Pemphigus in children symptoms. The main signs of viral pemphigus. How does viral pemphigus manifest itself in children? Symptoms of the disease

Pemphigus - chronic autoimmune disease, characterized by the occurrence special kind bubbles on the surface before healthy skin and mucous membrane. Among the types of pemphigus, one can distinguish: vulgar, vegetative, erythematous and leaf-shaped.

Pemphigus can be diagnosed if acantholytic cells are detected, which are detected in a taken smear or as part of blisters in the epidermis itself (with histological examination). For the treatment of pemphigus, glucocorticosteroids are first used (a whole course of administration is prescribed). The latter is always well combined with extracorporeal hemocorrection (plasmophoresis, cryoapherosis, hemosorption).

What it is?

Pemphigus is a serious disease that affects the human skin. As a result of its progression, pathological blisters are formed on the skin and mucous membranes, filled with exudate inside. This process begins due to the stratification of the epithelium. Pathological foci can merge and tend to grow rapidly.

Causes

The reasons for the development of pemphigus are not yet fully understood. One of the main causes of pemphigus is a violation of autoimmune processes, thereby cells become antibodies for the immune system.

Violation of the structure of cells falls under the influence of external factors, as well as aggressive conditions environment. As a result, communication between cells is broken, which leads to the formation of bubbles. The percentage of morbidity in people with a hereditary predisposition is much higher.

Mechanism of blister formation

Human skin can be figuratively described as a water-spring "mattress" covered with a kind of "wall". The “mattress” does not participate in the formation of blisters - it only suffers upper layer, epidermis.

The epidermal layer consists of 10-20 cell layers, which look like bricks under a microscope. The "bricks" of the second layer of the epidermis are connected to each other by a kind of "bridges". On top of the “wall” there are layers of cells, no longer quite similar to cells, resembling applied cream. These are scales, corneocytes, necessary for protection against mechanical, chemical and physical damage.

If under the influence of internal or external causes antibodies are formed, from which the “bridges” - desmosomes between the cells of the basal layer are destroyed (this is called acantholysis and can be seen under a microscope), this is true pemphigus. If tissue fluid penetrates between the basal and upper layers of the epidermis without destroying the "bridges", this is pemphigoid. Viral pemphigus also proceeds without destruction of desmosomes.

Classification

Varieties of nonacantholytic pemphigus:

Benign neocantholytic pemphigus. Pathological elements are formed exclusively in oral cavity person. On examination, inflammation of the mucosa, as well as its slight ulceration, can be detected.
Bullous form of nonacantholytic pemphigus. This is a benign disease that develops in both adults and children. Blisters form on the skin, but there are no signs of acantholysis. These pathological elements can spontaneously disappear without scarring.
Scarring nonacantholytic pemphigus. This pemphigoid is referred to as medical literature blistering eyes. Most often, it is diagnosed in women who have crossed the 45-year age limit. The characteristic symptom is visual apparatus, skin and oral mucosa.

Classification of true pemphigus:

erythematous form. The pathological process combines several diseases. Its symptoms are similar to seborrheic dermatitis, erythematous variant systemic lupus, as well as true pemphigus. Erythematous pemphigus in adults and children is very difficult to treat. It is worth noting that the disease is diagnosed not only in humans, but also in some animals. A characteristic symptom is the appearance on the skin of the body and face of red spots, covered with crusts on top. Simultaneously with this symptom, seborrheic manifestations appear on the scalp.
Pemphigus ordinary. This type of pathology is diagnosed in patients more often. Blisters form on the skin, but there are no signs of inflammation. If the treatment of pemphigus is not carried out on time, then pathological elements can spread throughout the skin. It is worth noting that they can merge and form large lesions.
Leaf-shaped bladder. The name of this form was due to the characteristics of pathological elements. Bubbles form on the human skin, which practically do not rise above the epidermis (not tense). On top of them, crusts are formed that have the property of layering on top of each other. Creates the effect of sheet material stacked.
Brazilian bladderwort. Has no restrictions regarding gender and age. Cases of its development were recorded in children. early age and in the elderly aged 70 to 80 years. Also, its progression in middle-aged people is not excluded. It is worth noting that this species is endemic, therefore it is found only in Brazil.

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Symptoms

Given that experts have identified several various types given pathology, then the symptoms of each of them will be very specific. Of course, there are a number of general trends and signs inherent in all types of the disease. This may include, for example, the wave-like course of the pathological process.

Periods of exacerbation alternate with the transition of pemphigus to a calmer stage, when the main symptoms subside or completely disappear. An important factor for the patient will be the fact that in the absence of timely diagnosis and prescribing an effective course of treatment, there is a high risk of developing severe conditions, weighed down comorbidities.

