Pigmented urticaria in children
Introduction
Introduction to Pediatric Pigment Measles Urticariapigmentosa is a type of mastocytosis (mastocytosis), a benign generalized skin mast cell hyperplasia characterized by pigmented macules on the skin, whealing after rubbing or scratching. basic knowledge Sickness ratio: 0.05% Susceptible people: children Mode of infection: non-infectious Complications: hypotension, vomiting in children, abdominal pain, diarrhea
Cause
Pediatric pigment urticaria cause
(1) Causes of the disease
Unknown, genetically predisposed, can be autosomal dominant, or autosomal recessive, caused by proliferation or aggregation of mast cells in the skin.
(two) pathogenesis
It is characterized by the majority of pleomorphic mast cell infiltration in the dermis. The cells can be arranged in a tumor-like manner. After staining with methylene blue or Giemsa, the cytoplasm is filled with large stained large particles.
In the type of systemic mastocytosis, not only the skin changes, but also the liver, spleen and lymph nodes, although the bones are asymptomatic, but the long bone X-ray shows cystic changes, bone marrow puncture specimens, visible hypertrophy Cell infiltration, blood and gastrointestinal tract can also be affected.
Prevention
Pediatric pigment urticaria prevention
Prevention of hereditary diseases:
1. General health care: Breathe fresh air, moderate sun exposure and physical exercise, pay attention to proper control of irritating foods and fish, shrimp and other sensitizing foods, always keep the skin clean and happy, and some skin patients should not wear chemical fiber. Textile underwear, socks.
2. Finding and removing the cause: For pruritic skin diseases, actively seek and remove the cause, control the symptoms, advise patients to avoid scratching and using irritating drugs, avoid spicy, irritating foods, do not use hot water to wash the skin and Use alkaline soap or the like to prevent skin lesions from aggravating and secondary infection.
3. For allergic skin diseases: Intensively search for allergens, avoid contact, avoid eating foods that are related to the disease or can make the disease worse, such as fish, shrimp, crab and other heterosexual proteins, such as allergies to drugs, The sensitizing drugs should be searched as much as possible, and the patients and their families should be informed about the situation. When visiting the hospital, they should also explain to the doctor to obtain a cooperation and no longer use the drug and drugs containing the drug ingredients sensitized to the drug.
Complication
Pediatric pigment urticaria complications Complications, hypotension, vomiting, abdominal pain, diarrhea
Combined systemic disease, may be associated with tachycardia, hypotension, vomiting, abdominal pain, diarrhea, etc., can be combined with juvenile yellow granuloma.
Symptom
Pediatric pigment urticaria symptoms common symptoms facial flushing red belly pain hypotension yellow nodule diarrhea tachycardia wheal rash granuloma dizziness
Commonly many pigmented plaques, papules or nodular lesions, the number can be more or less, the size varies, the diameter is generally 5 ~ 10mm, round or oval, yellow or yellow brown skin lesions, the surface of the skin is slightly rough, Can be sporadic or clustered, widely distributed, and sometimes blisters, especially in newborns, small babies and early disease, more common in the trunk, a few in the limbs, under mechanical stimulation, wheal can appear, redness at the skin lesions And higher than the skin, rare for sputum damage, mostly located in the squid, behind the ear, underarms and neck, when the yellow nodules can be fused to each other, similar to lipid jaundice, single mast cell tumor is not uncommon, accounting for 10%, mainly in infants, brown spots or yellow-brown plaques or nodules appearing soon after birth or after birth. The surface is like orange peel or rubber, and there may be blisters, bullae, and childhood. .
Generally, the incidence is slow, there is mild itching, a small number of children with systemic diseases, often accompanied by paroxysmal facial flushing, tachycardia, hypotension, dizziness, headache, vomiting, abdominal pain, diarrhea and so on.
Spontaneous urticaria can also be combined, sometimes with skin scratch marks. About 50% of cases can be combined with juvenile yellow granuloma. Skin pathology is needed to diagnose the disease.
Examine
Pediatric pigment urticaria examination
Should do blood, urine, routine examination, pay attention to the presence or absence of eosinophils, white blood cells, increased neutrophils, stools with eggs, should be serum complement examination, with or without hypocomplementemia, direct immunofluorescence, With or without immunoglobulin and complement deposition, and skin pathology.
If necessary, you should do an electrocardiogram, X-ray chest and other examinations.
Diagnosis
Diagnosis and diagnosis of pediatric pigmented urticaria
diagnosis
According to the early onset, typical skin damage, friction and other mechanical stimuli appear in the wind group, combined with skin tissue pathology, it is not difficult to diagnose, if necessary, X-ray and lymph node puncture examination to determine the presence or absence of systemic diseases.
Differential diagnosis
Urticaria needs to be differentiated from papular urticaria and polymorphic erythema, accompanied by abdominal pain, diarrhea, should be noted with acute abdomen and gastroenteritis, with symptoms of high fever and poisoning, should be considered as a serious infection symptoms One, angioedema must be differentiated from substantial edema such as erysipelas, cellulitis and eyelid contact dermatitis, adult scleredema, facial swollen malignant reticulosis, acquired angioedema and hereditary Angioedema can be identified according to the above points.
