Skin diseases of newborns. Frequent diseases and skin problems in newborns

Small transient changes in the skin, especially in the midst of a rash, often cause unfounded fears. Most relatively common skin diseases in newborns are benign, transient and do not require treatment.

Hyperplasia of the sebaceous glands. Abundant rashes of small yellowish-white papules, which can often be seen on the forehead, nose, upper lip, and cheeks of full-term newborns, represent hyperplasia of the sebaceous glands. These small papules gradually shrink and disappear during the first weeks of life.

Milium. These are superficial intraepidermal cysts containing layered keratin material. They are dense pearly white papules with a diameter of 1-2 mm. Miiums occur at any age. In newborns, they are scattered on the face, gums along the midline of the palate. (Milium of the last localization is called Epstein's pearls.) Milium in most cases desquamate spontaneously. Milium on scars and in places of skin trauma in older children is carefully opened and freed from the contents with a thin needle.

Bubbles from sucking. Single or multiple blisters are sometimes observed on the hands of newly born children; this is not, in the full sense, a skin disease of newborns. It is believed that they are formed as a result of vigorous sucking of the corresponding part of the hand in utero. These blisters, which quickly disappear without a trace, are usually located on the forearm, thumb and index finger. They should be distinguished from sucking pads (calluses) on the lips, which form in the first months of life and are caused by intracellular and hyperkeratosis. Their nature is confirmed by the participation of the corresponding parts of the lips in sucking.

Skin marbling. At low air temperatures, a transient bright pink or bluish vascular pattern appears on the skin of most of the body. It represents an enhanced physiological vasomotor response. It usually disappears with age, although sometimes marbling of the skin is noticeable even in children older than 1-2 years. The severity and persistence of skin marbling is characteristic of some hereditary diseases in newborns - Menkes syndrome (curly hair disease), familial autonomic dysfunction, Cornelia de Lange syndrome, Down syndrome, trisomy 18. With cutis marmorata telangiectatica congenita, skin marbling is also observed, but it is persistent, segmental, may be accompanied by the absence of the dermis, atrophy and ulceration of the epithelium. By 1 year there is an improvement, the vascular pattern is reduced by half. Cutis marmorata telangiectatica is accompanied by microcephaly, micrognathia, cleft palate, dental dystrophy, glaucoma, short stature, and skull asymmetry.

Harlequin's symptom. This is a relatively rare skin disease in newborns, but attracts attention. It is observed in newborns, mainly in those born with low body weight, and reflects an imbalance in the mechanisms of autonomic regulation. When the child is placed on his side, his body becomes as if divided longitudinally strictly along the midline into two halves in color - the upper one is pale and the lower one is intensely pink. The phenomenon lasts only a few minutes and can only affect the face or part of the body. If the baby is turned over to the other side, the color will change to the opposite. When the child moves independently, the intense pink color spreads over the entire surface of the skin and the difference disappears. The Harlequin phenomenon can occur repeatedly, which does not at all indicate a persistent disorder of autonomic reflation.

"Salmon" spots (nevus of Unna). Small pink vascular spots, which are found on the back of the neck, eyelids, upper lip, and glabella in 30-40% of newborns, are considered one of the mildest skin diseases of newborns. They represent limited areas of vascular ectasia, more noticeable during screaming and changes in ambient temperature. After a few months, they turn pale and disappear completely on the face, but on the back of the neck and back of the head they can remain visible for a long time. Salmon spots on the face should not be confused with wine stains. Salmon spots are usually symmetrical, located on both eyelids or on either side of the midline. Port-wine stains are often large, asymmetrical, and located at one end along the midline.

"Mongolian" spots. They are areas of skin of a blue or bluish-gray color with borders of varying clarity. Most often, the symptoms of skin disease in newborns in this case are located in the sacrum area, sometimes on the back of the thighs or legs, on the back, or shoulders. They can be single or multiple and sometimes occupy a significant area. “Mongolian” spots are found in 80% of infants of African-American, Asian and Indian origin and in less than 10% of whites. Their specific color is given by the accumulation in the dermis of melanin-containing melanocytes, apparently delayed in the process of migration from the neural crest to the epidermis. In most children, “Mongolian” spots fade during the first years of life, but sometimes persist for a long time. They do not undergo malignant degeneration. “Mongolian” spots, scattered over the entire surface of the skin, especially with an atypical location, are not prone to disappearing. “Mongolian” spots differ from bruises due to cruel treatment by their unique coloring and innate character.

Erythema toxicum. These are transient rashes that disappear without treatment, which are observed in 50% of full-term newborns; they occur less frequently in premature infants. The elements of the rash are dense yellowish-white papules or pustules with a diameter of 1-2 mm, surrounded by a halo of erythema, sometimes only erythematous spots. They can be single or abundant, located in a limited area or over the entire surface of the skin, except for the palms and soles. The peak of this skin disease in newborns occurs on the 1st day of life. In the following days, the number of rashes does not increase significantly, although new elements are possible. Then the rash disappears. In premature infants, erythema toxica appears several days or even weeks later than in full-term infants. Pustules are located under the stratum corneum of the epidermis or in the thickness of the latter and are accumulations of eosinophils around the upper part of the hair follicle. Eosinophils can be seen in Wright-stained smears of the contents of pustules. The contents of the pustules are sterile, which is confirmed by culture.

The cause of this skin disorder in newborns is unknown. Its differential diagnosis includes pyoderma, candidiasis, herpes, transient pustular melanosis of the newborn and milia, from which elements of erythema toxicum are distinguished by a characteristic pattern of eosinophilic infiltration in the absence of bacteria in stained smears. Erythema toxicum rashes disappear quickly and do not require treatment. Eosinophilic infiltration is also observed with pigment incontinence and eosinophilic pustular folliculitis, but they differ in a different localization of the elements, histological picture and persistence of the rash.

Transient pustular melanosis of newborns. It is a transient, benign skin disorder of newborns, a dermatosis requiring no treatment, that occurs more frequently in African American children than in white children. It is characterized by three types of rash elements:

• quickly disappearing superficial pustules;
• opened pustules with a rim of tender scales, in place of which there remain spots with a hyperpigmented center;
• hyperpigmented spots.

Rashes with this skin disease in newborns are present at birth, scanty or abundant. Elements of one or all types are detected. Pustules are fresh elements of the rash, spots are late elements. The pustular phase of the rash rarely lasts more than 1-3 days, hyperpigmented spots last 3 months. The rashes are located mainly on the front surface of the neck, on the forehead, lower back, but can be on the scalp, torso, limbs, palms, and soles.

