Pemphigus of newborns- a very serious and dangerous bacterial skin disease of newborns. The disease belongs to highly contagious (infectious) diseases, can cause serious complications and even death, therefore, requires immediate treatment and preventive measures.

Causes of pemphigus in newborns

The causative agent of pemphigus in newborns is Staphylococcus aureus. The source of the disease can be any person from the environment of the baby (as medical staff from the hospital, and the relatives themselves), who have purulent skin diseases (pyoderma). If there is an outbreak of infection in the maternity hospital, the disease is quickly transmitted from one child to another. Also, pemphigus can occur a second time, as a complication, if the child already has purulent diseases(for example, as a complication of omphalitis).

Risk factors contributing to the development of pemphigus in newborns

• Preeclampsia in pregnant women (while the immunity of the child in the womb is formed worse);
• Birth trauma (such children have more weak immunity);
• Prematurity of the baby (the skin of premature babies is even more susceptible to external influences and does not have all protective properties, immunity is reduced);
• Insufficient or not proper care behind the skin of the child (lack of daily toilet of the newborn);
• The presence of diseases of the umbilical wound in a child - omphalitis

Symptoms (clinical picture) of pemphigus in newborns

Pemphigus of newborns usually occurs at the end of the first - the beginning of the second week of a child's life.

Large blisters appear on the skin of the child, often up to 1 cm in size, but sometimes more, up to 2 cm. When they are opened, erosions form that itch and disturb the child. Then the erosions dry up into crusts.

The general condition of the baby is severely disturbed: the disease is accompanied by a strong fever, the child is lethargic, there is no appetite, as a result of which weight loss subsequently occurs.

Rashes may appear jerky, flashes. The disease is characterized by attacks of recurrent rashes. In total, uncomplicated neonatal pemphigus with appropriate care and treatment lasts from 2-3 to 5 weeks. At the same time, there are no traces of bubbles on the skin of the child.

Complications of pemphigus in newborns

Pemphigus of newborns is dangerous for its possible complications and even possible death in the progressive course of the disease. Complications usually occur in debilitated, premature babies, with no treatment and continued improper care of the child's skin. With pemphigus, the most common complications are:

• Abscesses
• Phlegmon
• Sepsis
• Fatal outcome(in our era of antibiotics - a rare but common outcome of the disease). Death occurs from complications (often from sepsis) in extremely debilitated children or in the absence of treatment.

Treatment of pemphigus in newborns

Treatment of pemphigus in newborns is carried out in a hospital, the child is isolated to avoid the spread of infection. Treatment is carried out by a pediatrician and a surgeon jointly.

Etiological treatment (directed against the pathogen) - be sure to prescribe antibiotics - to destroy the pathogen.

Bubbles on the skin of a child are opened under the supervision of a surgeon and treated with a solution of potassium permanganate or aniline dyes. In especially severe cases, hormone-containing ointments are used, namely, corticosteroid ointments.

Also appointed symptomatic treatment- to alleviate the symptoms of the disease and improve the well-being of the child. Prescribe antipyretics (if high temperature) and antihistamines(to relieve itching in a baby).

If necessary, a blood or plasma transfusion may be prescribed.

Prevention of pemphigus in newborns

Prevention of pemphigus in newborns includes 2 stages:

1. Prevention of pemphigus in a child. For this you need:

• Do not allow people with pyoderma to care for children ( pustular diseases on the skin);
• Frequent change of linen;
• Wet cleaning of the premises, regular airing and quartzing of the chambers, wet cleaning and airing of the house;
• Perform daily toileting of newborns - to ensure proper care of the baby's skin;
• Special attention focus on children at risk of developing pemphigus (premature, after birth trauma and born from pregnancies with preeclampsia, with weakened immune systems, etc.) - apply measures to strengthen immune system these children ( breast-feeding or an adapted mixture, proper care of the umbilical wound and skin, with close contact it is better to use disposable masks, especially when relatives come).

2. Prevention of the spread of infection to other children - if pemphigus occurs in a newborn in the maternity hospital, he is immediately isolated and an unscheduled disinfection of the room and linen is carried out.

Epidemic pemphigus of newborns (features)

Diagnostics

Diagnosis is usually based on external manifestations pathologies that are noticeable already in the first days of a baby’s life. To detect the pathogen, bacteriological culture of erosion discharged from the surfaces is usually carried out. It is also necessary to exclude syphilitic pemphigus (it is considered a manifestation of congenital syphilis). As diagnostics appoint:

• microscopy of the contents of the blisters (with its help determine the presence of pale treponema);
• diagnostics;
• RPR test.

In addition, differential diagnosis with such pathologies may be needed:

• epidermolysis (congenital form);
• different forms;

Diagnosis of epidemic pemphigus of newborns is given in the video below:

Treatment

In the fight against pemphigus in newborns, prescribe drug method treatment.

