Infant Eczema - Prevention, Causes, Symptoms, Treatment
Life Keep Up
1. Internal factors
For example, the body's immune function is unbalanced, or immunodeficiency, endocrine diseases, nutritional disorders, chronic infections, tumors, and other systemic diseases may also become the internal inducement of eczema; genetic or acquired skin barrier dysfunction.
2. External factors
Ingestion of food allergens in the digestive tract, such as milk, fish, shrimp, beef and mutton, eggs, other allergenic factors, or allergens in the environment, can cause type I allergies in the body. Mechanical friction, such as frequent irritation of saliva and galactorrhea, is also the cause of this disease. Improper care, such as excessive use of strong alkaline soap, extreme nutrition, and abnormal digestion in the intestines, can also cause this disease. Certain external factors, such as sunlight, ultraviolet rays , cold, damp heat, and other physical characteristics, contact with silk or human-made fibers, topical drugs, and bacterial skin infections, can cause eczema to aggravate its condition.
Clinical manifestations
The onset is mostly 1 to 3 months after birth and gradually relieves after six months. Most of the children heal on their own after one year and a half. Some children extend to infant or childhood. Varying severity, rash common in the head, face portion, and gradually spread to the neck, shoulders, torso, limbs. The skin lesions are pleomorphic, with erythema or red papules initially, and can gradually increase as the disease progresses. The condition may appear papules, small blisters, erosions, and scabs, which sometimes get better and worse with repeated attacks. There is a peculiar itching. The child cries at night, restless. Scratching may cause secondary infections, causing local lymph nodes to swell, and a minimal number of children may develop systemic diseases.
1 . Clinical staging
(1) Acute onset. In the process of acute stage, the skin manifests as a large number of new clusters of small red papules and erythema, basal edema, and quickly becomes bumps and small blisters. After rupture, the blisters erode with clear yellow exudate or yellow-white serous Sexual crusting, varying in thickness, with scattered small papules on the periphery. Facial skin may be flushed and swollen. The underarms, groin, and other parts are often combined with abrasions. Ulceration may be secondary to infection. The child has noticeable itching and irritability.
(2) The subacute phase evolved from acute eczema due to improper treatment. Exudation, redness, and swelling, scabs gradually reduced, skin lesions are mainly small blemishes, may have white scales, and little papules and erosions remain. Slightly less itchy
(3) The chronic phase evolves from the acute and subacute phases, or it may be the chronic phase from the beginning. Recurrent attacks, more common in infants and young children over 1-year-old. The main clinical manifestations are rough skin, hypertrophy, papules, scaly, and pigmentation. Under specific incentives, it may have an acute attack and prominent itching mostly distributed in the extremities.
2. Clinical classification
(1) Seborrheic type is more common in infants aged 1 to 3 months. The skin of the child's forehead, cheeks, and eyebrows is flushed, covered with greasy yellow scales, and there may be thick yellow liquid scabs on the top of the head. There may be rubbing, flushing, and exudation under the chin, nape of the neck, axilla, and groin in severe cases.
(2) The exudative type is more common in infants 3 to 6 months old, especially obese infants. Symmetrical red papules of millet grain size were seen on both the child's cheeks: small blisters and erythema, edema at the bottom, flaky erosion, and yellow serous exudation.
(3) Dry-type is more common in infants from 6 months to 1 year old. The skin lesions are manifested as papules, redness, swelling, hard chaff-like scales, and scabs, which are standard on the face, trunk, and extremities.
diagnosis
According to the age of new-onset and the rash's appearance, the beginning usually starts after the full month, and it usually occurs on the head and face, but the trunk can also be affected. Polymorphic rash in the acute stage, prone to exudate , severe itching, recurrent attacks, chronic infiltration, hypertrophy, and other characteristics, is not difficult to diagnose. Laboratory tests generally have no specific findings, and eosinophils in the blood reserve may increase.
Differential diagnosis
1. Erythema
Rubbing erythema is more common in the back of the ears, groin, perianal, and neck. It mostly occurs in obese infants. It is more common in summer because of heat and humidity, salivation, and improper local care.