In the active phase of the rash, pustules filled with neutrophils, detritus, and single eosinophils form in the stratum corneum of the epidermis or under it. The spots show only increased pigmentation of epithelial cells. Smear and culture help distinguish transient pustular melanosis from erythema toxicum and pyoderma. The contents of the pustules are sterile and do not contain dense accumulations of eosinophils. Transient pustular melanosis does not require treatment.

Infantile acropustulosis. This skin disease of newborns usually begins at the age of 2-10 months, but sometimes its rashes are already present at birth. It is observed predominantly in African-American boys, but occurs in newborns of both sexes and any race. The cause is unknown.

Non-confluent erythematous papules initially appear. Over the course of a day, they turn into vesicles and papules, then dry out to form crusts and heal. The rash is very itchy. During their appearance, the child can be restless and capricious. The palms, soles, and lateral surfaces of the feet are mainly affected, where the rashes are very profuse. Less abundant rashes are located on the back of the feet and hands, ankles, wrists, and isolated pustules are located on other areas of the skin. Each episode of profuse pustule rash lasts 7-14 days. Then follows 2-4 weeks. remission, and then a new episode of rash. The cyclical course is observed for approximately 2 years. Persistent recovery is preceded by prolongation of remissions. Infantile acropustulosis is not accompanied by damage to other organs.

Wright-stained smears from pustules reveal a large number of neutrophils. Sometimes eosinophils predominate. Histological examination reveals clearly defined pustules under the stratum corneum of the epidermis, filled with neutrophils with or without an admixture of eosinophils.

The differential diagnosis of skin diseases in newborns includes transient pustular melanosis, erythema toxicum, milia, cutaneous candidiasis, and staphylococcal pustulosis. In children under 3 years of age who have left the neonatal period, one should also keep in mind scabies, which often appears in the anamnesis, dyshidrotic eczema, pustular psoriasis, subcorneal pustular dermatosis, viral pemphigus of the oral cavity and extremities. In doubtful cases, a trial of anti-scabies treatment is justified.

Treatment of this skin disease in newborns is aimed at eliminating unpleasant sensations, in particular itching, which is alleviated and calmed by topical corticosteroids and oral medications. Oral dapsone is also effective at a dose of 2 mg/kg/day in 2 doses, but it should be used with caution, as it can cause hemolytic and methemoglobinemia.

The sensitive skin of a newborn baby is prone to exposure to various bacteria, resulting in a number of diseases. In this article, we will look at common skin problems in newborns that parents should be aware of in order to adequately treat them.

A similar skin problem occurs in every second newborn. A sign of this is considered to be a yellowish tint of the skin, which occurs due to excess bilirubin in the child’s body. Usually in full-term and healthy babies this is a physiological phenomenon that disappears without a trace after a month of life without appropriate treatment.

A very common skin problem in newborns. This disease appears on the baby’s face in the form of small spots or pink pimples. This phenomenon is considered not dangerous (of course, if it is not associated with infection of the body by various bacteria). The cause of the disease is maternal hormones, which will disappear from the child’s body in a month.

Important! Do not try to squeeze out pimples, much less give your child any antihistamines. Consult a specialist, perhaps he will prescribe something individual.

In these cases, the main thing is to provide the baby with proper care and proper hygiene.
Wash your baby regularly with warm boiled water. If itching occurs, use antiseptics Bepanten or Boroplus. Many parents confuse acne with Therefore, it is advisable to consult a pediatrician to confirm the diagnosis.

Miliaria in newborns

Skin problems in newborns in the form of various rashes are often a sign caused by overheating of the child and lack of proper care. Often, rashes in the form of small pink specks appear under the knees, on the pubic folds, under the arms and on the back of the head.

You can cope with these symptoms by using soothing compresses, baths or lotions with a decoction of chamomile, thyme and sage. Special children's cosmetics in the form of creams, oils and powders can also be used. With the right approach, you can quickly get rid of this skin problem in newborns.

Watch a video about skin problems in babies with Komarovsky.

Erythema in babies

This disease is quite rare, but if it does appear, it is diagnosed by the appearance of red spots on certain areas of the skin. This is usually a physiological phenomenon that goes away after three to four days without the use of medical therapy.

Sometimes the physiological form turns into a toxic one, a clear symptom of which is the appearance of rashes on the skin in the form of small blisters. This problem does not cause any complications, and air baths will help relieve the symptoms.

Children's humor! My son developed a rash on his chest and back. The dermatologist advised him to sunbathe. But the child is embarrassed to undress and does not want to go to the beach. I persuade:

No one will see you there. We’ll arrive, lie down next to the car and sunbathe.
- What, right on the asphalt?!

Seborrheic dermatitis in infants

Often newborns appear. This skin problem does not require mandatory treatment, but if the symptoms bother your baby, you can try to get rid of them. To do this, while bathing, carefully moisten the resulting crusts on the baby’s head. Then we dry and moisturize the head with ordinary baby cream or oil. After the cosmetics have been absorbed, we begin to carefully comb out the skin.

To do this, it is recommended to use a soft comb so as not to injure the newborn’s skin. You should not pick dry crusts, as this can cause pain in the baby. This may lead to infection.

With proper hygiene, the dermatitis disappears after a week.

Allergic reactions in a newborn, manifested on the skin

Allergies in newborns occur due to the child’s intolerance to certain foods and medications. Often the localization of symptoms of allergic reactions in a newborn is observed on the skin. Therefore, it is important not to confuse them with ordinary child skin problems that do not require treatment.

Children say! My son (2.5 years old) asks:
- Mom, where is my sister?
And our son is still one child in our family. I answer:
- We don't have a sister.
Andryusha asks:
- Mom, I want my little sister to grow in your tummy.

An allergy to the skin of a baby manifests itself in the form of:

There is also intolerance to certain medications. Often symptoms appear in the form of rashes on the baby’s neck and cheeks. A similar skin problem in a newborn can easily be confused with heat rash or diaper rash.

Note to moms! To prevent your child from suffering from allergies during the newborn period, follow a proper diet and daily routine. If the baby is “artificial”, choose the right mixtures.

Prevention of skin problems in infants

Prevention is considered an excellent measure that will help prevent various skin diseases in babies in the first days of life. This includes vaccinations, proper personal hygiene and care.

Parents are required to regularly bathe and wash the child, conduct hardening in the form of air baths, and strengthen the body with physical exercise and massage.