Therapeutic way

To treat the dermis located around the vesicles, the doctor may prescribe:

• salicylic alcohol;
• boric alcohol.

They can also perform piercing of bubbles, their quenching with a solution of aniline dyes. You can apply synthomycin emulsion, ointments, aerosols, in which antibiotics are present (“Neomycin”, “”, “”), on slightly dried erosions.

• Baths with a solution of potassium permanganate, which are carried out daily, are considered very effective.
• They also perform UVR (general, local).

In a medical way

Most often, penicillins resistant to penicillinase are used as the main drug:

• "Oxacillin".

Cephalosporins are also used:

• "Cephaloridin".

The specialist may prescribe the introduction:

• "Ascorbic acid".
• "Retinol".
• vitamins B.
• albumin (5%).

Disease prevention

The disease is spread by contact. Her causative agent is on linen, hands of medical staff, care items. To prevent infection healthy children the following preventive measures must be taken:

• isolation of a sick child;
• sterilization of linen;
• taking smears from medical personnel;
• use of gloves when examining children;
• room disinfection;
• detection of staphylococcus, carriage of infection in medical personnel, mother.
• AT difficult situations occurs (blood poisoning). When the infection spreads throughout the body, all organs can become inflamed. Thus, pneumonia may occur.

Complications

• The disease is curable with a benign course, especially if rational therapy is carried out.
• In severe situations, sepsis (blood poisoning) occurs. When the infection spreads throughout the body, all organs can become inflamed. Thus, meningitis, pneumonia can occur.
• A secondary infection may join.

Forecast

The forecast is made taking into account general condition baby.

• If the pathology proceeds in a benign form, a favorable prognosis is made for the baby.
• A serious prognosis can be for those babies who have a malignant form.

The clinical manifestations of epidemic pemphigus of the newborn are covered in this video:

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Pyococcal pemphigoid is the medical term for epidemic pemphigus in newborns. This disease is very acute, develops rapidly and belongs to the type superficial staphyloderma with a high degree of contagiousness. In newborns, pemphigus develops on the third or fifth day of life. The umbilical wound usually serves as a gateway for staphylococcus bacteria to enter the body. Development begins, and then a generalized infection develops rapidly.

Causes of the development of pemphigus

The cause of pemphigus in newborns is, but both streptococcus and a filterable virus can be the causative agent. Both epidemic and viral pemphigus in children require immediate treatment and isolation of the sick baby.

The risk group includes newborns with unusual skin reactivity. This situation occurs when birth trauma, prematurity, toxicosis during pregnancy. Bacteria easily overcome the skin barrier, and the skin reacts to infection by the formation of typical blisters.

Regarding the sources of infection, most often they include medical staff in maternity hospitals and women in labor who suffer from pyoderma. Treatment of epidemic pemphigus of the newborn should begin without delay, because high contagiousness can provoke an epidemic outbreak in the hospital. And if it has already happened, then medical institution must be closed for disinfection.

Symptoms of pemphigus

This disease is characterized by the appearance of blisters on the skin of babies. different shapes and sizes. In most cases, they are rounded, and the diameter ranges from 0.5-1.5 centimeters. The blisters have a sluggish thin lid, and the corolla is hyperemic along the periphery. In children, the symptoms of pemphigus are manifested by general intoxication: the temperature rises to 38 degrees, skin turn pale. In addition, babies become whiny, irritated, refuse to breastfeed, vilify, and vomit. Bubbles appear mainly in the folds of the skin, on the scalp, but on the feet and palms they should be absent. If blisters appear in these places, then there is a suspicion that the newborn has syphilitic pemphigus, which requires a completely different treatment.

If pemphigus leaks into mild form the treatment will take two to four weeks. In the presence of complications in the form of pneumonia, otitis media, septic conditions, the recovery time is significantly increased.

Treatment of the disease

The most important thing to do when a child has pemphigus is to isolate him. Treatment of this contagious disease without the use of antibiotics a wide range action is not possible. Penicillin is not suitable for this purpose, since nosocomial staphylococcus is resistant to it. In most cases, cefazolin, ceporin, kefzol, ceftriaxone are prescribed. Children also prescribe injections of albumin, polyglucin or antistaphylococcal y-globulin. Simultaneously with antibiotics, bifidumbacterin, lactobacterin should be taken, which protect the intestines from fungi and are a means of preventing dysbacteriosis. In addition, vitamins of groups B, C and A will not interfere. The affected areas of the skin are treated daily with a solution of aniline dyes. If the doctor deems it necessary, UVR will be applied locally.

In order to prevent all women in labor and the medical staff of maternity hospitals, they are checked for the presence of pyodermatitis by examining materials from the nose and throat. In institutions, regular wet cleaning, quartzing and frequent change underwear.

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