The presence of crusts, ranging from pale pink soft to red dense,;
There is a deterioration in the general condition;
Decreased immune response of the body;
Formation of bubbles of different density;
Also at severe course separation of the layers of the epidermis is noted, and it can proceed both in the lesion and away from it.
Injuries and ulcers of the mucous membrane of the mouth, nasopharynx or genitals;
Pain during the act of swallowing or when eating;
Bad breath, indicating damage to the mucous membranes;
Hypersalivation or, in other words, increased salivation;
With the seborrheic form, characteristic yellowish or brown-brown crusts appear on the scalp.
Bubbles of various appearance, ranging from flat to thin-walled, which burst with a slight touch. Erosions and, later, crusts form in their place.
In severe cases, the formation of an eroded surface of the skin in place of the blisters is possible. Their feature is the tendency to peripheral growth. Over time, such erosions occupy a large surface of the skin, causing pain and inconvenience to the patient.
In children, manifestations of pemphigus are localized over the entire surface of the skin, including the limbs.

Experts say that with this disease, both a pure form of the pathological process and mixed ones, smoothly turning into one another, can be noted. Therefore, the symptoms and signs of pemphigus in a particular person may vary and indicate the presence of several types of the disease.

What does pemphigus look like: photo

The photo below shows how the disease manifests itself in humans.

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Diagnostics

Experts say that a correct diagnosis can be made on the basis of comprehensive examination patient, which includes several important steps:

Examination of the patient for the presence of a clinical picture. At this moment, the doctor determines the nature of the lesions, their localization, the degree of development of the disease, etc.
Cytological analysis necessary to establish the presence of acantholic cells in biomaterial smears.
Carrying out the Nikolsky test, which allows to differentiate pemphigus from pathological processes similar to it.
Direct immunofluorescence technique. This study allows to reveal the presence of immunoglobulin in the intercellular substance of the epidermis.
Histological examination, which is based on the method of detecting cracks and other damage inside the epidermis.

Only the totality of all the results allows us to make an accurate diagnosis and prescribe an effective course of treatment leading to the recovery of the patient.

Treatment of viral pemphigus

Treatment of viral pemphigus involves the appointment of the following systemic drugs:

cytostatics stop the division of immune cells: Sandimmun, Azathioprine, Methotrexate;
antiviral: Viferon, Laferon, Cycloferon;
glucocorticosteroids: Dexamethasone, Prednisolone;
antipyretic: Ibuprofen, Paracetamol, Nimesil, Mefenamic acid;
antihistamines relieve itching: Cetrin, Diazolin, Fenistil.

For outdoor processing affected areas of the skin can be prescribed:

antimicrobial-local anesthetics for irrigation of the oral cavity, if viral pemphigus has affected the mucous membranes of the child: Forteza, Oracept;
antiseptics: Chlorhexidine, Methylene blue, Miramistin;
combined preparations of antiseptics and anesthetics: Oflokain, pharmacy talkers;
antipruritic lotions from nettle juice, aloe, walnut oil.

Since children with this diagnosis are usually treated in stationary conditions, to enhance the therapeutic course can be carried out healing procedures, aimed at cleaning the blood of antibodies:

plasmapheresis - replacement of the liquid part of the blood with similar solutions without microbes, immune complexes and antibodies;
hemosorption using a carbon filter.

Only a doctor can say how to treat viral pemphigus, because in each individual case it can acquire some special features. As for other forms of pemphigus, the therapeutic course for them is also determined individually.

How to treat other forms of pemphigus?

The process of treating pemphigus is quite complicated. Therefore, self-treatment of this type of disease is in no case unacceptable. The disease progresses rapidly, affecting large areas of the skin, which leads to disruption of the internal organs.

Treatment for pemphigus without fail carried out in a dermatological hospital. First of all, corticosteroid drugs, cytostatics and other drugs are prescribed to alleviate the course of the disease and the life expectancy of patients.

Drugs must first be taken in large doses. At the same time, pay attention to the level of sugar in the blood and urine, monitor blood pressure and follow the rules of personal hygiene. With frequent change of bedding, underwear, the manifestation of a secondary infection is prevented.

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Drugs for the treatment of pemphigus

The patient is shown taking glucocorticoids in high doses. For this, the following drugs can be used:

Metipred;
Prednisolone;
Dexamethasone;
Polcortolon.

With the onset of regression of symptoms, the doses of these drugs are gradually reduced to the minimum effective. Patients with organ pathologies gastrointestinal tract long-acting glucocorticoids are prescribed:

Metipred-depot;
Diprospan;
Depot medrol.