If a mother practices breastfeeding with her child, it is necessary to avoid foods that cause allergies for a while. It is ideal to collect tests from the newborn and determine which substances cause intolerance in the child.

Attention! It is not recommended to treat a newborn with problem skin on your own, as this may aggravate the symptoms and have no effect. Be sure to get the opinion of your pediatrician.

Watch the video on the topic of our publication.

Nursing process for non-infectious and infectious diseases of the skin and umbilical wound of a newborn, sepsis of a newborn

Lecture No. 4

Lecture outline:

1. Classification of diseases of the skin and umbilical wound in newborns.

2. Non-infectious diseases of the skin and umbilical wound. Definition. Incidence rate. Main causes and risk factors for development. Clinical manifestations and complications. Principles of treatment and planning of nursing care for patients. Prevention.

3. Pyoderma. Definition. Incidence rate. Main causes and risk factors for development. Clinical manifestations and complications of diseases. Principles of treatment and planning of nursing care for patients. Prevention.

4. Sepsis of newborns. Definition. Incidence rate. Main causes and risk factors for development. Clinical manifestations and complications. Principles of treatment and planning of nursing care for patients. Prevention.

5. Nursing process for purulent-septic diseases of newborns.

All diseases of the skin and umbilical wound can be divided into two large groups:

Non-communicable diseases:

· Diaper rash

· Heat rash

· Scleredema, sclerema.

· Umbilical hernia

· Navel fistulas

· Fungus of the navel

Infectious diseases (bacterial, localized purulent-septic)

Vesiculopustulosis

· Pemphigus of newborns

Exfoliative dermatitis

Pseudofurunculosis

· Omphalitis

Generalized purulent-septic diseases include neonatal sepsis.

Non-infectious skin diseases of a newborn baby:

Prickly heat. It is a red, pinpoint rash on the torso, neck, and inner surfaces of the extremities. Appears due to retention of sweat in the excretory tubules of the sweat glands when the child is overheated or insufficient hygienic skin care. The general condition of the child is not disturbed, the body temperature is normal. Elements of the rash can become infected with the development of pyoderma.

Treatment consists of eliminating the cause of increased sweating, carrying out hygienic baths with potassium permanganate, decoctions of chamomile, calendula, and string daily.

Diaper rash. The occurrence of diaper rash is associated with defects in care - rare changes of diapers and diapers, irregular hygienic baths and washing, reuse of dried diapers. Children with diathesis tend to develop rapidly and persistent diaper rash. Diaper rash is most often located in the buttocks, genitals, and skin folds. There are three degrees of diaper rash:

I. Moderate redness of the skin

II. Bright redness with large erosions.

III. Bright redness and weeping as a result of merged erosions.

Diaper rash with a violation of the integrity of the skin can become infected.

Treatment provides for changing diapers and swaddling or changing the child's clothes before each feeding, air baths, and ultraviolet radiation. In case of skin hyperemia, it is lubricated with boiled vegetable oil, a fatty solution of vitamin A, baby cream, and disinfectant and skin-protecting powders are used. The simultaneous use of powders and oils on the same areas of skin is not allowed. For erosions, the skin is treated with a 0.5% solution of resorcinol, a 1.25% solution of silver nitrate, and talc powder. It is recommended to add a decoction of oak bark and chamomile to the water when carrying out hygienic baths.

Scleredema and sclerema . This is woody density swelling of the skin and subcutaneous tissue. More often observed in premature babies with hypothermia. With scleredema, areas of compaction appear on the lower legs, feet, above the pubis, on the genitals, and can also affect other areas of the body. Unlike sclerema, they do not tend to generalize. The skin over the lesion is tense, cold to the touch, has a cyanotic tint, and does not fold. When you press with your finger, a depression remains, which disappears very slowly. Good care and warming of the child lead to the disappearance of the seals in a few weeks.

Sclerema is characterized by the appearance of a diffuse thickening, often in the area of ​​the lower leg muscles and on the face, then spreading to the trunk, buttocks and limbs. No depressions are formed when pressing on the skin. The affected areas appear atrophied, the face is mask-like, and movements in the limbs are limited. Body temperature is reduced. Children are lethargic, sleepy, and have difficulty latching on to the breast. The general condition is serious.

For treatment, the child is placed in an incubator or covered with heating pads, and warm baths are used. Cardiac medications, corticosteroid hormones, and oxygen therapy are indicated. The prognosis is unfavorable.

Non-infectious diseases of the navel of a newborn baby:

Umbilical hernia – This is a protrusion in the area of ​​the umbilical ring that increases when the child screams or is restless. Upon palpation, a wide umbilical ring is determined. The child’s condition is not affected, but in case of strangulation, the umbilical ring is small in size and has dense edges, painful reactions are possible.

Treatment, as a rule, conservative: Massage the anterior abdominal wall, placing the baby on the stomach for 10-15 minutes before each feeding. If severe anxiety occurs, under the supervision of a doctor, the umbilical hernia is reduced in a bath with a water temperature of 36-37 o C. The need for surgical treatment rarely arises.

Navel fistulas There are complete and incomplete. Complete fistulas are associated with non-closure of the vitelline duct located between the umbilicus and the loop of intestine, or preservation of the urinary duct connecting the bladder with the allantois. Incomplete fistulas arise due to non-fusion of the distal urinary or vitelline ducts.

Fistulas are manifested by persistent weeping of the umbilical wound. It is possible to release intestinal contents through the vitelline duct or urine through the urinary duct in complete fistulas. Around the navel there is irritation and maceration of the skin. In case of infection, the discharge from the umbilical wound becomes purulent.

To confirm the diagnosis, an X-ray examination and probing of the fistula canal are performed.

Treatment operational.

Fungus navel – mushroom-shaped growth of granulation tissue at the bottom of the umbilical wound measuring 1-3 cm in diameter.

Treatment. After treating the umbilical wound, the granulations are cauterized with a 5% solution of silver nitrate or a lapis pencil. In rare cases, there is a need for surgical treatment.

Pyoderma.

In the structure of morbidity and mortality of newborns and young children, the leading place is occupied by purulent-septic diseases.

Most often pathogens are:

· Staphylococcus

Group B Streptococcus

· Escherichia coli

Pseudomonas aeruginosa

· Klebsiella

Microbial associations

Vesiculopustulosis – This is a pustular skin disease in newborns or children in the first months of life. It is the most common form of local infection.

Clinical manifestations:

· In the natural folds of the skin, on the torso, scalp, and limbs, small superficial blisters appear, initially filled with transparent exudate (vesicles), and then with cloudy purulent contents (pustules).

