Herpetiform eczema
Introduction
Introduction to herpes-like eczema Herpes-like eczema (Eczema Herpeticum) was proposed by Kaposi in 1845, also known as Kaposi varicella-like rash, vaccination eczema and Coxsack eczema. Refers to a skin disease that occurs when the herpes simplex virus or vaccinia virus is infected on the basis of the original skin disease. Children who occur within 5 years of age can also be seen in adults. After infection with herpes simplex virus, after 5d to 9d incubation period, there are sudden symptoms of high fever, general malaise, nausea, vomiting, etc.; the rash begins on the original skin such as the face, neck, upper limbs and trunk, and can also occur on normal skin. Lower limbs are rare. basic knowledge The proportion of illness: 0.005%-0.008% Susceptible population: children who occur within 5 years of age Mode of infection: non-infectious Complications: tonsillitis conjunctivitis pneumonia
Cause
Herpes-like eczema etiology
Dietary factors (30%):
Commonly used in food are fish, shrimp, etc., such as pollen, dust mites, wool, etc. inhalation, microorganisms such as S. pyogenes and superficial fungi, living environment such as sunlight, heat, dryness, various animals Fur, dander, and various chemicals such as cosmetics, soap, synthetic fibers, etc.
Individual factors (25%):
Such as chronic infections, chronic cholecystitis, tonsillitis, intestinal parasites, endocrine and metabolic changes such as menstrual cycle, pregnancy and other factors, blood circulation disorders such as calf varicose veins induced calf eczema, neuropsychiatric factors and the occurrence of this disease also Close relationships, such as mental stress and excessive fatigue.
Disease factors (20%):
In the same environment and conditions, some people are prone to eczema while others do not. However, under certain conditions, the patient's condition may be aggravated, and in other cases, the disease may not be recurred. According to clinical manifestations, pathogenesis and histopathology, the pathogenesis of some patients may be related to delayed type hypersensitivity.
Prevention
Herpes-like eczema prevention
1. Eczema patients should avoid drinking alcohol, coffee, spicy and fried foods, diet should be light, eat more fruits and vegetables. Durian, mango, longan, lychee and other hot fruits are eaten less, so as to avoid the disease "fire on the fire." Patients can eat more hot and humid food such as mung beans, melon, lotus seeds and bitter gourd.
2. Avoid contact with suspected allergens, allergies to dust mites, avoiding carpets, allergies to animal feathers and fur, and try not to raise pets at home.
Complication
Herpes-like eczema complications Complications tonsillitis conjunctivitis pneumonia
Usually secondary to low body constitution, or long-term use of immunosuppressants and fungal infections such as onychomycosis, such as concurrent bacterial infections may have fever, skin swelling, ulceration and purulent secretion and other performance. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Herpes-like eczema symptoms Common symptoms Pustular leukocytes reduce lymphadenopathy varicella-like rash nausea baby scalp blood stasis baby eczema erysipelas-like appearance
Children who occur more than 5 years old can also be seen in adults. After infection with herpes simplex virus, they have a latent period of 5 to 9 days, sudden high fever (39 to 40 ° C), general malaise, nausea, vomiting and lethargy. The rash begins in the original skin area such as the face, neck, upper limbs and trunk, and can also occur on normal skin. Lower limbs are rare.
Examine
Herpes-like eczema
1. Blood routine: Leukopenia.
2. Tzanck cytology: giant cells are seen in the blister smear.
3. Histopathology: vesicles or pustules can be seen in the epidermis or under the epidermis. There are reticular degeneration and balloon degeneration. There are often multinuclear epithelial cells. The dermis has a large number of inflammatory cells infiltrating, mainly neutrophils, and basal cells in the original plasma. There is a Guarnieri body (vaccinia inclusion body).
Diagnosis
Diagnosis of herpes-like eczema
diagnosis
According to the history of herpes simplex exposure and clinical features, multiple umbilical follicles and pustules appear on the original eczema skin, and systemic symptoms can be diagnosed.
Differential diagnosis
(1) Vaccinia eczema: This disease has a history of acne, histopathological examination, and vaccinia inclusion bodies in the basal cell.
(2) Chickenpox: The systemic symptoms are mild before rash, and there is no rash such as primary eczema.
(3) Smallpox: There is a history of infectious epidemics, no history of primary eczema, severe systemic symptoms, and dense umbilical follicles.
(4) impetigo: pustules superficial, easy to break form honey yellow purulent, pustules are not umbilical fossa, no systemic symptoms.