2. Contact Dermatitis. Contact dermatitis has a history of contact, and skin damage occurs at the contact site with clear boundaries. Feasible patch test identification.
3. Candida infection
Candida infections are pale red patches and small flat papules, with raised edges and transparent borders, with a small amount of scaly on the edges, and often combined with thrush. Possible fungal inspection.
4. Diaper dermatitis
Eczema that occurs in the diaper area or perianal area should be differentiated from diaper dermatitis. Diaper dermatitis is diffuse erythema, papules , papules, and scales bordered in the diaper area.
Treatment
1. Diet Management
It can find and avoid allergens. For example, children with milk protein allergy should switch to amino acid formula powder or deep protein formula powder.
2. Protect skin barrier function
For exudative and dry eczema, some non-allergic moisturizing cream should be used to moisturize the child if the surface is not ulcerated.
Local short-term topical corticosteroid cream can be applied for severe eczema, which has obvious anti-inflammatory and antipruritic effects. Please avoid long-term high-dose application to prevent side effects. If the local ulcer is infected, you need to apply antibiotic ointment locally for anti-inflammatory treatment. Use woven cotton cloth for regular air circulation on the skin
3. Local treatment
It is the primary method of treating infant eczema, and appropriate medication should be selected according to the stage of eczema. The acute phase is mainly redness and blemishes. When there is no exudation, it is recommended to use calamine lotion, calamine nitrofural lotion, glucocorticoid cream, or gel.
When there is a considerable exudation, 1% to 3% should be selected. Boric acid solution, 0.1% nitrofurazone solution cold, wet compress, zinc oxide oil can be used after wet compress and 1% chloramphenicol zinc oxide oil for external use in case of infection. It is recommended to use a 1% to 3% boric acid solution or physiological saline to wash outside, apply zinc oxide paste and glucocorticoid cream in the subacute stage.
Chronic lesions recommendations hormone ointment (e.g., 20% ~ 40% urea ointment, 5% ~ 10% salicylic acid ointment, etc.) and the glucocorticoid used interchangeably with the ointment.
4. Systemic medical treatment
( 1 ) Oral antihistamines can be taken orally under a doctor's guidance, such as chlorpheniramine.
( 2 ) Systemic application of corticosteroids, whether oral or intravenous corticosteroids, can quickly control symptoms, but it is easy to relapse after stopping the drug and cannot be cured. There are dependence and various adverse reactions after long-term application, so it should be considered appropriate for caution. For patients with generalized acute eczema whose other treatments are not sufficient, prednisone can be taken orally for a short period. The dose will be gradually reduced after the condition improves.
( 3 ) Antibiotics For children with widespread infection, fever, and increased white blood cell count, antibiotics can be treated systematically.
5. Physiotherapy. Ultraviolet radiation therapy can be used for chronic refractory eczema.
Preventive care
1. Children, in addition to a bath every day outside, should always keep proper hygiene and the skin clean and moist. Avoid using strong irritant for external use. Please pay attention when choosing wet wipes for babies. The simpler the ingredient list is, the better. When buying baby wipes, pay attention to the product ingredients on the packaging. They must not contain alcohol, fluorescent agents, bleaching powder, chemical flavors, and pigments. Any scented wet wipes will contain different amounts of chemical fragrances, directly stimulating the baby's skin.
It is recommended to choose fragrance-free wet wipes, preferably having 2020 medical-grade EDI technology of pure water, which is pure and fragrance-free, safe, and gentle. The first choice is the spunlaced nonwoven fabric for wet wipes with high viscose content, lint-free and lint-free, flexible, and thick. The second is bamboo fiber nonwoven, which has a natural material antibacterial effect, but the softness is not good enough; The blacklisted products are ordinary polyester nonwoven fabrics, which are low-cost. They are chemical fibers, which are easy to irritate the skin.
2. Try to avoid scratching and rubbing, dress loose, not too thick, wear materials like cotton clothes, and avoid contact with woolen and chemical fiber clothes.
3. Breastfeeding, mothers should not eat spicy, hot, fishy, beef and mutton, etc.; children should avoid adding shrimp, crab, fish, and other allergic foods.
The etiology is more complicated and related to various internal and external factors, and sometimes it is challenging to clarify the specific cause.
