desquamative erythroderma
Introduction
Introduction to desquamative erythroderma Deteriorating erythroderma (erythrodermadesquamativum), also known as Leiners disease (Leinersdisese), is seen in infants within 2 months and has clinical manifestations of diffuse flushing and desquamation of the skin. Insufficient endowment, acquired disorders, spleen and stomach weakness, skin dying. basic knowledge The proportion of illness: 0.0003% Susceptible people: infants Mode of infection: non-infectious Complications: pneumonia nephritis
Cause
Causes of desquamative erythroderma
(1) Causes of the disease
It is not clear, generally more common in breast-fed babies, it is speculated that breast milk contains less vitamin H (biotin), less fat, and is considered to be a generalized seborrheic dermatitis in infants. .
(two) pathogenesis
May be related to gastrointestinal digestion and absorption dysfunction, vitamin deficiency, less biotin, excessive consumption of fat, hypoproteinemia and anemia, etc., also believe that C5 complement dysfunction leads to leukocyte phagocytosis is associated with this disease.
Prevention
Descaling erythroderma prevention
Strengthen nutrition, strengthen nursing, prevent infection, prevent fatigue, prevent cold and heat, actively treat the primary disease, closely observe the general condition, and timely deal with it.
Complication
Debilitating erythroderma complications Complications pneumonia
Can cause pneumonia, nephritis, etc., leading to infant death.
Symptom
Symptoms of desquamative erythroderosis Common symptoms Squamous lymphadenopathy Leukocytosis Greasy scaly diarrhea
It usually occurs within 2 months after birth. It is more common in female infants. The incidence is sharp, and the initial onset is limited erythema. It is more common in the perianal, perineal, groin, flexion of limbs and other folds, and then rapidly expands, involving the head, torso and Extending the limbs, the oily dermatitis-like greasy scales can be seen in the eyebrows, behind the ears, the nasal passages and the mouth. The greasy scales of the scalp are yellow, thicker, and the skin redness is mildly inflammatory after peeling off. The skin of the whole body is diffuse and flushed. After a few days, there are grayish white shredded scaly scales of different sizes, some of which are large in shape. The extremities of the extremities can have large gray scales, which can be changed with a nail and alopecia. The site is susceptible to secondary Candida and Staphylococcus aureus infection, often accompanied by diarrhea, malnutrition, fever, anemia, leukocytosis and lymphadenopathy. After 2 to 4 weeks after onset, the skin lesions can gradually subside, but because of the easy secondary Infection, if not handled properly, can cause pneumonia, nephritis and other causes of infant death.
Examine
Examination of desquamative erythroderma
Pathological examination: mainly non-specific acute or subacute inflammatory changes. Excessive keratinization, parakeratosis, hypertrophy of the spinous cell layer, intercellular and intracellular edema, edema of the dermis, and infiltration of lymphocytes, tissue cells and eosinophils. In addition, specific or non-specific changes can occur in lymph nodes. Non-specific expression is thickening of the capsule, inflammatory cell infiltration mainly composed of tissue cells and plasma cells, and specificity may be histological changes of lymphoma. The erythroderma caused by different causes may have a special change in its pathogenesis in pathology.
Diagnosis
Diagnosis and identification of desquamative erythroderma
diagnosis
According to the typical clinical manifestations, the diagnosis is generally not difficult. The disease occurs within 2 months after birth. It is more common in female infants. The incidence is sharp, and the initial onset is limited erythema. It is more common in perianal, perineal, groin, flexion of limbs and so on. Then it spreads rapidly, involving the head, the trunk and the extremities, and the oily dermatitis-like greasy scales are visible in the eyebrows, behind the ears, nose and mouth. The greasy scales of the scalp are yellow, thicker, and peeled off. The skin is red with a mild inflammatory reaction, and the skin of the whole body is diffusely flushed. After a few days, there are grayish white shredded scaly scales of different sizes, some of which are large in shape, and there are large gray scales on the extremities of the extremities. (Toe) A change and hair loss, the fold is easy to be secondary to Candida and Staphylococcus aureus infection, you can consider this disease.
Differential diagnosis
1. Genetic allergic dermatitis occurs more than 2 months after birth. In addition to erythema, papules, blisters, itching, chronic disease, recurrent attacks, and light weight are also seen.
2. Congenital ichthyosis-like erythroderma is born with redness, rough and thick, scaly desquamation, mainly with limbs.
3. Neonatal exfoliative dermatitis develops within 1 month after birth. There are shallow blisters on the basis of erythema, erosive formation after rupture, Nikolsky sign positive, often accompanied by systemic symptoms such as fever, poor prognosis, and no head and face seborrheic Sexual dermatitis changes.
4. The rash is usually a chronic disease, which is more common in obese and sweaty babies. There is no diffuse redness and desquamation in the whole body. The secondary candida infection should be differentiated from this disease.
