carried out, examination is carried out three times with an interval of 10 days.

Carrying out ongoing disinfection in areas of scabies is mandatory.

Prevention

The main preventive measures include early identification of patients with scabies, contact persons and their treatment. Disinfection bedding and clothes can be done by boiling, machine washing or in a disinfection chamber. Things that are not subject to heat treatment are disinfected by airing for 5 days or 1 day in the cold or placed in a hermetically sealed plastic bag for 5-7 days.

A-PAR aerosol* is also used to treat upholstered furniture, carpets, toys and clothing.

Consulting

It is necessary to warn patients about the contagiousness of the disease, strict adherence to sanitary and hygienic measures in the family, team, strict adherence to treatment methods, and the need to re-visit the doctor in order to establish the effectiveness of therapy.

Pediculosis

There are 3 types of pediculosis in humans: cephalic, body and pubic. Among children, head lice is the most common. Pediculosis is most often detected among people who antisocial image living in overcrowded conditions and not complying with sanitary and hygienic standards.

Clinical picture

Clinical symptoms typical for all types of head lice:

Itching, accompanied by scratching and bloody crusts; itching becomes pronounced on the 3-5th day from the moment of infection (only after sensitization to proteins in the saliva of lice), and with repeated infection (reinfection) it develops within several hours;

Irritability, often insomnia;

Detection of lice on the head, pubis, body and clothing, as well as nits on hair;

The appearance of erythema and papules (papular urticaria) at the sites of lice bites;

Dermatitis and eczematization of the skin with a long course of head lice and phthiriasis;

Secondary pyoderma as a result of penetration of coccal flora through damaged skin during scratching;

Regional lymphadenitis with widespread pyoderma.

Head lice (pediculosis capitis)

Girls and women are most often affected, especially those with long hair. The main route of transmission is contact (through the hair). Sharing combs, hairpins, and pillows can also lead to infection. The age peak of incidence is 5-11 years. Outbreaks of the disease are often observed in schools and kindergartens.

The head louse lives on the scalp, feeds on human blood and actively reproduces. Eggs (nits) pale white in color, oval in shape, 1-1.5 mm long, covered on top with a flat cap (Fig. 4-43). They are glued with the lower end to the hair or fibers of the fabric with a secretion secreted by the female during laying. Skin rashes on the scalp occur when lice, when biting, inject saliva with toxic and proteolytic enzymes.

Most often, lice and nits are found on the scalp of the temporal and occipital areas (inspection of the scalp of children to detect lice in children's institutions and hospitals begins in these areas). The main clinical signs of pediculosis are itching, the presence of lice, as well as nits tightly attached to the hair shaft, single petechiae and itchy papules, and excoriations. Bonding of hair with serous-purulent exudate against the background of a secondary infection is noted in a common process (Fig. 4-44). Possible damage to eyebrows, eyelashes, and ears.

Rice. 4-43. Lice

Rice. 4-44. Lice (nits, eczematization)

Clothes lice (pediculosis corporis)

Unlike head louse, body louse most often develops in the absence of proper hygiene. Infection occurs through personal contact, through clothing and bedding. The body louse bites in those areas where clothing interferes with its movement - in places where folds and seams of linen and clothing touch. Patients are bothered by severe itching. The main elements are urticarial papules, dense nodules covered with hemorrhagic crusts, excoriations. A chronic widespread process is characterized by lichenification, secondary pyoderma, post-inflammatory melasma (“tramp skin”) as a result of prolonged mechanical irritation when a person scratches insect bites, the toxic effect of their saliva, “blooming” of bruises and scratching. Unlike scabies, the feet and hands are not affected.

Pediculosis pubis (phthiriasis)

Pediculosis pubis (pediculosis pubis) develops only in adolescents after puberty. The main route of transmission is direct, from person to person, most often through sexual contact. Transmission through hygiene items is also possible. Lice are found in the hair of the pubis and lower abdomen. They can crawl onto the hair of the armpits, beard, mustache, eyebrows and eyelashes. At the sites of pubic louse bites, petechiae are first detected, and after 8-24 hours the lesions acquire a characteristic bluish-gray tint and spots appear (macula coeruleae) 2-3 mm in diameter, irregular in shape, located around the hair, into the mouths of which flats are introduced.

When young children are infected, damage to eyelashes and eyebrows is noted, blepharitis may develop, and less commonly, conjunctivitis.

Treatment

Treatment of pediculosis is carried out with pediculocidal drugs. Most available highly active drugs contain permethrin (a neurotoxic poison). The preparations are applied to the scalp, left for 10 minutes, then the hair is washed. Shampoo "Veda-2" * is also effective in the treatment of pediculosis. After treatment, the hair is moistened with water (2 parts) with the addition of vinegar (1 part) and left for 30 minutes. Vinegar makes it easier to remove nits by repeatedly combing your hair with a fine-toothed comb. Mechanical removal of nits is an important point in the treatment of pediculosis, since medications do not penetrate well into the nit shell. After 1 week, it is recommended to repeat the treatment to destroy lice that have hatched from the remaining nits. When examined under a Wood's lamp, live nits, unlike non-viable (dry) ones, give off a pearly white glow.

Permethrin, 20% water-soap emulsion or benzyl benzoate emulsion ointment are approved for use in children over 1 year of age, paraplus* - from the age of 2.5 years.

Nits on eyelashes and eyebrows are removed mechanically using thin tweezers, after smearing them with Vaseline. (Permethrin preparations are not approved for use in the eye area!).

Anti-epidemic measures

Anti-epidemic measures consist of a thorough examination and treatment of family members and contact persons, sanitary treatment of clothing, bed linen, and personal hygiene items. Clothes are washed at the highest possible temperatures (60-90 °C, boiling) or special dry dry cleaning, as well as ironed with steam on both sides, paying attention to folds and seams. If such treatment of clothing is not possible, then it is necessary to isolate contaminated clothing in hermetically sealed plastic bags for 7 days or store it in the cold. Combs and combs are soaked in warm soapy water for 15-20 minutes.

To disinfect premises, preparations based on permethrin are used.

Children should not attend school if they have live lice.

Dermatovenereology: a textbook for students of higher educational institutions / V. V. Chebotarev, O. B. Tamrazova, N. V. Chebotareva, A. V. Odinets. -2013. - 584 p. : ill.

Types of skin diseases in children

Atopic dermatitis

Diaper dermatitis

Hives

Prickly heat

Pimples and boils

Chicken pox

Warts

Dermatomycosis

Psoriasis

Keloid

Seborrheic dermatitis

Treatment of skin diseases in children

Prevention of skin diseases in children

Conclusion

General information

Classification of fungal skin diseases in children

Causes of fungal skin diseases in children

Symptoms of fungal skin diseases in children

Forecast and prevention of fungal skin diseases in children

Rashes of infectious origin

Exanthems

Pustular and viral diseases

Non-infectious skin lesions

Prevention

Treatment

Medicines

How chickenpox begins: how the initial stage manifests itself in children

"Acyclovir" for chickenpox in children

Causes and consequences

Classification of fungal skin diseases in children

Childhood illnesses with skin rashes

Atopic dermatitis

Allergic contact dermatitis

Diaper dermatitis

Skin diseases - symptoms (signs)

Classification of skin diseases in children

Symptoms of skin diseases in children

Treatment of skin diseases in children

Prevention of skin diseases in children

Chapter 4. INFECTIOUS SKIN DISEASES

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