Causes:1. Internal factors
For example, the body's immune function is unbalanced, or immunodeficiency, endocrine diseases, nutritional disorders, chronic infections, tumors, and other systemic diseases may also become the internal inducement of eczema; genetic or acquired skin barrier dysfunction.
2. External factors
Ingestion of food allergens in the digestive tract, such as milk, fish, shrimp, beef and mutton, eggs, other allergenic factors, or allergens in the environment, can cause type I allergies in the body. Mechanical friction, such as frequent irritation of saliva and galactorrhea, is also the cause of this disease. Improper care, such as excessive use of strong alkaline soap, extreme nutrition, and abnormal digestion in the intestines, can also cause this disease. Certain external factors, such as sunlight, ultraviolet rays , cold, damp heat, and other physical characteristics, contact with silk or human-made fibers, topical drugs, and bacterial skin infections, can cause eczema to aggravate its condition.
Clinical manifestations
The onset is mostly 1 to 3 months after birth and gradually relieves after six months. Most of the children heal on their own after one year and a half. Some children extend to infant or childhood. Varying severity, rash common in the head, face portion, and gradually spread to the neck, shoulders, torso, limbs. The skin lesions are pleomorphic, with erythema or red papules initially, and can gradually increase as the disease progresses. The condition may appear papules, small blisters, erosions, and scabs, which sometimes get better and worse with repeated attacks. There is a peculiar itching. The child cries at night, restless. Scratching may cause secondary infections, causing local lymph nodes to swell, and a minimal number of children may develop systemic diseases.
1 . Clinical staging
(1) Acute onset. In the process of acute stage, the skin manifests as a large number of new clusters of small red papules and erythema, basal edema, and quickly becomes bumps and small blisters. After rupture, the blisters erode with clear yellow exudate or yellow-white serous Sexual crusting, varying in thickness, with scattered small papules on the periphery. Facial skin may be flushed and swollen. The underarms, groin, and other parts are often combined with abrasions. Ulceration may be secondary to infection. The child has noticeable itching and irritability.
(2) The subacute phase evolved from acute eczema due to improper treatment. Exudation, redness, and swelling, scabs gradually reduced, skin lesions are mainly small blemishes, may have white scales, and little papules and erosions remain. Slightly less itchy
(3) The chronic phase evolves from the acute and subacute phases, or it may be the chronic phase from the beginning. Recurrent attacks, more common in infants and young children over 1-year-old. The main clinical manifestations are rough skin, hypertrophy, papules, scaly, and pigmentation. Under specific incentives, it may have an acute attack and prominent itching mostly distributed in the extremities.
2. Clinical classification
(1) Seborrheic type is more common in infants aged 1 to 3 months. The skin of the child's forehead, cheeks, and eyebrows is flushed, covered with greasy yellow scales, and there may be thick yellow liquid scabs on the top of the head. There may be rubbing, flushing, and exudation under the chin, nape of the neck, axilla, and groin in severe cases.
(2) The exudative type is more common in infants 3 to 6 months old, especially obese infants. Symmetrical red papules of millet grain size were seen on both the child's cheeks: small blisters and erythema, edema at the bottom, flaky erosion, and yellow serous exudation.
(3) Dry-type is more common in infants from 6 months to 1 year old. The skin lesions are manifested as papules, redness, swelling, hard chaff-like scales, and scabs, which are standard on the face, trunk, and extremities.
diagnosis
According to the age of new-onset and the rash's appearance, the beginning usually starts after the full month, and it usually occurs on the head and face, but the trunk can also be affected. Polymorphic rash in the acute stage, prone to exudate , severe itching, recurrent attacks, chronic infiltration, hypertrophy, and other characteristics, is not difficult to diagnose. Laboratory tests generally have no specific findings, and eosinophils in the blood reserve may increase.
Differential diagnosis
1. Erythema
Rubbing erythema is more common in the back of the ears, groin, perianal, and neck. It mostly occurs in obese infants. It is more common in summer because of heat and humidity, salivation, and improper local care.
2. Contact Dermatitis. Contact dermatitis has a history of contact, and skin damage occurs at the contact site with clear boundaries. Feasible patch test identification.
