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Skin infections in newborns (pyodermatitis). Skin diseases in newborns

Skin infections in newborns (pyodermatitis). Skin diseases in newborns

30.07.2019

All diseases of the skin of newborns can be conditionally divided into three groups. The first group is diseases that are unique to infants in the first days of life and are never found in people of other ages. The second group is skin problems in newborns, provoked improper care. The third is pustular diseases caused by bacteria.

Skin diseases of infants: ichthyosis, erythema and prickly heat

The neonatal period is characterized by such skin lesions that do not occur in other periods of a child's life.

Sebaceous ichthyosis- skin diseases in newborns associated with excessive formation and delayed rejection of generic lubricant, which later turns into a film. The skin with the disease becomes dry, rough, acquires a brownish tint. It is easily covered with cracks, after which peeling appears.

Toxic erythema of the newborn appears on the 2-3rd day of life. This non-infectious skin disease of newborns is characterized by a polymorphic rash that soon disappears; possible secondary rashes.

The doctor should decide on the treatment of these diseases.

Prickly heat- is not infectious diseases newborn skin associated with defects in child care

Causes of the disease. Prickly heat occurs when the child's body temperature rises or when he is wrapped up excessively.

Signs of the disease. The disease is characterized by the appearance on the body of a child against the background of non-inflamed skin of reddish rashes or small vesicles filled with a clear liquid. Usually, rashes are located on the neck, in the groin and other natural folds of the body, but in advanced cases they can cover the entire body of the baby. The child suffers from itching, but this does not affect his appetite and sleep. After hygiene procedures (and treatment, if required), the bubbles disappear without leaving any traces.

Treatment. By itself, prickly heat is not terrible and is not even considered a disease, but it can lead to serious complications - bacteria (streptococci and staphylococci) easily penetrate into damaged skin, which ends in pustular infections.

Special treatment is not required, the main thing is to eliminate the cause of excessive sweating. The child is given hygienic baths with a slightly pink solution of potassium permanganate.

If the bubbles are large enough and cause discomfort to the baby, they are treated with a very weak solution of iodine (1-2 drops of 5% iodine tincture per glass of water), capturing the surrounding skin folds. They can also be washed with baking soda(1 teaspoon per glass of water), lubricate with 1% methylene blue solution, 1% brilliant green solution, Castellani paint, Lassar paste. Good help and herbal remedies, for example, tricolor violet herb: 1 teaspoon of the herb is crushed, poured with a glass of boiling water, kept in a water bath for 15-20 minutes (adjusting the fire so that the boiling of the liquid is not visible), filtered. This infusion is used to wipe the affected areas, it can also be added to the water for daily bathing.

In very severe cases, the places of greatest damage are lubricated 2-3 times a day with hormonal ointments: lorinden, dermozolon, etc., wipe with a 40% solution of urotropine.

To prevent this skin disease of a newborn, the child is bathed by adding infusions or decoctions to the water. medicinal herbs with antiseptic and astringent properties: chamomile flowers, oak bark, sage herb. After bathing and each washing, the baby's skin is thoroughly dried with a cotton napkin and powdered with baby powder or smeared with baby cream. You should not use oils (even baby ones) and glycerin - they are quickly erased from the skin with diapers and sliders, without having time to have the desired effect.

Another necessary preventive measure- air baths, they are especially useful in hot weather.

Skin problems in newborns: diaper rash

Intertrigo- this is a skin disease of a newborn child that has arisen in places of excessive friction, in areas that have been exposed to urine and feces for a long time, in skin folds.

Causes of the disease. Irritation appears on the most sensitive areas of the skin, which are also often wet (in the groin). Sweat, urine and feces provide a breeding ground for microorganisms that cause inflammation. Often, the occurrence of diaper rash is provoked by substances that make up diapers, disposable wipes and other hygiene items.

Infants with overweight, endocrine pathology, vessels close to the skin are prone to the appearance of diaper rash on the skin of newborns (the vascular network in such babies shines through thin, delicate skin).

Signs of the disease. Diaper rash I degree characterized by reddening of the skin without violating its integrity. They are located in the groin, where moist skin is most exposed to external influences (friction).

About diaper rash II degree evidenced by bright red skin, covered with microcracks, sometimes even individual pustules. The child has itching, so the baby becomes restless.

Diaper rash III degree- very severe damage to the skin. The skin becomes bright red, covered with weeping cracks, pustules and even ulcers, causing severe pain. The baby is constantly crying, his body temperature may rise.

Treatment. Diaper rash I degree do not require special medical care, rather thorough hygienic care, daily baths with a pale pink solution of manganese permanganate, air baths for 10-20 minutes 2-3 times a day. It is recommended to abandon the use of diapers and switch to gauze diapers or wide sliders. Diapers should be changed as often as possible, rinsing them thoroughly after washing with the addition of vinegar (1 tablespoon of 6% vinegar per 1 liter of water).

