Exfoliative dermatitis (Ritter's dermatitis) is the result of vital activity on the surface of the skin of Staphylococcus aureus. This disease is characterized by a severe course and manifestations of intoxication of the body. More about this pathology will be discussed later in the article.
How does exfoliative dermatitis get infected
Most often newborns suffer from Ritter's dermatitis. This is due to the imperfection of the immune system in newly born babies and the structural features of their skin. Premature babies or those born with low birth weight are especially susceptible to this pathology.
Exfoliative dermatitis in newborns can appear as early as the second day after birth or one to two weeks later. By the way, the earlier this disease develops, the more severe it is.
Infection with pathogens comes from the mother or hospital staff and is accompanied by damage and rejection of the epidermis.
Stages of dermatitis
First symptomsdermatitis (erythematous stage) is redness and exfoliation of the skin around the mouth, navel and in natural folds (around the anus, genitals and neck). The pathological process very quickly, within 6-12 hours, spreads to the entire body of the baby. It becomes hyperemic, edematous, blisters appear on the skin, filled with a clear liquid. The mucous membrane of the mouth and genital organs of the baby is often affected.
At the second stage, occurring on the second or third day from the onset of the disease, exfoliative dermatitis is manifested by the opening of blisters, in place of which weeping erosions occur. And around them, in seemingly unaffected areas, the skin easily peels off (the so-called Nikolsky syndrome). By the way, it all looks like a severe burn.
At the same time, the baby's temperature can rise to 40 ° C, he suffers from indigestion and dehydration, as he sucks poorly at the breast. The child cannot sleep, rapidly loses 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 returns to normal.
Features of the course of dermatitis
Exfoliative dermatitis of newborns is dangerous not only in itself. This is a disease that, 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 a worsening of the courseillness. And complications of this pathology can be otitis media, pneumonia, meningitis or peritonitis.
In medicine, there are three degrees of severity of the described pathology.
- Mild degree has blurred clinical signs and poorly distinguishable stages of the disease. Recovery occurs already on the 10th day from the onset of the disease.
- In the moderate degree, the stages of the disease are clearly distinguishable, the symptoms are pronounced, but there are no complications, and the baby is recovering safely.
- Severe course implies the addition of a secondary infection and purulent inflammatory diseases of other organs. Sometimes the infection enters 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 over 50 years old) and develops against the background of already existing serious diseases that greatly reduce immunity. These include diabetes mellitus, malignant tumors and various forms of heart disease. True, it should be clarified that in 30% of cases, doctors fail to establish the cause of erythroderma (this is also called this disease). Moreover, 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 exfoliative dermatitis is played by aggravated heredity and congenital diseases. In some caseserythroderma may be a toxic reaction to certain medications or the result of pre-existing psoriasis or drug allergies.
How adult exfoliative dermatitis progresses
In adults, the course of the disease largely depends on physiological factors and the general he alth of the patient. In most cases, the pathology is manifested by redness and peeling of the skin. And, characteristically, it can flake off at the slightest touch, even in seemingly he althy areas.
The patient experiences severe itching, blisters form on the surface of the skin and, after opening them, erosion. Lymph nodes increase, and the temperature rises. Patients often complain of feeling chilly, cold.
Exfoliative dermatitis proceeds, as already mentioned, with different intensity. With its rapid development, thick crusts form on the patient's body, which crack, causing pain.
Diagnosis of disease
Ritter's exfoliative dermatitis is not difficult to diagnose, as its symptoms are usually pronounced. And the positive Nikolsky syndrome (slight separation of the upper layer of the epidermis around erosions) provides another opportunity to accurately determine the disease.
Laboratory studies make it possible to exclude the presence of burns and determine the pathogen, for which the contents of the blisters are taken for sowing. Differential diagnostics is also carried out, comparing the course of the disease with pemphigus, epidermolysis bullosa,cellulitis, ichthyosis and contact dermatitis.
Principles of treatment of exfoliative dermatitis
If exfoliative dermatitis is suspected (a photo of the symptoms of which you can see in the article), a separate room (box) is provided for the mother and the sick child. Treatment consists of injections of antibiotics and plasma containing anti-staphylococcal gamma globulin.
To avoid dehydration, the baby is given infusion (drip) hemodez and polyglucin. And at the end of the course of antibiotics, probiotics (bifidumbacteria) are prescribed.
The baby's skin is treated with a weak solution of salicylic alcohol or furacilin, and the blisters are opened and zinc oil and antibacterial ointments are applied. Exfoliative dermatitis also involves daily bathing with the addition of a weak solution of potassium permanganate to the water. At the same time, the newborn is not dressed so as not to cause pain, and ironed clean diapers are sprinkled on top with medical talc or zinc oxide. It is also recommended to shift the baby as little as possible to avoid separation and desquamation of the skin.
In severe cases, the crumbs are placed in an incubator (incubator), where a certain temperature and humidity are maintained.
How to avoid getting sick
Exfoliative dermatitis, a photo of the manifestations of which in children and adults you can see in the article, is prevented only by the strict observance by the mother of the newborn of the basic hygiene rules in the postpartum department and the wearing of a gauze bandage.
Frommaternity hospital staff are required to regularly quartz the neonatal ward, clean and change bed linen, and regularly check for the presence of Staphylococcus aureus.
In adults, this disease is prevented by avoiding allergens that can cause dermatitis, timely treatment of any type of inflammation or irritation on the skin, following a diet and maintaining immunity in good condition.
