red lips
Introduction
Introduction Lip redness is the initial manifestation of changes in the oropharynx of the mucosal lymph nodes. Skin mucosal lymph node syndrome, also known as Kawasaki syndrome, is an acute systemic vasculitis that is mainly caused by infants and young children. After persistent fever, rash, lymphadenitis and other characteristic cases, the disease was first named as mucocutaneous lymph node syndrome. After that, it was discovered that Kawasaki disease is not a benign disease, and many children are congenital. Vascular disease leads to death. In fact, Kawasaki disease has become one of the two major causes of childhood acquired cardiovascular disease, and in many places its risk is even greater than rheumatic fever.
Cause
Cause
(1) Causes of the disease
Although many scholars have done a lot of research, the etiology of Kawasaki disease is still unclear, but a large number of epidemiological and clinical observations show that Kawasaki disease is caused by infection, given the fever, rash, and self-limiting disease. Conjunctival hyperemia, cervical lymphadenopathy and predisposition in children, the obvious geographical distribution during the outbreak of the epidemic suggests that the incidence is related to infection.
(two) pathogenesis
The main pathological change of Kawasaki disease is vasculitis, and the pathological changes can be divided into three phases:
1. Stage I onset of 0 to 9 days, the main pathological changes for small vasculitis, to the small arterial full-thickness inflammation, common inflammation around the middle and large arteries, at the same time visible whole heart disease, this period is prone to arrhythmia and heart failure, and even heart Source of shock and death.
2. Stage II onset of 10 to 25 days, microvascular inflammation and carditis are relieved in this period, but full-thickness inflammation occurs in the middle artery. The most common coronary artery is aneurysm and thromboembolism, which may be due to severe heart failure and arrhythmia. Myocardial infarction and coronary aneurysm rupture and die.
3. After 28 to 40 days after the onset of stage III, although arteritis and carditis subsided in this stage, the granulation tissue in the middle artery is proliferated, the intima is thickened, and there may be aneurysmal dilatation and thrombosis, which may be due to myocardial infarction. And die.
Examine
an examination
Related inspection
Chest perspective two-dimensional echocardiography Doppler echocardiography dynamic electrocardiogram (Holter monitoring)
(1) Fever: lasts for more than 5 days, a few less than 5 days, antibiotic treatment is invalid.
(2) Changes in extremities: In the acute phase, there are hard swelling of the hands and feet, and there are erythema at the palm () and finger (toe) ends; there is a membrane peeling at the transition of the nail bed skin during the recovery period.
(3) rash: erythema multiforme, more trunks, no blisters and molting.
(4) bulbar conjunctiva: double eyeball conjunctival hyperemia.
(5) Oral mucosa: mouth flushing, bayberry tongue, diffuse hyperemia of the oropharynx mucosa.
(6) cervical lymphadenopathy: non-suppurative, diameter greater than 1.5cm.
Diagnosis
Differential diagnosis
Care should be taken to distinguish from the following:
1. The normal lip color is mostly pink.
2. Lip red red: Normal lip color is mostly pink. If the red color is too bright or dark purple, it may be caused by the so-called "fire" in the body. Such as with bad breath, hiccups, indicating spleen and stomach damp heat; accompanied by two flank pain, anorexia, indicating that the liver fire is too strong.
3. Lip color reddish purple: If you have a fever or carbon monoxide poisoning, you may have heart disease, lung disease, heart failure and other problems, heart failure, hypoxia or lung disease, the lips will be dark red.