Treatment of diaper rash II degree start with the activities already listed; if within the next day there is no improvement, wet compresses are carried out with infusions of medicinal herbs (chamomile, string, walnut leaves, etc.), drug therapy is added. The affected areas are lubricated 2-3 times a day with protective creams and ointments (tannin, methyluracil, drapolene, bepanthen), talkers (talc - 20.0 g, zinc oxide - 20.0 g, glycerin - 10.0 g, lead water - 50, 0 ml or zinc oxide - 15.0 g, glycerin - 15.0 g, distilled water - 15.0 ml), UV irradiation of the skin is carried out.

Treatment of diaper rash III degree carried out only by a pediatrician. Parents should clearly remember: it is impossible to treat weeping skin with fat-based ointments and oils, they form an impenetrable film, under which favorable conditions are created for the reproduction of fungi and bacteria.

Seeing a doctor for this skin disease in newborns is necessary if:

diaper rash does not go away for a long time;
despite the efforts made diaper rash, increase in size;
against the background of irritated skin, cracks appeared, bubbles with transparent contents, and even more so pustules and weeping.

To prevent these skin diseases in newborns, it is necessary to wash the child after each toilet, change diapers regularly, lubricate problem areas with sterile vegetable oil or creams, carry out air baths.

Purulent skin disease of newborns omphalitis

Omphalitis- a purulent skin disease of newborns in the umbilical wound.

Causes of the disease. The umbilical wound usually heals by the beginning of the second week of life. If an infection gets into it, healing does not occur on time, and omphalitis begins.

Signs of the disease. A simple form of inflammation is the so-called weeping navel. The umbilical wound does not heal for a long time (within several weeks), a transparent viscous liquid constantly oozes from it.

In more severe cases, phlegmon of the navel begins: the wound and the tissues surrounding it turn red, swell, pus begins to stand out from the navel. The child is restless at first, and then becomes lethargic, apathetic, refuses to breastfeed; his weight is rapidly decreasing. The baby's body temperature rises, vomiting appears.

If appropriate measures are not taken, phlegmon spreads to the anterior abdominal wall, and pus spreads through the vessels throughout the body, which leads to the formation of abscesses during internal organs and even blood poisoning.

The most severe inflammation in this skin disease of infants usually occurs in premature and debilitated infants: a long-term non-healing ulcer with jagged edges forms at the site of the navel, the tissues around it also become inflamed and begin to fester. An ulcer can penetrate the entire depth of the abdominal wall, which leads to very dangerous complications.

Treatment. To prevent this skin disease in newborns, it is necessary to treat the stump of the umbilical cord daily, and after it falls off - umbilical wound 3% hydrogen peroxide solution, potassium permanganate solution, etc. until the navel is completely healed.

The weeping navel after treatment with alcohol with a strength of 60 ° is cauterized with a 10% solution of silver nitrate or a strong solution of potassium permanganate. The baby is given baths every day with a slightly pink solution of potassium permanganate.

In case of purulent inflammation, the umbilical wound is washed with a solution of hydrogen peroxide, bandages are applied to it with rivanol (1:1000), furacilin in a hypertonic solution (1:5000), chlorfilipt, chloramphenicol. If there is no effect, antibiotics are prescribed orally, UHF is performed.

In the event of the formation of excess tissue in the umbilical wound (navel fungus), it is removed surgically.

Skin disease in infants diaper dermatitis

Pustular skin disease in newborn infants pemphigus

Pemphigus of newborns- This is a contagious pustular skin disease of the newborn, characteristic of children in the first days of life. The disease does not apply to children older than 1 month and adults. The disease often occurs against the background of prematurity, birth trauma, in children whose mothers suffered from toxicosis of pregnancy.

The cause of the disease. Cause of this skin disease infants is staphylococcus aureus.

Signs of the disease. Against the background of unchanged or slightly reddened skin, gradually increasing blisters with cloudy contents appear. They quickly open with the formation of superficial erosions that do not heal well. The body temperature of the baby rises to 38-38.5 ° C, regurgitation, vomiting, and sometimes diarrhea appear.

Treatment. In this disease of the skin of a newborn baby, antibiotics or sulfonamides, vitamins B6, B12, C are administered. , or boron-naphthalic) ointment.

Skin disease in infants exfoliative dermatitis Ritter

Ritter's exfoliative dermatitis- a contagious disease of the skin of newborns, characterized by its exfoliation, is observed in infants during the first 2-3 weeks of life. Usually registered in premature infants and toddlers who are on artificial feeding.

The cause of the disease. Like pemphigus, Ritter's exfoliative dermatitis is caused by staphylococcus aureus.