· The blisters open 2-3 days after their appearance, forming small erosions, and gradually become covered with dry crusts (they do not leave scars after healing).

· The general condition of the child, as a rule, does not suffer.

The course of vesiculopustulosis can be complicated by the development of infiltrates and multiple abscesses.

Pemphigus of newborns is a type of pyoderma that develops in a newborn baby, most often on days 3-5, less often in the second week of life.

Clinical manifestations:

· Suddenly, multiple round and oval blisters (up to several centimeters in diameter), single-chamber, filled with a clear yellowish liquid, which later becomes cloudy, appear on the unchanged skin. The consistency of the blisters is sluggish, their walls are thin, they easily open, forming a bright red erosion.

· Localization of blisters is often on the back, abdomen, in the area of ​​the axillary and inguinal skin folds.

· The rash occurs in bursts, so the rash is polymorphic in nature.

· The child’s condition is serious, intoxication is pronounced, body temperature rises to 38-39 o C, the child becomes lethargic, refuses to breastfeed, and does not gain weight well.

If treatment is started in a timely manner, recovery occurs within 2-3 weeks, but if the course is unfavorable, the disease can end in sepsis.

Exfoliative dermatitis – the most severe form of staphylococcal skin lesions in a newborn baby.

Clinical manifestations:

· Diffuse hyperemia appears around the navel or mouth; after some time, detachment of the epidermis occurs, revealing large eroded areas. The affected area gradually increases, and after 8-12 days the newborn’s skin takes on a burnt appearance (large areas of hyperemia and erosion).

· The condition is severe, symptoms of intoxication are pronounced, there is a high fever, the child is lethargic, refuses to breastfeed, and does not gain weight well.

· Abscesses and phlegmon are often associated.

Pseudofurunculosis – inflammation of the sweat glands. The disease can begin with prickly heat, vesiculopustulosis. The skin most often affected is the scalp, back of the neck, back, buttocks, and limbs (in areas of greatest friction and contamination).

Clinical manifestations:

· In place of the excretory ducts of the sweat glands, subcutaneous compactions of purplish-red color up to 1.5 cm in diameter appear. Subsequently, fluctuating purulent contents appear in the center of the inflammatory focus, and after healing a scar remains.

· The child’s condition is disturbed, symptoms of intoxication are noted, and body temperature periodically increases.

· In the presence of small multiple skin abscesses, regional lymph nodes are enlarged.

If treatment is started in a timely manner, recovery occurs within 2-3 weeks, however, if the course is unfavorable, the disease can be complicated by sepsis.

Omphalitis – This is an inflammatory process in the area of ​​the umbilical wound. The umbilical wound is a very convenient entrance gate for the penetration of pathogenic microorganisms.

There are three forms of omphalitis:

Catarrhal omphalitis

Phlegmonous (purulent) omphalitis

· Necrotizing omphalitis.

Catarrhal omphalitis (wetting navel) ) – develops with delayed epithelization of the umbilical wound.

Clinical manifestations:

· The umbilical wound becomes wet, serous discharge is released, the bottom of the wound is covered with granulations, the formation of bloody crusts is possible, slight hyperemia of the bottom of the wound and moderate infiltration of the umbilical ring are noted.

· With a prolonged process of epithelization, fungus may appear at the bottom of the wound.

· The condition of the newborn, as a rule, is not disturbed, the body temperature is normal, the umbilical vessels are not palpable.

With timely diagnosis and treatment, the umbilical wound heals within a few weeks. If the course of the disease is unfavorable, the process may spread to the tissues adjacent to the navel and umbilical vessels.

Purulent (phlegmonous) omphalitis – characterized by the spread of the inflammatory process to the tissue around the umbilical ring (subcutaneous fat, umbilical vessels) and severe symptoms of intoxication. Purulent omphalitis can begin with symptoms of catarrhal omphalitis.

Clinical manifestations:

· The skin around the navel is hyperemic, edematous, and there is an expansion of the venous network on the anterior abdominal wall.

· The umbilical wound is an ulcer covered with fibrinous plaque; when pressed, purulent contents are released from the navel.

· The umbilical region gradually begins to bulge above the surface of the abdomen, because deeper tissues are gradually involved in the inflammatory process.

· The umbilical vessels are inflamed (thicken and palpable in the form of cords).

· The child’s condition is serious, symptoms of intoxication are pronounced, he is lethargic, sucks poorly, regurgitates, body temperature rises to febrile levels, and there is no increase in body weight.

With this form of omphalitis, the child’s condition is always regarded as serious, because metastasis of purulent foci and the development of sepsis are possible.

Necrotizing omphalitis It is extremely rare and is a complication of phlegmonous in children with low immunity.

Clinical manifestations:

· The skin around the navel becomes purple-cyanotic in color.

· Tissue necrosis quickly spreads to all layers with the formation of a deep wound.

· The child’s condition is extremely serious, symptoms of intoxication are pronounced.

This form of omphalitis in most cases ends in sepsis.

Basic principles of treatment of newborns with local forms of purulent-inflammatory diseases:

1. Children with vesiculopustulosis and catarrhal omphalitis without disturbing the general condition and with properly organized care can be treated at home. Other forms of localized purulent-septic diseases require hospital treatment.

2. Etiotropic therapy:

· Vesiculopustulosis: treat intact skin around the rash with a 70% solution of ethyl alcohol, observing the rules of asepsis, open and remove vesicles and pustules with a sterile swab moistened with alcohol, suck out the contents of large blisters using a disposable syringe, cut off the walls of the bubble with sterile scissors, then treat the eroded surface daily bactericidal preparations (30% dimexidine solution, chlorophyllipt solution, 1% aqueous solutions of brilliant green or methylene blue), irrigate or apply dressings with staphylococcal bacteriophage. For complicated forms, antibacterial therapy is carried out in combination with immunocorrective agents, vitamin therapy, and ultraviolet radiation.

· Pseudofurunculosis: the elements are treated with a 70% solution of ethyl alcohol, bandages are applied with a 20% solution of dimexide or its ointment, surgical treatment is performed according to indications, antibacterial and restorative treatment, and physiotherapeutic procedures are carried out.

· Catarrhal omphalitis: remove crusts from the umbilical wound with a 3% solution of hydrogen peroxide, dry with 95 o (70% solution) ethyl alcohol 2-3 times a day.

· Purulent and necrotizing omphalitis, pemphigus, exfoliative dermatitis are treated in a hospital setting according to all the principles of treatment of sepsis.

