prickly heat
Introduction
Introduction Gardenia is a superficial, inflammatory skin disease that is common in summer or hot environments. Also known as miliary rash, it is caused by excessive sweating in the hot and humid environment, which is not easy to evaporate, causing obstruction of the sweat gland duct, and the sweat tube ruptures after sweat retention, causing superficial inflammatory reaction caused by sweat spilling into the surrounding tissues, including four types. Type: white or crystalline miliary rash, red or red miliary rash, purulent or pustular miliary rash and deep or deep miliary rash. Because of the high temperature and sultry environment, a large amount of sweat is not easy to evaporate, so that the stratum corneum is impregnated and swollen, and the sweat gland duct is narrowed or blocked, resulting in sweat retention, sweat exudation around the tissue, formation of papules, blisters or pustules, which occur in the wrinkles. Some people think that the occlusion of the sweat hole is due to primary staphylococcal infection, and some people think that the occurrence of lice is not related to excessive sweating, but related to the proliferation of micrococcal bacteria on the surface of the skin. basic knowledge The proportion of illness: 0.001% Susceptible people: young children and adults who are overweight and sweaty Mode of infection: non-infectious Complications: folliculitis abscess
Cause
Cause
Poor sweat excretion (35%):
In the following cases, scorpion is prone to occur: in the hot and humid season, infants, young children, and adults who are not sweating, or long-term bedridden patients are poorly excreted by sweat and blocked by sweat pores.
Vitamin A deficiency (20%):
In addition, in patients with vitamin A deficiency, the stratum corneum of the skin is thickened, and the sweat gland ducts are swollen by the retained sweat, causing the sweat pores to narrow or block.
Pathological changes:
There are three steps in the development of scorpion: keratinous plug formation of the small sweat gland duct, catheter rupture and sweat extravasation to below the obstruction level. The level of catheter obstruction determines the type of miliary rash. The superficial horny plug in the cornea causes white sputum. The catheter ruptures just below the angle plug, forming a bulging transparent blisters, and the top is completely composed of keratinocytes. The deeper epidermis at the site causes red miliary rash, which can cause erythema and itching, which is caused by the enzyme released by sweat after the epidermal cells are damaged. The sweat duct at the junction of the epidermal dermis blocks the upper end of the dermis of the sweat tube, causing sweat retention in the superficial dermis, resulting in deep sputum formation.
Prevention
Prevention
1, indoor ventilation, try to lower the room temperature, keep cool and dry, hot and humid air is not good for the decline of the scorpion.
2, take a bath, use warm water when bathing, disable hot water scalding, cold water is not good, disable alkaline soap with irritating. Wipe dry immediately after washing.
Complication
Complications Complications folliculitis abscess
Excessive scratching due to itching can cause secondary infections, which occur:
1. Folliculitis: refers to the suppurative inflammation that occurs when Staphylococcus invades the hair follicle.
2. : It is an acute suppurative infection of a single hair follicle and its sebaceous glands caused by the invasion of S. aureus from hair follicles or sweat glands. The inflammation often extends to the subcutaneous tissue.
3, abscess: is an acute infection process, tissue, organs or body cavity, due to lesion tissue necrosis, liquefaction, the occurrence of localized pus accumulation, surrounded by a complete pus wall.
Symptom
symptoms common symptoms itching papules hot blush blushing tongue yellow
1, white
Common in the rubbing part, the rash is the size of the cap needle white dense thin wall transparent small blisters, about 1mm size, the blister wall is easy to break, the appearance is dew-like, there is no redness around, it appears quickly, and disappears quickly after a few days, after drying There are very thin and small scales, naturally shedding, often no symptoms, more common in bedridden, high fever and poor sweat and postoperative weakness, vitamin A deficiency caused by this type.
2, red dragonfly
Generally seen in the hot and humid summer, the rash occurs in the elbow fossa, armpits, neck, chest, back and children's head and face, buttocks, under the breasts of women, but the palms and soles of the feet do not appear, the onset of rapid onset, erythema begins to appear, followed by Intensively arranged needle-sized papules or herpes, surrounded by redness, rashes appear in batches, with mild desquamation after resolving, secondary infections can cause folliculitis, bloated, sometimes can continue for several weeks, consciously Hot and itching.
3, purulent
Skin lesions occur in the skin folds such as the flexor and genitals of the extremities. The head and neck of the children are also visible. The tip of the ankle has a small pustule with a needle size. The bacteria can be found in the blister and consciously have a tingling sensation. Micro-heat or high fever, often occurs in infants with eczema, diaper dermatitis, contact dermatitis, poor body resistance or poor skin hygiene conditions, can be secondary to infection on the basis of red sputum to form purulent sputum.
4, squat
The rash occurs in the trunk, neck, and skin lesions are dense and consistent with the sweat pores. The non-inflammatory normal skin is deep in the blister, about 1 to 3 mm in diameter, and the blistering blister has clear liquid outflow, no erythema and itching. Occurred in the tropics, more common in patients with recurrent red malignant rash, patients often have compensatory facial hyperhidrosis and swollen inguinal and axillary lymph nodes, most of which have extensive loss of small sweat gland function, swollen lymph nodes with miliary The rash disappears and becomes smaller.
Examine
Awkward inspection
Histopathology: all types of sputum have horny and parakeratotic embolus and sweat retention blister. The glycogen staining technique can confirm that the sacral catheter still has a sustained secretion ability. There is no other tissue change in the sputum, and the perivascular lymphocytic infiltration occurs in the red sputum. And part of the vasodilatation, recurrence and extensive lesions can be accompanied by aseptic pustules and bacterial infectious pustules.
Diagnosis
Diagnostic diagnosis
Diagnostic criteria
According to its clinical symptoms, the characteristics of the damage and the season of the disease can be diagnosed.
TCM pathogenesis and syndrome differentiation: Chinese medicine believes that this disease is mostly caused by summer moisture, re-sensation of summer heat, fumigation of the skin, closure of the hair, sweating, and causing sweat to stay in the skin; there are also factors such as food lag The person who suffers from the heat of the heat and the disease.
TCM syndrome differentiation:
1, Shushi Yunji
Main card: skin flushing, miliary size papules with dense integrated tablets, herpes, itch, upset thirst, yellow urine, red tongue, yellow or greasy moss, slippery pulse.
Dialectical: The heat is wet and the sweat is not smooth.
2, damp heat and steaming type
Main card: long illness in bed or high heat sweat is incomprehensible, chest and abdomen have crystal-like miliary size blisters, white and transparent, warm and heavy, chest tightness and vomiting, dry stool, red urine, yellow tongue coating, pulse number.
Dialectical: wet and hot steaming, heat does not leak.
3, Shushi Jiandu type
The main card: rash red, doped pustules, itching and pain, upset thirst, it will be red, red tongue, yellow greasy moss, pulse slippery.
Dialectical: heat and poison.
Differential diagnosis
The disease must be differentiated from summer dermatitis, the latter history, the degree of inflammation and the distribution of damage are different from the disease.