Signs of the disease. Against the background of edematous and reddened skin, extensive blisters appear, which almost immediately open with the formation of an erosive surface. If you touch (hand, fabric, etc.) the edge of such erosion, the epidermis begins to exfoliate, exposing the deep layers of the skin. Newborns suffering from this skin problem experience severe pain, constantly crying, and refusing to breastfeed. His body temperature rises (up to 38.4-38.8 ° C), vomiting and diarrhea occur. With this skin disease of newborns, babies quickly lose weight.

Treatment. For the treatment of Ritter's exfoliative dermatitis, the treatment is the same as for pemphigus of the newborn.

Skin disease in young children pseudofurunculosis

Pseudofurunculosis- purulent inflammation of the sweat glands, characteristic of children in the first and second years of life.

The cause of the disease. This skin disease of infants is caused by staphylococcus against the background of functional digestive disorders (frequent diarrhea), with special sensitivity to staphylococcus aureus.

Signs of the disease. On the skin of the back, buttocks, back of the thighs, on the back of the head, multiple rounded formations up to a large pea appear, which gradually soften in the center, and then open with the release of pus. This infectious disease of the skin of newborns proceeds cyclically: after drying of one batch of abscesses, others form.

Treatment. The child is given antibiotics, taking into account the sensitivity of the microorganisms that caused the disease to them. Until sensitivity is detected, antibiotics of the penicillin series begin to be administered. If a child is allergic to such drugs, he is prescribed sulfonamides: biseptol, etazol, bactrim, etc. In order to increase immunity, antistaphylococcal gamma globulin is administered or autohemotherapy is performed.

In the treatment of this skin disease in children early age the use of nerabol, chymopsin, antihistamines and other drugs is mandatory, vitamin therapy is prescribed.

The skin at the sites of lesions is lubricated with Alibura liquid, Castellani paint or a 5% solution camphor alcohol. With a common process, a 4% heliomycin ointment or ointments with antibiotics (erythromycin, lincomycin, etc.) and corticosteroid hormones (oxycort, lorinden C, etc.) are locally applied, UVI is performed.

Disease prevention: careful hygiene care, regular air baths, hardening.

Skin disease of infants impetigo

Impetigo- superficial pustular skin disease of infants, most often they suffer from children who are bottle-fed and suffering from diaper rash, prickly heat.

The cause of the disease. The disease is caused by staphylococcus and streptococcus. The disease is contagious.

Signs of the disease. In young children, blisters often appear on the skin of the face, often around the mouth, first with transparent, and then gradually cloudy yellowish contents, surrounded by a reddish corolla at the edges. They quickly open, forming weeping areas, which eventually become covered with leaf-like crusts. Over time, a pinkish spot forms at the site of the lesion. Sometimes the disease is complicated by inflammation of nearby lymph nodes and blood vessels.

Treatment. To get rid of this skin problem in a newborn, the blisters are smeared with aniline dyes (methylene blue, brilliant green), and the skin around them with Alibur liquid or 5% camphor alcohol.

If the process is common, be sure to prescribe antibiotics, antihistamines, vitamins C, A, E.

All infectious skin diseases in newborns require treatment in a hospital.

The article has been read 28,977 times.

For citation: Suvorova K.N. SKIN DISEASES IN CHILDREN OF THE FIRST YEAR OF LIFE: DIAGNOSIS QUESTIONS // BC. 1996. No. 10. S. 1

The management of newborns and infants suffering from skin diseases requires precise decisions and prompt actions from a dermatologist, the effectiveness of which largely depends on correct and timely diagnosis. Pediatric dermatovenereology has now turned out to be not only extremely responsible, but also the most difficult area for dermatovenereologists. Despite the fact that doctors of various specialties are involved in the treatment of children with skin pathology, it is not possible to achieve satisfactory results in terms of reducing the level of the disease and increasing the effectiveness of preventive care. The number of diagnostic errors is especially high. Pediatric dermatology is closely related to the prevention of hereditary pathology, since the birth of a sick child encourages relatives to consult a doctor to determine the genetic prognosis. Raising the level of professional nosological diagnostics is the initial and necessary condition for the development of therapeutic, preventive and medical genetic assistance. Brief reviews are offered on the issues of diagnosis, treatment, prevention and rehabilitation of children suffering from skin and venereal diseases.

To cure neonates and babies who suffer from skin diseases requires that a dermatovenerologist should take accurate decisions and make prompt actions whose efficiency largely depends on correct and timely diagnosis. Pediatric dermatovenereology has proven to be not only a highly crucial but the most chalenging area for dermatovenereologysts. Despite the fact that physicians of various disciplines participate in the treatment of infants with skin abnormalities, there are no saticfactory results in reducing incidence rates and enhancing therapeutical and preventive care.
There are a great deal of diagnostic errors. Pediatric dermatovenereology is closely associated with the prevention of hereditary pathology as the birth of an ill baby makes his relatives to visit a doctor to determine a genetic prognosis. To enhance the level of professional nosological diagnosis is a primary and essential condition for the development of therapeutical, prophylactic, and medical and genetic care.
Brief reviews on 1) diagnosis, 2) treatment, prevention, rehabilitation of infants, with skin and venereal diseases are proposed.