4. Sepsis of newborns.

Neonatal sepsis – This is a generalized infectious disease caused by the spread of microorganisms from the primary focus into the blood and lymph, then into various organs and tissues, occurring against the background of reduced or perverted immunity. The incidence of sepsis is 0.1% in full-term newborns and about 1% in preterm infants. In the structure of infant mortality, sepsis ranks 3-4.

Etiology:

Streptococci

· Escherichia coli

· Klebsiella

Pseudomonas aeruginosa

· Staphylococcus

Haemophilus influenzae

Viral-microbial associations

Predisposing factors: 1. Factors that violate (reduce) the anti-infective properties of natural barriers - catheterization of the umbilical and central veins, tracheal intubation, mechanical ventilation; severe respiratory viral diseases, birth defects, burns, trauma during childbirth or surgical interventions; reduction of intestinal resistance in intestinal dysbiosis. 2. Factors that inhibit the immunological reactivity of a newborn - a complicated antenatal period, pathology during childbirth leading to asphyxia, intracranial birth trauma, viral diseases, hereditary immunodeficiency conditions, nutritional defects of the pregnant woman. 3. Factors that increase the risk of massive bacterial contamination of the child and the risk of infection with hospital flora - an anhydrous period of more than 12 hours, unfavorable sanitary and epidemiological conditions in the maternity hospital or hospital (there is a possibility of cross-infection), severe infections in the mother at the time of birth or after. 4. Purulent-inflammatory diseases in the 1st week of life. A child is especially sensitive to infection at the time of birth and in the first days of life, which is associated with an excess of glucocorticoids in his blood, transient dysbiocenosis, the formation of an immunological barrier of the mucous membranes and skin, and the catabolic orientation of protein metabolism.

Pathogenesis. The entry points for infection are: the umbilical wound, injured skin and mucous membranes (at the site of injections, catheterization, intubation, probes, etc.), intestines, lungs, less often - the middle ear, eyes, urinary tract. In cases where the entrance gate of infection is not established, cryptogenic sepsis is diagnosed. The source of infection can be medical staff and a sick child. The routes of transmission of infection are the mother's birth canal, the hands of personnel, instruments, equipment, and care items. The following main links in the pathogenesis of sepsis are identified: entrance gates, local inflammatory focus, bacteremia, sensitization and restructuring of the body's immunological reactivity, septicemia and septicopyemia.

Clinical picture.

Precursors of sepsis:

Late umbilical cord loss

Sluggish healing of the umbilical wound

Elements of pustules on the skin

· Mucus discharge from the nose

· No weight gain

· Protracted jaundice

Early signs of sepsis:

General restlessness of the child, followed by lethargy

Pale skin, cyanosis of the nasolabial triangle, acrocyanosis

Frequent regurgitation

· Decreased appetite, breast refusal

· Increasing intoxication

· Local purulent focus

Signs of sepsis during its peak period:

· The skin is dry, pale with a grayish-cyanotic tint. Then dry skin is replaced by swelling, pastiness with areas of sclerema, tissue turgor decreases, multiple pustules or hemorrhagic rash may appear.

· Inconsistency of body temperature (from low-grade to hectic).

· Dyspeptic disorders: persistent regurgitation, loss of appetite up to anorexia, unstable stool lead to a drop in body weight

· Changes in the cardiovascular system: hypotension, arrhythmia, expansion of the borders of the heart, dullness of heart sounds, impaired microcirculation (marbling of the skin, a symptom of a “white” spot), a collaptoid state may develop.

· Changes in the respiratory system: shortness of breath, apnea.

· Enlarged liver and spleen.

There are two clinical forms of sepsis:

· Septicemia– occurs due to the massive entry of pathogenic organisms into the bloodstream, occurs without visible local purulent-inflammatory foci, and has an acute course. Characteristic: severe symptoms of intoxication, high fever, pallor and cyanosis of the skin, dyspeptic disorders, changes in the cardiovascular system, rapid loss of body weight, septic hepatitis. The child may die from septic shock within a short time. More often observed in premature babies.

· Septicopyemia– characterized by a wave-like course due to the constant development of new metastatic foci in the body. Characteristic: severe symptoms of intoxication, signs of respiratory and cardiovascular failure, constantly appearing new purulent metastatic foci in various organs. It develops more often in full-term infants.

Diagnostic methods:

1. Clinical blood test.

2. Bacteriological examination of blood, cerebrospinal fluid, etc.

The prognosis for sepsis depends on the virulence of the pathogen, the state of the child’s immunity, the timeliness and adequacy of therapy. It remains serious in children at risk (death in 15-30% of cases).

Basic principles of treatment of neonatal sepsis:

1. Protective mode, if possible, a separate sterile box, use sterile linen.

2. Feeding the child with breast milk, the method of feeding according to the condition.

3. Drug therapy:

· Antibacterial drugs: a combination of several antibiotics by different routes of administration (ampicillin with aminoglycosides or cephalosporins). Change courses every 7-10 days.

· Detoxification therapy, maintenance of bcc: plasma, 5% glucose solution, isotonic electrolyte solutions, albumin, rheopolyglucin.

· Immunocorrective therapy: specific immunoglobulin, blood products, plasma.

· Local treatment of pyemic lesions (omphalitis, pyoderma, etc.).

· Pathogenetic and symptomatic therapy: enzymes, vitamins, cardiac drugs, biological products, angioprotectors, disaggregants, anticoagulants, etc.

4. Physiotherapy: microwave, UHF, etc.

5. Herbal medicine: medicinal baths with infusions of string, chamomile, St. John's wort, decoctions of oak bark, birch buds.

Skin diseases in children are much more common than in adults. This is because children are more sensitive and susceptible to infections. Skin diseases in children are often allergic in nature. Treatment of the disease should begin only when the diagnosis is accurately established and confirmed.

Let's look at diseases that are more common than others.

Atopic dermatitis

is a chronic, genetically determined inflammatory skin disease.

The first and most important reason for the onset of the disease is genetic predisposition (relatives suffering from various allergies);

Important! Atopy is the tendency of a child’s body to develop allergies. You can read about allergy treatment.

1. Increased hyperreactivity of the skin (increased sensitivity to external factors).
2. Disruption of the child's nervous system.
3. Using tobacco products in the presence of a baby.
4. Bad ecology.
5. Food contains a lot of dyes and flavor enhancers.
6. Dry skin.

Important! This type of dermatitis affects children under 12 years of age; at older ages it is extremely rare.

