DISEASES OF THE SKIN : PEMPHIGUS NEWBORNS (PEMPHIGUS NEONATORUM) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Pathogens - strepto - and staphylococci. A contagious disease. Observed in neonates during the first days of life. The infection mainly through nursing, as well as from adults, patients with pyoderma.
Symptoms. Precipitation (shocks) bubbles at normal or slightly reddened skin with peripheral growth, with a rapidly receding contents. At the opening of the bladder formed by erosion with a red bottom and loose scraps, saped of the epidermis at the edges. By merging erosions formed large moist areas. Sometimes there is a slight increase in temperature. Localization: the torso and extremities; palms and soles are usually not affected. Initially, the eruption appears usually in the lumbar region, buttocks, navel. In severe cases the formation of large surfaces deprived of the epidermis.
For. In most cases the disease ends in recovery for 3 to 4 weeks. In some cases, especially in immunocompromised children, the disease assumes the character of a diffuse exfoliative dermatitis without inclinations to epithelialization of erosions, with high fever, diarrhea, vomiting. Sometimes a picture of sepsis, death.
It is important to distinguish from syphilitic pemphigus, often observed in patients with early congenital syphilis, sometimes at birth. Bubbles with syphilitic pemphigus are localized on the palms and soles, symmetrically surrounded by rolling infiltrate, quickly covered with a crust; the content of bubbles detected spirochetes; the skin often find other phenomena of syphilis; Wassermann reaction is positive, sometimes false paralysis, syphilitic rhinitis, damage to internal organs.
Prevention in hospitals is the strict observance of asepsis, clean diapers, clothes, towels, sponges, and other care items. Thorough treatment of the umbilical cord and skin care of newborns. Do not permit the employment of persons with newborns, patients with pyoderma. A thorough inspection of pregnant women and timely treatment of pyoderma. Prompt isolation of the sick child and disinfection of all items used in the care of him.
Meticulous care, feeding breast milk. Inside sulfa drugs rate of 0.2 g per 1 kg of body weight of the child. Hemotherapy (see multiple Abscesses). In severe cases, penicillin intramuscularly (see ibid). Topically: fast opening of bubbles, remove tires and pieces of the epidermis. Lubrication erosions 1 - 2% alcoholic solution of aniline dyes (metilvioleta, gentian violet, brilliantly), 2% aqueous solution of silver nitrate. Bandage sulfiding emulsion. On a separate erosion impose an aqueous slurry of powder white streptocid. Dusting powder with 10% white streptocid or xeroform. Rubdown healthy skin camphor spirit. In the future, when drying a 1% yellow mercury ointment. Bathe only after the cessation of precipitation and drying of the rash was in the bath with potassium permanganate (25,0 5% solution of the bath).