Department of Dermatovenereology (Head - Doctor of Medical Sciences Prof. K. N. Suvorova) of the Russian Medical Academy of Postgraduate Education.
Prof. K.N. Suvorova, MD, Head of the Department of Dermatovenerology, Russian Medical Academy of Postgraduate Training

Introduction

In children of the first year of life, various skin lesions are found more often than in other age groups. The pathology of the skin during this period is distinguished by a pronounced specificity of the nosological profile and the unusual clinical manifestations of dermatosis, which are also known in adults, but manifest differently. A dermatovenereologist should be aware of the special skin conditions in newborns, specific approaches to the treatment of dermatosis, and the characteristics of the child's body. infancy that determine his reactions to medications or contribute to the aggravation and chronicity of dermatoses and the development of complications typical of this age. In the first months of life, suddenly severe and acute dermatoses can occur, when an accurate diagnosis and urgent care are urgently needed, which can only be provided by the joint efforts of pediatricians and dermatologists. Secondary skin lesions may occur in congenital metabolic defects and other multiple organ syndromes with onset in infancy; a dermatologist, having an adequate understanding of such diseases, should refer the child to a pediatrician and other specialist in a timely manner in accordance with their diagnostic assumptions. On the other hand, often the most common skin lesions are first discovered by a pediatrician who constantly monitors the child. In such cases, he should be able to suspect a skin disease and refer the child to a dermatologist.
The task of the pediatrician is to identify and treat internal diseases that contribute to the exacerbation or torpid course of dermatosis, and the dermatovenereologist is obliged to correctly diagnose skin and venereal diseases, at whatever age they occur, based on professional knowledge of the semiotics of dermatosis and sexually transmitted diseases, and the ability to use special methods of nosological recognition. Knowing the main etiological and pathogenetic methods of treating dermatoses, a dermatovenereologist must determine the stages of therapy, use various options for special treatment with various topical agents, and carry out rehabilitation. According to the professional and job requirements for a specialist, every dermatovenereologist should know pediatric dermatovenereology, since there is no separate specialty in this discipline. In practice, this section, especially skin pathology in children of the first year of life, is the most difficult for a dermatovenereologist. Based on the experience of the Department of Dermatovenereology of the Russian Medical Academy of Postgraduate Education and the Children's Department of the Moscow Clinical Dermatovenerological Hospital No. 14, we propose to discuss some issues related to this area.

Conclusion

Reliable nosological recognition of skin diseases in newborns and infants must be carried out as soon as possible. This possibility is provided by the visual accessibility of the organ, provided that the clinical and morphological analysis of eruptive elements is professionally performed, the correct assessment of age-dependent symptoms, specific differential diagnosis within the nosological profile of each age interval, knowledge of the age-related evolutionary dynamics of skin pathology.

Literature:

1 . F. Zverkova. Skin diseases in young children. Saint Petersburg. - Sothis. -1994 - 235 p.
2. K.N. Suvorov, A.A. Antoniev, N.P. Kuznetsova, I.O. Malova. Skin and venereal diseases in children. .Irkutsk, - Irkutsk University Publishing House. -1995.
3. Yu.K. Skripkin, G.Ya. Sharapova. Skin and venereal diseases. - M.: - Medicine. -1972.
4. Yu.K. Skripkin, F.A. Zverkova, G.Ya. Sharapova, A.A. Studnitsin. Guide to pediatric dermatovenereology. - A.; Medicine. - 1983.

The neonatal period is the most critical age stage of life, in which adaptation processes are barely outlined. The duration of the neonatal period has individual variations, but on average it is 28 days. The condition of the child immediately after childbirth is determined by its genetic code, the conditions in which pregnancy and childbirth took place, the sanitary and hygienic regime of the habitat, the nature of nutrition, the state of the immune system, etc. The skin of a newborn is one of the organs that is directly exposed to various environmental influences and reacts on these influences by various manifestations.

It is known that some skin diseases, especially congenital defects, deformities, nevi, and others, can begin from the first weeks of life, remain for the entire period of childhood or for life. There is a group of skin diseases that appear and disappear only during the neonatal period. These are the so-called skin diseases of newborns.