With atopic dermatitis, the child’s skin becomes dry, begins to peel, and a rash appears in spots, especially in certain places: on the face, neck, on the bends of the elbows and knees. This disease has a wave-like course, periods of remission (extinction of symptoms) are replaced by periods of exacerbation.

Diaper dermatitis

- this is an irritable and inflammatory process that occurs under the diaper, due to limited air flow to the skin of the perineum or prolonged moisture. This is a good environment for bacteria to grow.

Important! Occurs in babies who wear diapers, regardless of age.

When using diapers and diapers, irritants are:

1. High humidity and temperature.
2. Prolonged contact of feces and urine with the skin.
3. Accelerated development of fungal infection.

Fungal infection plays a major role in this case. Scientists have proven that many children suffering from diaper dermatitis have a fungal infection, which is the causative agent of candidiasis.

Important! At the first manifestations of a rash, it should be remembered that the baby may be allergic to new soap, cream, or even new diapers, provided that there have been no hygiene violations.

Symptoms:

1. Children with diaper dermatitis experience severe inflammation of the skin in the perineum and buttocks.
2. Hyperemia of the skin, blisters or even small wounds may be detected.
3. Very severe inflammation is observed in the skin folds and between the buttocks.
4. In this case, the baby will be restless, whiny, and nervous.
5. He will pull his hands into the groin area and try to remove the diaper.

Hives

is a skin disease that is characterized by the appearance of itching, and after the appearance of blisters, the blisters at the beginning of the disease are single, later merge and form an inflamed area, which can cause an increase in temperature and disruption of the stomach and intestines.

Reasons that contribute to the appearance of skin diseases:

1. Hypersensitivity of the skin.
2. Foods that contain many allergens (citrus fruits, strawberries, chocolate, honey).
3. Medications.
4. Dust or pollen, animal hair.
5. Infectious and viral diseases.
6. Cold, heat, water, UV rays.
7. Insect bites.

Symptoms:

1. The first things to appear with hives are blisters and a red rash that causes itching and a desire to scratch (like a nettle burn).
2. The child scratches these blisters, causing them to coalesce.
3. Localized around the lips, on the cheeks, in the folds of the skin, on the eyelids.
4. The body temperature rises, sometimes nausea occurs and...

Prickly heat

- This is one of the forms of dermatitis that appears as a result of skin irritation due to increased sweating.

According to symptoms, prickly heat is divided into three types:

1. Crystalline prickly heat - newborn babies are more often affected by this type; the elements of the rash look like white blisters about 2 mm in size. The rash may coalesce and form large white areas; these blisters are easily damaged, resulting in areas that peel off. The rash is localized on the neck, face, and upper half of the body.
2. Miliaria rubra - with this type, a rash appears in the form of nodules around which hyperemia appears along the periphery. This rash does not merge, itches and causes pain when touched.
3. Miliaria profunda - with this type, a rash appears in the form of beige or pale pink blisters. The rash can be located not only on the neck, face, but also on the legs and arms. This rash goes away as quickly as it appeared, leaving no traces or scars.

But this type most often affects adults who have suffered from prickly heat more than once, but there are exceptions when children suffer from it.

Important! If a child develops a rash on the skin, under no circumstances should it be smeared with cosmetic creams or ointments that you once used. Remember - your child’s health is only in your hands!

Causes of the disease:

1. Very thin and delicate skin.
2. Active blood supply, as a result of which the baby quickly overheats.
3. Poorly developed sweat ducts.
4. High skin saturation with water (92%).

Acne

Acne in children is a disease of newborns, which manifests itself in small white rashes that are localized on the chin and cheeks of the baby. They can appear in the first 6 months of a child’s life, this is due to hormonal changes that occur in the baby’s body.

Important! Also, this type of skin disease can manifest itself during adolescence.

1. Blockage of the ducts of the sebaceous glands.
2. Changes in the child's hormonal levels.
3. Excessive amounts of estrogen (female hormones) entering the body.

Symptoms: Acne appears as single papules, white or slightly yellowish.

Over time, they can turn into blackheads. Acne usually goes away quickly, within 14 days, after it subsides there are no scars or spots left on the skin.

But the situation can be complicated by acne infection. Signs of infection are swelling of the skin where acne is present and redness. In this case, you need to consult a doctor.

Boils

Boils in children are a skin disease caused by staphylococci. The presence of boils on the child’s body indicates serious disorders in the baby’s body.

The reasons for the appearance are divided into 2 types:

1. Mechanical effects (wearing clothes that are too tight and do not fit).
2. Failure to comply with hygiene rules (scratching the skin with dirty hands, rarely changing diapers, irregular bathing).

Internal:

1. Malnutrition of a child.
2. Diseases of the baby's endocrine and nervous systems.
3. Congenital or acquired immunodeficiency.

The boil has its own stage of development, which is determined by the symptoms:

1. First, a hard infiltrate appears with unclear boundaries, which gives pain.
2. Swelling forms along the periphery, around the boil, and the pain increases. After which the boil itself opens and the purulent contents and the core, which is formed from dead leukocytes and bacteria, come out of it.
3. After this, the ulcer on the skin heals, leaving behind a scar.

Important! A boil located on the head is especially dangerous; it can infect other areas of the skin.

Carbuncle

A carbuncle can also form - this is an inflammatory process of several boils united with each other.

In this case, the general condition of the child is disrupted:

1. The child's weight may decrease.
2. The temperature rises.
3. The skin turns pale.
4. Weakness.
5. Enlarged lymph nodes, near a nearby boil.

Making a timely and correct diagnosis is a direct path to success in treating your child’s skin disease, remember this!

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The neonatal period is the most critical age stage of life in which adaptation processes are barely visible. The duration of the neonatal period varies individually, but on average it is 28 days. The condition of the child immediately after birth is determined by its genetic code, the conditions in which pregnancy and childbirth took place, the sanitary and hygienic regime of the environment, 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 to these influences in various manifestations.