3. Candida infection
Candida infections are pale red patches and small flat papules, with raised edges and transparent borders, with a small amount of scaly on the edges, and often combined with thrush. Possible fungal inspection.
4. Diaper dermatitis
Eczema that occurs in the diaper area or perianal area should be differentiated from diaper dermatitis. Diaper dermatitis is diffuse erythema, papules , papules, and scales bordered in the diaper area.
Treatment
1. Diet Management
It can find and avoid allergens. For example, children with milk protein allergy should switch to amino acid formula powder or deep protein formula powder.
2. Protect skin barrier function
For exudative and dry eczema, some non-allergic moisturizing cream should be used to moisturize the child if the surface is not ulcerated.
Local short-term topical corticosteroid cream can be applied for severe eczema, which has obvious anti-inflammatory and antipruritic effects. Please avoid long-term high-dose application to prevent side effects. If the local ulcer is infected, you need to apply antibiotic ointment locally for anti-inflammatory treatment. Use woven cotton cloth for regular air circulation on the skin
3. Local treatment
It is the primary method of treating infant eczema, and appropriate medication should be selected according to the stage of eczema. The acute phase is mainly redness and blemishes. When there is no exudation, it is recommended to use calamine lotion, calamine nitrofural lotion, glucocorticoid cream, or gel.
When there is a considerable exudation, 1% to 3% should be selected. Boric acid solution, 0.1% nitrofurazone solution cold, wet compress, zinc oxide oil can be used after wet compress and 1% chloramphenicol zinc oxide oil for external use in case of infection. It is recommended to use a 1% to 3% boric acid solution or physiological saline to wash outside, apply zinc oxide paste and glucocorticoid cream in the subacute stage.
Chronic lesions recommendations hormone ointment (e.g., 20% ~ 40% urea ointment, 5% ~ 10% salicylic acid ointment, etc.) and the glucocorticoid used interchangeably with the ointment.
4. Systemic medical treatment
( 1 ) Oral antihistamines can be taken orally under a doctor's guidance, such as chlorpheniramine.
( 2 ) Systemic application of corticosteroids, whether oral or intravenous corticosteroids, can quickly control symptoms, but it is easy to relapse after stopping the drug and cannot be cured. There are dependence and various adverse reactions after long-term application, so it should be considered appropriate for caution. For patients with generalized acute eczema whose other treatments are not sufficient, prednisone can be taken orally for a short period. The dose will be gradually reduced after the condition improves.
( 3 ) Antibiotics For children with widespread infection, fever, and increased white blood cell count, antibiotics can be treated systematically.
5. Physiotherapy. Ultraviolet radiation therapy can be used for chronic refractory eczema.
Preventive care
1. Children, in addition to a bath every day outside, should always keep proper hygiene and the skin clean and moist. Avoid using strong irritant for external use. Please pay attention when choosing wet wipes for babies. The simpler the ingredient list is, the better. When buying baby wipes, pay attention to the product ingredients on the packaging. They must not contain alcohol, fluorescent agents, bleaching powder, chemical flavors, and pigments. Any scented wet wipes will contain different amounts of chemical fragrances, directly stimulating the baby's skin.
It is recommended to choose fragrance-free wet wipes, preferably having 2020 medical-grade EDI technology of pure water, which is pure and fragrance-free, safe, and gentle. The first choice is the spunlaced nonwoven fabric for wet wipes with high viscose content, lint-free and lint-free, flexible, and thick. The second is bamboo fiber nonwoven, which has a natural material antibacterial effect, but the softness is not good enough; The blacklisted products are ordinary polyester nonwoven fabrics, which are low-cost. They are chemical fibers, which are easy to irritate the skin.
2. Try to avoid scratching and rubbing, dress loose, not too thick, wear materials like cotton clothes, and avoid contact with woolen and chemical fiber clothes.
3. Breastfeeding, mothers should not eat spicy, hot, fishy, beef and mutton, etc.; children should avoid adding shrimp, crab, fish, and other allergic foods.
 |
| spunlace nonwoven fabric for wet wipes |
Comments
Post a Comment