Omphalitis. Normally, the mummified remnant of the umbilical cord falls off by the end of the 1st week. The remaining umbilical wound epithelizes, granulates and a scar is formed by the end of the 2nd - the beginning of the 3rd week of life. If the umbilical wound becomes infected with staphylococcus, streptococcus, intestinal, Pseudomonas aeruginosa, diphtheria, tetanus bacilli, the fall-off of the remainder of the umbilical cord and the healing of the umbilical wound is delayed. Tetanus is currently extremely rare, but this should be remembered, since isolated cases can be observed during childbirth on the road, in the field, when the umbilical wound turns out to be the entrance gate. The disease begins between the 5-10th day of life and is manifested by the child's anxiety, difficulty sucking due to spasm of the facial muscles, cyanosis, muscle rigidity, and general tonic convulsions. At the same time, the umbilical wound was not changed externally. Anti-tetanus serum is used for treatment at the rate of 3000-10000 IU per 1 kg of body weight (introduced once according to Bezredka), seduxen - for convulsions

Weeping navel (catarrhal omphalitis). With prolonged healing as a result of infection of the umbilical wound, its weeping is observed, followed by the formation of crusts. After their rejection, wounds with a bleeding surface are exposed. The general condition of the child is not disturbed, the appetite is good, the temperature remains normal. With a decrease in the overall resistance of the child's body, increased virulence of the microbial flora, and in the absence of rational therapy, the process can turn into a more extensive and severe lesion and even lead to sepsis. With damage to the skin and subcutaneous fatty tissue, omphalitis develops around the navel. The umbilical region protrudes significantly, it is hyperemic, edematous, infiltrated. Thin blue stripes extend radially from the umbilical wound (dilated veins). Often, next to the blue stripes, red ones are noticeable, due to the addition of lymphangitis. The general condition of the child is disturbed, he sucks poorly, burps, becomes restless. Breathing is shallow, rapid. The legs are brought to the stomach, the temperature rises to 37.2 - 37.5 ° C. With a mild course of the disease, complete recovery occurs. In severe cases, peritonitis and sepsis are possible. As a result of infection of the wound with streptococcus, erysipelas of the navel, inflammation of the umbilical vessels in the form of phlebitis and arteritis may develop. The most severe form of the inflammatory process is navel gangrene, in which the inflammatory process spreads both on the surface and in depth. Destruction of the abdominal wall and gangrene of intestinal loops may occur. The prognosis for the life of the child is unfavorable.

Treatment. With a weeping navel (catarrhal omphalitis), the umbilical wound is thoroughly washed daily with a 3% solution of hydrogen peroxide, dried and irradiated ultraviolet rays, then the wound is treated with 1% - 2% solution of brilliant green or 5% solution of potassium permanganate, or 2% - 5% solution of silver nitrate. With the development of granulations, they are cauterized with lapis. If the inflammatory process spreads to the surrounding tissues and in depth, the temperature rises, along with the local one, a general treatment is carried out. Assign injections of antibiotics (oxacillin, ampioks, tseporin, methicillin, etc.), 2-3 injections of antistaphylococcal immunoglobulin.

Prevention of infection of the umbilical wound should begin in the delivery room. The navel is treated first with a 3% solution of hydrogen peroxide, and then with a 5% solution of potassium permanganate, a 1% alcohol solution of aniline dyes.

Frequent infections

Infectious erythema at first proceeds like a classic cold. Then rashes appear on the face and body.

The disease spreads by airborne droplets, an infected person is especially dangerous for others on early stage disease until a rash appears.

Medicines (including painkillers) are prescribed by a doctor. The baby should drink more fluids, adhere to bed rest. Active games and physical activity are contraindicated.

Toxic (infectious) erythema. Tips for parents from the Union of Pediatricians of Russia:

Chicken pox reveals itself as a rash that causes itching and a constant desire to scratch the skin, so the infection spreads very quickly throughout the body.

At the site of redness, small wounds form. In the later stages of the disease, blisters cover the skin, which open, dry out, and turn into crusts.

Coxsackie's disease has a second name - "hand-foot-mouth". First there are sores in the mouth, then blisters and rashes (not itchy) on the arms and legs, sometimes on the buttocks. Body temperature rises sharply.

The infection is spread by airborne droplets and through the diapers of a sick child. Doctors prescribe the patient and Acetaminophen, recommend to drink more fluids, and caring adults - to wash their hands more often.

Disease of the palms, feet and mouth - Coxsackie enterovirus, advice to parents from Pediatrician Plus:

Experts explain its nature by the problems of heredity and the weak immune system of the baby (by the way, 80% of cases are children under the age of 7).

Treatment is long, as it is required not only to get rid of the external manifestations of dermatitis, but also to eliminate the threat of relapse.

This problem is common in young children., especially if parents dress them too warmly: the child sweats, the body reacts to this with the appearance of a rash. They fight with it with the help of talc, decoctions of medicinal herbs.

Problems due to changes in the nervous system

Among the diseases in this group are neurodermatitis(redness and thickening of skin areas, the formation of nodules on them - papules) and psoriasis(scaly areas of different sizes and shapes).

Both diseases are chronic and difficult to treat with medication.

They are often "family", passed down from generation to generation., but provoke their outbreak by any transferred disease, stress, failures in immune system.

How to prevent

In the article, we indicated the names, gave a description and showed how common skin diseases look in the photo in children - newborns, preschool and older, briefly talked about the treatment of childhood dermatological diseases.