It is known that some skin diseases, especially birth defects, deformations, nevi and others, can begin in the first weeks of life and remain throughout childhood or throughout life. There is a group of skin diseases that appear and disappear only during the neonatal period. These are 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 epithelializes, granulates, and a scar forms by the end of the 2nd - beginning of the 3rd week of life. If the umbilical wound becomes infected with staphylococcus, streptococcus, intestinal, pseudomonas, diphtheria, tetanus bacilli, the fall of the umbilical cord remnant 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 5-10 days of life and is manifested by the child’s restlessness, difficulty sucking due to spasms of the facial muscles, cyanosis, muscle rigidity, and general tonic convulsions. At the same time, the umbilical wound is not externally changed. For treatment, antitetanus serum is used at the rate of 3000-10000 units per 1 kg of body weight (administered once according to Bezredka), seduxen - for convulsions
Weeping navel (catarrhal omphalitis). With prolonged healing as a result of infection of the umbilical wound, it becomes weeping, followed by the formation of crusts. After their rejection, wounds with a bleeding surface are exposed. The child's general condition is not affected, his appetite is good, and his temperature remains normal. With a decrease in the general resistance of the child’s body, increased virulence of the microbial flora and in the absence of rational therapy, the process can develop into a more extensive and severe lesion and even lead to sepsis. When the skin and subcutaneous fatty tissue around the navel are affected, omphalitis. The umbilical region protrudes significantly, it is hyperemic, edematous, and infiltrated. Thin blue stripes (dilated veins) extend radially from the umbilical wound. Often, red stripes are visible next to the blue stripes, due to the addition of lymphangitis. The general condition of the child is disturbed, he sucks poorly, spits up, and becomes restless. Breathing is shallow and rapid. The legs are brought to the stomach, the temperature rises to 37.2 - 37.5 o 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 and 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 over the surface and in depth. Destruction of the abdominal wall and gangrene of intestinal loops may occur. The prognosis for the child's life is unfavorable.
Treatment. In case of a weeping navel (catarrhal omphalitis), the umbilical wound is thoroughly washed daily with a 3% solution of hydrogen peroxide, dried and irradiated with ultraviolet rays, after which the wound is treated with a 1% - 2% solution of brilliant green or a 5% solution of potassium permanganate, or a 2% - 5% solution silver nitrate. When granulations develop, they are cauterized with lapis. If the inflammatory process spreads to the surrounding tissues and in depth, the temperature rises, along with local treatment, general treatment is carried out. Injections of antibiotics are prescribed (oxacillin, ampiox, tseporin, methicillin, etc.), 2 - 3 injections of antistaphylococcal immunoglobulin.
Prevention 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, and a 1% alcohol solution of aniline dyes.

Limited congenital defects of the skin and subcutaneous tissue.
Etiology and pathogenesis unknown. The disease can be inherited in an autosomal dominant manner, or be the result of a viral infection suffered by the mother during pregnancy, intoxication as a result of radiation therapy, as well as a failed abortion attempt and under the influence of other factors.
Clinic. Defects of the skin or subcutaneous tissue are detected immediately after the birth of a child, most often in the form of oval or round ulcers, sometimes oblong, ranging in size from 0.2 - 0.5 cm to 4 - 5 cm in diameter. In the following days, crusts appear on their surface. Localization varies, most often on the scalp, but can be on the torso and limbs. Defects can be either single or multiple. Ulcerative lesions, despite treatment, heal slowly within 4 weeks to 2-3 months. They may bleed, a secondary infection may occur, and they leave behind hypertrophic or atrophic scars. At first they are pink in color, and then take on the color of the surrounding healthy skin. The cosmetic defect depends on the location. Hair does not grow in places where defects have healed on the head. Congenital skin defects can be combined with other developmental disorders: cleft of the hard palate and upper lip, syndactyly, lack of individual fingers, hydrocephalus, congenital heart defects. Differential diagnosis carried out with congenital syphilis, epidermolysis bullosa, thermal and mechanical damage to the skin caused by medical personnel during childbirth or shortly after the birth of the child.

Treatment. First of all, defects must be protected from infection. For multiple and widespread defects, antibiotics are administered for several days. Externally, the lesions are lubricated with a 1% aqueous solution of aniline dyes, and bandages with Vishnevsky ointment are applied.

Subcutaneous adiponecrosis. Subcutaneous adiponecrosis usually occurs at 1-2 weeks of life in well-nourished children during difficult labor as a result of tissue compression. The lesions are localized on the shoulders, back, limbs, and sometimes on the head, especially in children removed with medical forceps. Characteristic is the appearance of sharply demarcated dense infiltrates or nodes the size of a pea to a child's palm. Apparently, normal skin always remains between the affected areas, and above the infiltrates it is cyanotic, sometimes violet-red, and later becomes pale. Very rarely, softening with fluctuation may occur in the center of the infiltrates, from where a small amount of white crumbly mass is released. The general condition is not disturbed. The course of the disease is benign with a favorable prognosis. Slowly, over 3 to 4 months, infiltrates usually spontaneously resolve without leaving traces; in some patients, scars sometimes remain. Very rarely, secondary pyococcal infection or calcification may occur. Differential diagnosis carried out with abscesses of subcutaneous fat in septic conditions. In this case, purulent foci form during the period of sepsis with the presence of deep inflammatory infiltrates. There is no typical localization and traumatic situation during difficult childbirth.

Treatment. To quickly resolve infiltrates, thermal procedures such as sollux, dry dressings, UHF, phonophoresis, and magnetic therapy are used.

Scleredema is a peculiar form of skin edema, accompanied by significant tissue compaction. The disease appears on 2 - 4

day of life, usually in premature and weak children, but can also occur in full-term, strong normal children. Etiology and pathogenesis are not clear. Prolonged and sudden cooling of the child is important. The appearance of scleredema can be promoted by infectious diseases, malnutrition, pulmonary atelectasis, and congenital heart defects. The prognosis is serious and depends on the intensity of the treatment.

Clinic. The lesion begins from the legs or thighs in the form of a doughy thickening of the skin and subcutaneous tissue, then quickly spreads to the feet, genitals and torso, and can cover the entire body. When pressed, a hole remains. The general condition is serious, the child is lethargic, does not cry, hypothermia and bradycardia are noted. Differential diagnosis carried out with sclerema and adiponecrosis.

Treatment. The child is placed in an incubator and gradually and carefully warmed up with warm baths, Sollux, and heating pads. Blood transfusions of 25 - 30 ml every other day, gamma globulin, Aevit into the muscle, antibiotics, prednisolone 1-2 mg per 1 kg of body weight are effective. For prevention you need to protect the child from hypothermia, and if it occurs, then Aevit is administered intramuscularly 0.1 ml 2 times a day for 5 - 7 days and warm the child.

Sclerema of newborns- a very serious illness. It develops exclusively in children with malnutrition, weak, premature or septic conditions in the first days or weeks of life. Usually on the 3rd - 4th day of life, diffuse thickening of the skin and subcutaneous tissue appears symmetrically in the area of ​​the calf muscles, buttocks, thighs, shoulder blades, and face. When pressed, no indentations remain. The skin in the affected areas is pale with a bluish tint, dry, tense. On palpation, the lesions are cold, the skin does not fold, and the face is mask-like. The joints of the lower jaw are immobile, and the mobility of the limbs is limited. Unlike scleredema, the soles, palms, scrotum and penis are not affected. The disease often ends in death. Treatment is carried out in the same way as for scleredema.

