Exfoliative dermatitis (in another way it is called erythrodermia or dermatitis Rittera) - quite often occurring damage to the skin of a person. It manifests a pronounced inflammatory reaction, swelling of the skin and peeling practically throughout the epidermis. The impetus to the development of the disease gives an infection - staphylococcal or streptococcal..
- 2Causes and symptoms of erythroderma
3Diagnostic and therapeutic measures
- 3.1Treatment of children
- 3.2Treatment of adults
Most often the disease is diagnosed in infants in the first weeks after birth, this is due to the fact that protective functions of the skin and immunity in general, the baby is still weak, but exfoliative dermatitis in adults, too is found.
In an infant, the ailment can manifest itself almost immediately after birth (usually diagnosed at the age of one to two weeks). In this case, it is caused, as a rule, by infection of the child in the womb of the mother with staphylococcal or streptococcal infection. Weak immunity and insufficient protective functions of the skin allow infectious agents to penetrate into the upper layers of the skin and provoke the development of purulent inflammation.
In adults and older children, erythrodermia occurs against a background of decreased immune defense of the body due to the following factors:
- severe chronic diseases (diabetes, swelling);
- reception of immunosuppressive drugs.
Often, inflammation of the epidermis manifests itself as a toxic reaction to medications.
Exfoliative dermatitis with severe course is recorded in about one to two percent of people aged fifty years. Women suffer from erythrodermia about five times more often than men.
Causes and symptoms of erythroderma
Exfoliative dermatitis Ritter is common among patients of different ages, but many doctors attribute this illness to diseases of newborns. In addition to the intrauterine route of infection, the infection often affects infants in maternity hospitals due to non-compliance with basic hygiene standards.
The manifestation of erythrodermia in newborns occurs in three stages:
In the erythematous stage, the child begins reddening and peeling of the epidermis, usually the skin is affected near the lips and in the abdomen.
Then the process goes to the large folds of the skin, the genitals and anus are affected, until finally the skin covers are affected throughout the body. The epidermis begins to swell, bubbles appear on it, inflammation can affect the mucous surface of the mouth and genitals.
Exfoliative stage - the height of the disease. At this time, the symptoms are manifested as much as possible. The bubbles that have appeared begin to burst, areas with erosive erectile skin are formed, its upper layers begin to peel off. Externally, the inflammation of the epidermis resembles a thermal burn. The child has a fever, an upset stomach and dehydration due to the fact that he refuses to breast. The baby does not sleep well and actively loses weight. Urgent medical care is required, otherwise there is a possibility of a lethal outcome.
On the third - the regenerative stage - the infant recovers. The bursted blisters heal, a new skin is formed on the affected areas, a reduction in swelling and redness can be seen visually. After some time the child fully recovered.
The manifestations of Ritter dermatitis in adults are of a similar nature.
In older children and adults, erythrodermia can provoke neglect or inadequate treatment of ordinary dermatitis. Combing the skin in the affected areas, a person enters into a scratch an infection, the inflammation of the epidermis begins to increase. Everything happens against the background of other serious diseases or weakened immunity.
Symptoms are almost the same as in young children:
- bright red skin;
- the appearance of bubbles with liquid;
- formation of wetting areas;
- in the absence of treatment, ulceration of the affected skin occurs.
Diagnostic and therapeutic measures.
Competent dermatologists easily diagnose the disease during a primary examination. However, to confirm the diagnosis (and to completely exclude other forms of inflammation of the epidermis with similar clinical symptoms) of the discharge from the skin blisters are always sent to the laboratory for bacterial analysis.
In addition, the doctor can prescribe PCR diagnostics together with the RPR test (he is appointed to exclude intrauterine infection of the child with pale treponema). Similar diagnosis is also carried out in adults.
Treatment of children
Children under the age of twelve are treated in a hospital regardless of the severity of the disease, the therapy is carried out in a hospital. Newborns with mothers should be in the special hospital wards-isolators in quarantine throughout the treatment. Chambers with patients must be cleaned daily with antiseptic agents and quartzed.
Bed linen patients must be replaced daily. Moms and all personnel in contact with sick children, including doctors and nurses, are regularly examined. Small patients with erythrodermia are usually prescribed antibacterial drugs intramuscularly with Timalin, antistaphylococcal plasma and gamma globulins.
To detoxify and protect from dehydration, the infants are given infusion therapy with various solutions.
In acute disease, persistent abnormalities in the work of the gastrointestinal tract and for the prevention of dysbiosis, the reception of probiotics is indicated. For the duration of the treatment, the doctor can prescribe the child a strict diet. Usually sweet and flour dishes are completely excluded. As external agents, oils and ointments with antibacterial properties are used. Perhaps the appointment of trays with a weak solution of potassium permanganate.
Treatment of adults
Adult patients are treated with antibiotics, and in severe forms, their intake is combined with the intake of corticosteroids (Prednisolone).
External anti-inflammatory and antiseptic agents are also indicated. The use of various folk remedies in the form of broths and infusions of herbs in combating the disease is ineffective (since the main cause of the disease is eliminated - infection) and should be carried out strictly under the supervision of the doctor on the background of the main drug therapy.
Treatment procedures for erythroderma in an adult and a child have a number of significant differences. For example, those who are ill at the age of twelve years and older with a mild course of illness can be treated on an outpatient basis. In severe forms of the disease in adults, hospitalization is indicated.
Preventive measures are the prevention of nosocomial infection and regular examinations of medical personnel for the carriage of staphylococcal or streptococcal infections. Of great importance is the observance of hygiene measures, regular change of bed linen. It is necessary to take care of the protective functions of the body, taking immunostimulants on the recommendation of the doctor. All relatives of a sick person when contacting him should wear gauze masks..