Many skin problems (whatever their nature) can be avoided if a child is taught hygiene from an early age.

And you also need to maintain cleanliness throughout the house, avoid allergenic foods and stressful situations for children.

If the problem still arises, you need to take it seriously and seek medical attention as soon as possible.

In contact with

Dermatovenereology: a textbook for students of higher educational institutions / V. V. Chebotarev, O. B. Tamrazova, N. V. Chebotareva, A. V. Odinets. -2013. - 584 p. : ill.

Chapter 3

Hemangiomas

Hemangiomas (haemangioma)- the most common skin tumors in newborns, they are detected in 5-7% of children. Hemangiomas are true vascular nevi that develop from blood vessels. They are capillary, cavernous, in the form of flaming nevi.

. Capillary hemangioma occurs for the first time a few weeks after birth and undergoes spontaneous regression within 2-4 years. Often located in the head or neck, less often - on the trunk, legs. The tumor is a flattened nodular element or plaque of a soft, bright red color, with irregular outlines, sharp borders and a slightly bumpy surface (Fig. 3-1). With vitropressure, the color of the element does not turn pale - the main difference from telangiectasias. After the regression of the hemangioma, cicatricial atrophy remains. Treatment is not required.

. Cavernous hemangioma characterized by multiple vascular hyperplasia and the formation of dilated vascular cavities located deep in the dermis or hypodermis. Node boundaries are blurred. The skin color is not changed or has a reddish-bluish tinge. Sometimes large cavernous hemangiomas grow rapidly and are complicated by thrombocytopenia. (Kazabakh-Merritt syndrome). Patients with cavernous hemangiomas are observed by a pediatrician and pediatric surgeon.

. Flaming nevus - malformation of the capillaries of the dermis in the form of their persistent, irreversible dilatation. The face is usually affected. It is clinically characterized by a spot of bright red "wine" color with irregular outlines and clear boundaries. Cosmetic correction is possible.

Rice. 3-1.Capillary hemangioma

Congenital aplasia of the skin

Congenital aplasia of the skin (aplasia cutis congenita) and subcutaneous adipose tissue in limited areas of the scalp, less often the trunk, with a diameter of 0.2 to 3-4 cm, is detected already at the time of birth (Fig. 3-2). The process ends with scarring. Perhaps a combination with other malformations. Treatment is reduced to protection from infection and damage, stimulation of the healing of the skin defect.

Rice. 3-2.Congenital aplasia of the skin

Adiponecrosis

Adiponecrosis (adiponecrosis)- focal necrosis of the subcutaneous

cellular tissue. It develops on the 1st-2nd week of life in the form of well-demarcated dense nodes with a diameter of 1-5 cm (sometimes more) on the buttocks, back, shoulders, limbs. The skin over the infiltrate is cyanotic, purple-red, later turns pale. Palpation of the infiltrate is painful. The general condition of the child is not disturbed, the body temperature is normal. Infiltrates spontaneously disappear without treatment within 2-4 months.

Sebaceous ichthyosis

Sebaceous ichthyosis (ichthyosis sebacea)- a peculiar condition of the skin, which is based on increased secretion of the drying secret of the sebaceous glands. After the disappearance of physiological erythema in the first days of life in some newborns, abundant physiological peeling of the skin is noted. At the same time, sometimes the child's body is covered with a dense brownish crust, consisting of scales and hairs. After several hygienic baths and subsequent treatment of the skin with emollient creams, the crusts disappear.

Toxic erythema of the newborn

Toxic erythema of the newborn (erythema neonatorum toxicum) develops on the 2-4th day of a child's life (but not from birth). Rashes are represented by erythematous spots, often merging with each other, as well as papules, pustules, surrounded by a hyperemic corolla. In the erythematous-papular form, there is a tendency for the elements to merge and form extensive lesions on the back, buttocks, and cheeks. The palms and soles are not affected. The course of the disease is benign, rashes disappear on their own in 1-2 weeks. Pustular elements are treated with a 1% solution of brilliant green.

Diseases of the umbilical wound

Catarrhal omphalitis

Catarrhal omphalitis (weeping navel) is characterized by the presence of hemorrhagic crusts, serous discharge from the umbilical wound after the umbilical cord falls off and a slowdown in the timing of its epithelization. In some cases, mild hyperemia and slight infiltration of the umbilical ring occur (Fig. 3-3). Condition but-

Rice. 3-3. Catarrhal omphalitis

congenital is not broken. Local treatment consists in treating the umbilical wound with a 3% hydrogen peroxide solution and lubricating with a 1% solution of aniline dyes, 1% potassium permanganate solution.