Diaper rash- these are limited inflammatory changes in the skin in areas that are easily subject to friction and maceration, complicated by secondary infection. They occur due to poor child care, infrequent washing, excessive wrapping, maceration of the skin with urine and feces, washing clothes with synthetic washing powders, and rough diapers and oilcloths. Lesions are localized in the inguinal, femoral, axillary folds, and behind the ears. There are three degrees of diaper rash based on intensity. First degree- mild, characterized by only moderate redness of the skin; second degree- moderate severity, with pronounced hyperemia and erosions; third degree- severe, manifested by bright redness, with pronounced weeping and individual erosions and ulcers.

Treatment. It is necessary first of all to eliminate defects in child care. For first degree diaper rash It is enough to dust the affected areas with a powder of talc with dermatol (3% - 5%), zinc oxide, white clay, as well as lubricating with sterile vegetable oil. In the second degree an indifferent shaken mixture (water or oil) is used, as well as lubricating the lesions with a 1%-3% solution of silver nitrate, followed by dusting with talc or zinc oxide. For diaper rash of the third degree Cool lotions with Boer fluid or lead water, 0.5% resorcinol, 0.25% lapis should be prescribed for 2 to 3 days. Then it is advisable to lubricate with a 1% - 2% solution of aniline dyes. After this, the affected skin is lubricated with zinc or Lassar paste.
Prevention is important in preventing diaper rash. Mothers need to be explained the need for careful and proper hygienic care for their newborn and infant, correct from the very beginning of feeding the child, which prevents the occurrence of dyspeptic stools that cause skin irritation.

Diaper dermatitis can be classified as contact dermatitis, develops in the first days of life and is associated with friction of the skin on diapers, with exposure of the skin to decomposition products of urine, feces, ammonia, and detergents remaining in diapers after washing. Lesions in the form of redness and swelling, papular, vesicular, pustular elements are localized on the inner surfaces of the thighs, buttocks, anogenital area, and lower extremities.
Prevention- proper hygienic maintenance of the child’s skin, the use of cotton or linen diapers, diapers, washing diapers not with washing powders, but with soap, followed by repeated rinsing.

Treatment. Treatment of lesions with a solution of potassium permanganate, powders, creams.

Prickly heat often observed in infants, especially obese ones. The disease is promoted by overheating of the child, which happens either when the child is excessively wrapped in a warm room, or when the body temperature increases during infectious diseases, when sweating increases. Miliaria is distinguished crystalline, when many transparent bubbles the size of millet grains appear, scattered; heat rash red- with an abundance of red nodules with bubbles at the top and a red halo around; white prickly heat - when blisters turn into pustules. With improper care, such heat rash can develop into vesiculopustulosis.

Treatment consists of wiping the skin with 1% boric or salicylic alcohol, calendula solution, and using boric acid powder.
Prevention consists of proper hygienic care of the child.

Seborrheic dermatitis may appear at the end of 1-2 weeks of life, and sometimes by the end of the 1st month, rarely up to 3 months of life. Highlight light, medium, heavy forms of the disease . In a mild form, the lesion usually begins with the buttocks, and within a few days spreads to the natural folds (inguinal, femoral, less often - axillary, cervical, behind-the-ear). The skin in the lesions is hyperemic and moderately infiltrated. Along the periphery of the lesions, a scattered rash in the form of small spots and papules with pityriasis-like peeling is noted. The general condition of the child is not impaired. Regurgitation and unstable stools are rare. In the moderate form, all natural folds of the skin are clearly hyperemic, infiltrated, their maceration is visible, and peeling along the periphery. Hyperemia and peeling quickly spread to the skin of the trunk and limbs. In many children, the scalp is also affected, where scales and crusts accumulate. The general condition is disturbed: children sleep poorly, are restless, catarrhal otitis, dyspeptic disorders, poor appetite are often observed, hypochromic anemia develops. A severe form of seborrheic dermatitis is characterized by damage to 2/3 of the skin, it is hyperemic, infiltrated with pityriasis-like peeling on the surface, on the scalp massive crusts appear. Clinical manifestations resemble desquamative erythroderma. Children with severe seborrheic dermatitis are subject to hospitalization.

Treatment. In severe and moderate forms, complex therapy with antibiotics is carried out for 7 - 10 days (penicillin, semi-synthetic penicillins), infusion plasma, albumin, glucose with ascorbic acid, gamma globulin, enzyme therapy (hydrochloric acid with pepsin, gastric juice) is prescribed. In mild forms of seborrheic dermatitis, sometimes it is enough to lubricate the lesions with a 1% -2% aqueous or alcohol solution of aniline dyes, 2% -3% naphthalan paste, 0.5% prednisolone cream. Vitamins are prescribed internally. When the general condition improves and skin manifestations resolve, all patients with seborrheic dermatitis are given a course of ultraviolet irradiation up to 15 sessions

Desquamative erythroderma of newborns Leiner - Moussou. In the development of the disease, disturbances in protein and carbohydrate, fat and mineral metabolism in sick children, lack of nutritional vitamins A, E, B1, B2, B12, C, folic acid, and dysfunction of the gastrointestinal tract are of great importance in the development of the disease. small intestine, sensitization of the body by pyococcal and yeast flora. Clinic. The disease most often begins in the first month of life, less often older, but no later than 3 months. First, the skin of the buttocks and inguinal folds is affected, then the process spreads over the entire surface of the skin, as a result of which the entire skin is brightly hyperemic, infiltrated and profusely peels off. On the scalp, a kind of shell is formed from an accumulation of fatty scales, descending onto the forehead and eyelids. The face becomes mask-like. Weeping and deep cracks are noted in the folds. The general condition is severe, accompanied by dyspeptic disorders, anemia, there may be abscesses, phlegmon, blepharitis, conjunctivitis. Such children vomit up to 7-10 times a day, loose stools. Forecast adverse.

Treatment consists of immediate hospitalization. To prevent infection, antibiotics, gamma globulin, albumin, plasma transfusions, drips with glucose and Ringer's solution are prescribed. In severe conditions, glucocorticoids are indicated at a rate of 0.5 - 1 mg per 1 kg of body weight. Locally disinfectants (aniline dyes), ichthyol, ointments with glucocorticoids and antibiotics are prescribed