pustular bacterial eruption
Introduction
Introduction to pustular bacterial rash Pustularbacteria (pustularbacterid) reported by Andrews in 1941 is an allergic rash caused by the body's bacterial infection, characterized by palmar symmetry, clusters of blisters and pustules. Sachs et al believe that this disease is the same disease or the same disease as phlegm dermatitis, so the disease is called acrodematitis pustuloseperstans. basic knowledge Sickness ratio: 0.05% Susceptible people: often occur in middle-aged people Mode of infection: non-infectious Complications: pruritus
Cause
Pustular bacterial rash
Infection (35%):
At present, there is a lot of controversy. Sachs et al believe that this disease is the same disease or the same disease type as phlegm. Some people think that this disease is a special reaction of the body to eczema or psoriasis, or the eczema of psoriasis. However, Andrews believes that this disease often occurs in middle-aged people. There is no history of psoriasis in the past, and there are infectious lesions in the tonsils, teeth, paranasal sinus or other parts. When using antibiotics or removing such lesions, the lesions are often It can be cured, so it is considered that this disease may be an independent disease associated with infectious lesions.
Pathophysiology
There is a single atrial pustule in the lower part of the epidermis. There is a small amount of inflammatory cells infiltrating around the pustule. The epidermis of the blister is slightly thickened, but the epidermis between the pustules is basically normal. The pustule contains a lot of neutrophils and a small amount of degeneration. The epidermal cells have a small amount of neutrophil infiltration at the upper layer of the dermis at or near the pustule.
Prevention
Pustular bacterial rash prevention
1. Pay attention to skin hygiene. Children's underwear should be washed frequently, especially in the summer, taking a bath and cutting nails.
2. If you have a lice or itchy skin disease, you should treat it promptly to avoid bacterial infection.
3. Found that there are signs of this disease, if there are papules, pustules, should seek medical advice in a timely manner, do not delay the time, but also can not easily apply hormone drugs or wash the affected area repeatedly, which will make the disease quickly expand.
4. The baby room or nursery school should immediately isolate and disinfect the disease and strengthen the health education for the staff.
5. For weak children, nutrition should be strengthened and resistance should be enhanced.
6. In the summer, give children more home-based refreshing drinks, such as watermelon juice and mung bean soup.
7. Timely treatment of dermatitis, lice, eczema and other pruritic skin diseases.
Complication
Pustular bacterial rash complications Complications pruritus
Initiate an infection.
Symptom
Pustular bacterial rash symptoms Common symptoms Itching scaly pustules
The basic damage is pustules, which may be blisters at first, but soon become pustules, sometimes with punctures between pustules. It usually begins in the middle of the palms and ankles, and then gradually spreads to the entire palm, ankle, and even its lateral edges. A small number of patients can begin to occur at the tip or ankle of the finger, but the toe and toe The face is not infringed. Most of the beginning is unilateral, and then gradually develops to the opposite side, and there is also a symmetry on both sides. The rash appears in batches and is often consistent. When it subsides, there is obvious desquamation. The scales are dry and hard, and adhere to the skin surface, consciously itching, chronic disease, often recurrent, and the total number of white blood cells and neutrophils increase during the attack period.
Examine
Examination of pustular bacterial rash
Laboratory inspection:
In the early stage of the disease, white blood cells increased by (1.2 ~ 1.9) × 104 / dl, neutrophils reached 65% ~ 80%.
Other auxiliary inspections:
Histopathology: There is a single atrial pustule in the deep part of the epidermis. There is a small amount of inflammatory cells infiltrating around the pustule, and the epidermis of the blister is slightly thickened, but the epidermis between the pustules contains a large number of neutrophils.
Diagnosis
Diagnosis and identification of pustular bacterial rash
diagnosis
The diagnosis points of this disease: 1 is chronic intractable pustule, often symmetry occurs in the palms and ankles. 2 is directly related to infectious lesions, if the lesion is removed, it can be cured; 3 white blood cells increase, especially in the attack period. 4 skin allergic reactions to Staphylococcus and Streptococcus. 5 There is a single atrial pustule in the lower layer of the epidermis. 6 pustular blister fluid culture was negative. 7 antibiotic treatment is effective.
Differential diagnosis
Need to be identified with the following diseases:
(A), continuous acral dermatitis
Often occurring after minor trauma, it is unilateral, often starting from the fingertips, accompanied by changes in nail infection and nails.
(B), pustular psoriasis
Typical psoriatic lesions on the elbow, knee or other parts of the body. Pathological changes are the same as psoriasis vulgaris except for Munro's abscess.
(3), hand and foot
Skin lesions often occur on the sides of the fingers, between the toes, and on the toes. Microscopic examination reveals fungi.