Omphalitis

Omphalitis is a bacterial inflammation of the bottom of the umbilical wound, umbilical ring, subcutaneous fatty tissue around the umbilical ring, umbilical vessels. Often the disease begins with manifestations of catarrhal omphalitis and is characterized by the presence of purulent discharge from the umbilical wound. There is a pronounced hyperemia and infiltration of tissues, the expansion of the vessels of the anterior abdominal wall, the attachment of lymphangitis are characteristic. The child's condition is disturbed, the body temperature rises to 37-38°C. With the spread of the infectious process, sepsis may develop. Treatment includes general antibiotic therapy, local treatment of the umbilical wound with aniline dyes, 1% potassium permanganate solution, antibacterial ointments.

Umbilical granuloma

umbilical granuloma (fungus, fungus)- proliferation of bluish-red granulation tissue after the umbilical cord falls off, filling the umbilical wound and rising above the edges of the umbilical

rings. Umbilical granuloma is typical for newborns with a large body weight, having a thick umbilical cord and a wide umbilical ring. The child's condition is not disturbed, there are no inflammatory changes. Local treatment consists in cauterization of granulation with a pencil with silver nitrate (lapis), as well as the use of cryodestruction or surgical excision.

Harlequin Syndrome

Harlequin syndrome - the periodic appearance of a bright red color of one half of the face, trunk and limbs and blanching of the other half of the body. Attacks occur in the first days or weeks of life and can be repeated many times. This syndrome indicates a violation of the central regulation of vascular tone. It can occur with intracranial hemorrhage and in premature babies.

transient edema

Transient edema develops in the 1st week of life in children. The skin (more often in the limbs and genitals) is characterized by a tendency to edema. The occurrence of edema is associated with various causes: compression of tissues at birth, cooling, infection, diseases of cardio-vascular system, kidney, etc. Edema of the rear of the foot and hands may be the first sign of Shereshevsky-Turner syndrome ( chromosomal abnormality). Given the numerous causes of edema, it is necessary to understand each specific case.

Scleroderma-like diseases

Scleroderma-like diseases are considered by many authors as reactive conditions in newborns, which are more severe than other transient phenomena (edema, erythema).

Scleredema of the newborn

Scleredema of the newborn (scleroedema neonatorum) develops on the 2-4th day of a child's life. Initially, there is a slight swelling of the skin and subcutaneous fatty tissue in the area of the calf muscles, feet, genitals, then a dense swelling of the tissues develops. Edematous skin is pale, sometimes with a cyanotic tinge, cold to the touch, in a fold

does not gather, when pressed, a hole remains. The development of scleredema is associated with hypothermia in a child, especially a premature one, malnutrition (hypoproteinemia), and severe general diseases. The prognosis is determined by concomitant diseases, since scleredema itself with good care, warming the child and rational feeding takes place within a few weeks.

Sclerema of newborns

Sclerema of newborns (sclerema neonatorum) is a more severe condition and is considered a connective tissue disease (collagenosis). Healthy children do not suffer from this disease, it is always the result of background or previous severe disorders. The condition is characterized by diffuse thickening of the skin, dense swelling of the subcutaneous adipose tissue of the extremities, and in severe cases, it spreads to the trunk and other parts of the body. When pressing on the skin, the fossa does not appear. The general condition of the child is severe, the prognosis is serious, the disease often ends in death. Treatment is carried out with glucocorticoids and symptomatic agents, transfusion of blood components, vitamins are prescribed.

Dermatitis of the anogenital area

Anogenital dermatitis is a group of diseases that develop in infants due to various reasons and includes: simple contact dermatitis, ammonia dermatitis, perianal dermatitis, anogenital candidiasis, streptoderma (papuloerosive form).

Simple contact dermatitis

Simple contact dermatitis of the anogenital area can develop in children younger age when using disposable synthetic diapers (pampers), as well as diapers washed with aggressive detergents. Clinically, this condition is characterized by diffuse erythema of the skin in contact with a diaper or tissue, with clear boundaries and not extending beyond the diapers. In case of contact dermatitis, it is necessary to replace ordinary diapers with hypoallergenic types or completely abandon them, and when washing diapers, use non-detergents,

A baby soap. Externally on irritated skin prescribe powders with talc, agitated suspensions, as well as external glucocorticoids (hydrocortisone ointment, creams with methylprednisolone aceponate, alklomethasone, etc.).

Ammonia dermatitis

Ammonia dermatitis (diaper dermatitis) is diaper rash in the anogenital region caused by maceration and irritation of the skin by urine and feces. The development of dermatitis is facilitated by a rare change of diapers and diapers, the use of waterproof pants, frequent loose stools with an alkaline or sharply acidic reaction. In mild cases, the lesion is limited to areas of the skin that are directly irritated by urine and feces: buttocks, back and inner thighs, genitals, perineum. The skin in these areas is hyperemic, bright red, shiny, "lacquered", erosion occurs in the folds, peeling occurs along the periphery of the foci. After removing the irritation, the rashes gradually regress.

