Dermatitis exfoliative in adults and newborns (photo)

Dermatitis exfoliative (Ritter dermatitis) is the result of vital activity on the skin surface of Staphylococcus aureus. This disease is characterized by a severe course and manifestations of organism intoxication. More about this pathology will be described later in the article.

How does infection with exfoliative dermatitis occur?

Most often, newborns suffer from Ritter's dermatitis. This is due to the imperfection of the immune system in newly born babies and the peculiarities of the structure of their skin. Especially prone to this pathology are premature babies or those born with small weight.

Exfoliative dermatitis in newborns may appear on the second day after birth or after one or two weeks. By the way, the earlier this disease develops, the harder it is.

Infection with pathogenic microorganisms comes from the mother or the maternity hospital and is accompanied by the defeat and rejection of the epidermis.

Stages of dermatitis

The first symptoms of dermatitis (erythematous stage) are redness and exfoliation of the skin around the mouth, navel and in natural folds (around the anus, genitals and on the neck). The pathological process very quickly, within 6-12 hours, spreads to the whole body of the baby. It becomes hyperemic, edematic, on the skin there are bubbles filled with a clear liquid. Often the mucous membrane of the mouth and genitals of the baby are affected.

In the second stage, which occurs on the second or third day after the onset of the disease, exfoliative dermatitis is manifested by the opening of blisters, on the site of which erupt erosion occurs. And around them, on seemingly unaffected areas, the skin is easily peeled off (so-called Nikolsky syndrome). By the way, all this looks like a strong burn.

In this case, the baby's temperature can rise to 40 ° C, he suffers from indigestion and dehydration, as he sucks badly on the chest. The child can not sleep, rapidly losing weight and without proper treatment can be fatal.

The third stage of the disease is regenerative. As its name implies, the child gradually recovers: erosions heal, hyperemia and swelling go away, and the general condition of the baby normalizes.

Features of the course of dermatitis

Exfoliative dermatitis of newborns is dangerous not only in itself. This disease, which, in the absence of adequate treatment and care for a sick baby, can lead to the development of purulent foci of infection at the site of erosion, which, in turn, will provoke weighting of the course of the disease. And otitis, pneumonia, meningitis or peritonitis can be complications of this pathology.

In medicine, there are three degrees of severity of the pathology described.

1. A mild degree has blurred clinical signs and poorly distinguishable stages of the disease. Recovery is already on day 10 from the onset of the disease.
2. In the moderate stage, the stages of the disease are clearly distinguishable, the symptomatology is pronounced, but there are no complications, and the baby is safely recovering.
3. Severe course involves joining secondary infection and purulent inflammatory diseases of other organs. Sometimes the infection gets into the blood and the disease is complicated by sepsis. Fortunately, with timely and proper treatment, this is extremely rare.

What causes exfoliative dermatitis in adults

In adults, the described pathology is much less common than in children (1-2% of people older than 50 years) and develops against the already existing severe diseases, greatly reducing immunity. These include diabetes, malignant tumors and various forms of heart disease. True, it should be clarified that in 30% of cases, doctors have not been able to establish the cause of erythroderma (this is also called this disease). And the ratio of the occurrence of the pathological process in men and women is 5: 1.

Not the last role in the risk of getting dermatitis exfoliative is played by both weighed heredity and congenital diseases. In some cases, erythrodermia may be a toxic reaction to the taking of certain medications, or a consequence of the already existing psoriasis or drug allergy.

How exfoliative dermatitis occurs in adults

In adults, the features of the course of the disease largely depend on the physiological factors and overall health of the patient. In most cases, the pathology is manifested by reddening and peeling of the skin. And, which is characteristic, it can slip off from the slightest touch even on seemingly healthy areas.

The patient experiences severe itching, on the surface of the skin bubbles form and, after their opening, erosion. Lymph nodes increase, and the temperature rises. Patients often complain of a feeling of chills and cold.

Dermatitis exfoliative Proceeds, as already mentioned, with different intensities. With its rapid development, the patient develops thick crusts on the body that crack, causing painful sensations.

Diagnosis of the disease

It is not difficult to diagnose exfoliative dermatitis of Ritter, as its symptoms are usually expressed. And the positive syndrome of Nikolsky (easy separation of the upper layer of the epidermis around erosions) gives one more possibility of an accurate definition of the disease.

Laboratory tests allow to exclude the presence of burns and determine the pathogen, for which the contents of the blisters are taken for seeding. Differential diagnostics is also carried out, comparing the course of the disease with pemphigus, bullous epidermolysis, phlegmon, ichthyosis and contact dermatitis.

Principles of treatment of exfoliative dermatitis

If there is a suspicion of exfoliative dermatitis (photos of the symptoms of which you can see in the article), the mother and the sick child are provided with a separate ward (box). Treatment is an injection of antibiotics and plasma containing antistaphylococcal gamma globulin.

To avoid dehydration, the infusion (drip) gemodez and polyglucinum is administered to the baby. And at the end of the course of antibiotic use, probiotics (bifidumbacteria) are prescribed.

The skin of the baby is treated with a weak solution of salicylic alcohol or furacilin, and the bubbles are opened and zinc oil and antibacterial ointments applied . Dermatitis exfoliative also involves daily bathing with the addition of a weak solution of manganese in water . The newborn is not dressed in order not to cause pain, and the ironed clean diapers are sprinkled with medical talc or zinc oxide on top. It is also recommended that you shift the baby as little as possible to avoid separation and sloughing of the skin.

In severe cases, the crumb is placed in a kuvez (incubator), where a certain temperature and humidity are maintained.

How to avoid disease

Exfoliative dermatitis, a photo of which in children and adults you can see in the article, is prevented only by strict adherence to the mother of the newborn basic hygiene rules in the postpartum department and wearing a gauze dressing.

From the maternity hospital staff requires regular quartz movement of the newborn's ward, cleaning and changing of bed linen, as well as regular check for the presence of Staphylococcus aureus.

In adults, this disease is prevented by avoiding allergens that can cause dermatitis, timely treatment of any kind of inflammation or irritation on the skin, compliance with diet and maintaining immunity in good condition.