Limited variant of ammonia dermatitis - perianal dermatitis, which develops in the intergluteal fold. This lesion is observed in children with dyspeptic symptoms, dysbacteriosis. Clinically, manifestations are characterized by erythema and slight swelling of the skin around the anus.

External treatment includes the use of indifferent pastes (special creams for diapers, with zinc oxide, drapolene *, etc.), as well as powders with talc and zinc oxide. For the prevention of ammonia dermatitis in young children, it is recommended that at each change of diapers and diapers, after cleansing the skin, apply barrier protective cream or paste to the anogenital area to prevent skin contact with liquids (special creams for diapers, soft zinc pastes, Vaseline oil etc.).

Anogenital candidiasis

Anogenital candidiasis develops in young children against the background of already existing ammonia dermatitis, diaper rash, and also as a complication of antibiotic therapy (with comorbidities). Rashes are represented by bright red erythematous spots with clear boundaries, erosions with the edge of exfoliated epidermis, single vesicular elements on healthy skin (Fig. 3-4).

Rice. 3-4.Anogenital candidiasis

Rashes are localized around the genitals, in the inguinal folds and folds of the anus. External treatment consists in the use of antimycotic external agents: 1% clotrimazole cream 2-3 times a day for 5-7 days, powders with clotrimazole at each diaper change, as well as barrier protective creams and pastes on the anogenital area.

Streptoderma of the anogenital region

Streptoderma of the anogenital region (papulo-erosive streptoderma, syphiloid papular impetigo) is a disease

developing in young children with the addition of streptococcal infection against the background of diaper rash and ammonia dermatitis. Rashes are represented by lenticular papules, single erosions located on an erythematous background. With a common infectious process, broad-spectrum antibiotics are prescribed. The external anogenital area is treated with antiseptic solutions (0.05% solutions of chlorhexidine, nitrofural, miramistin *, 0.5% potassium permanganate solution, etc.) 1-2 times a day, apply antibacterial ointments (2% lincomycin ointment, 1% erythromycin ointment, mupirocin, bacitracin + neomycin, etc.).

Diseases associated with sebaceous hyperplasia in infants

Most newborns and infants experience a hormonal crisis caused by exposure to circulating sex hormones transmitted transplacentally. In some cases, skin lesions develop associated with inflammation of hyperplastic sebaceous glands: inflammation of sebaceous cysts, neonatal acne, gneiss, seborrheic dermatitis, generalized Leiner-Moussou dermatitis.

Inflammation of sebaceous (miliary) cysts

Inflammation of the sebaceous (miliary) cysts is characterized by the appearance of a corolla of inflammation around the milia. Externally, the elements are treated with aqueous solutions of aniline dyes (1% brilliant green solution, 1% methylene blue solution).

neonatal acne

Neonatal acne (acne of babies) is observed in children up to 1-2 years of age. They are characterized by grouped papules and inflammatory acne localized on the face (forehead, cheeks, chin), often ending in the formation of punctate scars (Fig. 3-5). With age, acne disappears on its own. Antiseptic solutions, aniline dyes are prescribed for rashes, and with a common process - 1% erythromycin or chloramphenicol alcohol, zinc acetate + erythromycin (lotion), adapalene cream, etc.

Rice. 3-5. neonatal acne

Gneiss

Gneiss occurs in more than 1/2 of newborns and infants (up to 1-1.5 years old) and is characterized by the appearance of multi-layer fatty scales or scales on the scalp (especially the parietal region) (Fig. 3-6). In some cases, with poor care, the scales are located on hyperemic edematous skin, which is associated with the addition of conditionally pathogenic flora. Moderate gneiss does not require treatment. With massive layers, it is possible to soften the scales with 1% salicylic ointment or vegetable oil, followed by soft combing out with a children's bristle comb. In the presence of inflammation, antimycotic agents (clotrimazole cream), combined glucocorticoid preparations (hydrocortisone cream + natamycin + neomycin), naftalan oil ointment, 10% ichthyol ointment, etc. are externally prescribed.

Rice. 3-6. Gneiss

Seborrheic dermatitis

Seborrheic dermatitis is typical for children under the age of 1 year, most pronounced in the first months of a child's life. The main elements are localized on the scalp, eyebrows, in the area of nasolabial folds and intertriginous areas - axillary, femoral folds (Fig. 3-7). The rashes are represented by erythematous-squamous foci covered with yellowish greasy scales, easily rubbed in the hands (Fig. 3-8). In the folds, they exfoliate and maceration and erosion may occur.

Desquamative erythroderma Leiner-Moussou

Leiner-Moussou desquamative erythroderma is a common seborrheic dermatitis that occurs exclusively in children of the first 3 months of life and is associated with congenital immunological disorders (decreased phagocytic activity, defects in the complement system) and immunodeficiency.

The disease develops in most children immediately after birth from erythematous infiltrated foci of bright red color with abundant peeling, located mainly in the folds (groin