Treatment with hormonal agents can cause a number of complications, but they are not a reason to stop corticosteroids. This is because the refusal to take them can lead to relapses and progression of pemphigus.

Possible complications during treatment:

acute psychosis;
arterial hypertension;
depressive states;
insomnia;
increased excitability of the nervous system;
steroid diabetes;
thrombosis;
obesity;
angiopathy;
erosion or ulcers of the stomach and / or intestines.

With a sharp deterioration in the patient's condition while taking corticosteroids, the following measures may be recommended:

dieting: restriction of fats, carbohydrates and salt, introduction to the diet more protein and vitamins;
drugs to protect the gastric mucosa: Almagel and others.

In parallel with glucocorticoids to increase the effectiveness of therapy and the possibility of reducing doses hormonal drugs cytostatics and immunosuppressants are prescribed.

For this, the following drugs can be used:

Sandimmun;
Methotrexate;
Azathioprine

For the prevention of electrolyte imbalance, the patient is recommended to take calcium and potassium supplements. And with secondary infection of erosions - antibiotics or antifungal agents.

final goal drug therapy aimed at the disappearance of rashes.

Preventive measures

There are no specific measures to prevent the development of pathology. The higher the level of immune protection, the less chance for the occurrence of dermatological diseases.

control the nature of chronic diseases;
strengthen immunity;
observe personal hygiene;
eat properly.

Measures to prevent pemphigus in newborns:

change your underwear more often;
it is forbidden to care for newborns with pustular skin lesions;
take care of your child's skin regularly;
strengthen the immune system of weakened children;
need daily wet cleaning, airing the room.

If you find any rashes on the skin, the formation of pustules and blisters, contact a dermatologist immediately.

Forecast

The prognosis for acantholytic pemphigus is conditionally unfavorable. On the one hand, in the absence of effective treatment, the likelihood of complications and death is high.

On the other hand, patients with pemphigus are forced to take glucocorticosteroids for a long time, and sometimes for life, which is fraught with the development side effects. But the hasty refusal of drugs leads to an immediate relapse of the disease. Glucocorticosteroids do not eliminate the cause of the disease, but inhibit the pathological process and prevent its progression.

Viral pemphigus in children is a dermatological lesion of the skin with blisters that quickly spread, grow and merge. The disease is characterized by a slow course, passing into the stage of exacerbation and followed by remission. Viral pemphigus is dangerous enough for young children if it is running. In particular dangerous cases celebrated fatal outcome Therefore, medical attention is needed immediately upon detection of the first symptoms.

The occurrence of pemphigus is associated with autoimmune disorders, when the processes in the tissues between cells are disturbed, and numerous blisters appear throughout the body. Big influence It also has a genetic factor, in which case the child is at risk.

Symptoms of various forms of the disease

Pemphigus vulgaris

The most common viral form of the disease, which occurs most often and is characterized by the appearance of watery blisters. The main symptoms are the appearance of a rash in the mucous membrane of the oral cavity, and then the spread of the focus to all parts of the body. and armpits, but not always becomes noticeable immediately. With the progression of the disease, huge blisters can form on the body, from which a bloody or clear secret flows when punctured. The surface of the formations is very thin in structure and easily breaks through from any minor mechanical damage. As the surface of the blisters dries, a crust is formed that has a brown color. The upper layers of the skin, which are among the blisters, peel off easily when rubbed.

Common manifestations of pemphigus vulgaris - malaise, feeling of weakness, fever, pain when swallowing saliva and eating.

The disease carries many complications, turning into malignant form, over time, the kidneys, liver and heart muscle are affected, which can lead to death.

seborrheic pemphigus

Small blisters appear on the body of children, which quickly dry out and become covered with yellow or brown crusts in the form of scales. They form on the face and in the hair, then the rash spreads to the back and chest. Bubbles of the seborrheic form are practically not found in the oral mucosa. After removing the dried crust, weeping erosions are observed at the site of the bubble. The disease is characterized by a long course with a favorable prognosis.

Pemphigus foliaceus

The first symptoms of this form of the disease are flat, flaccid blisters with a thin surface that protrudes slightly above the skin. The rash usually occurs anywhere on the skin. When the surface of the blisters breaks, erosions are visible, which do not heal for a long time, causing severe discomfort to the sick child. Films of bubbles dry up and take the form of scaly plates growing on each other.

The leaf-shaped form of the disease is dangerous because the blisters appear constantly, merging with the affected foci and forming one continuous wound on the surface of the body.

Another symptom of pemphigus leafis is a violation water-salt metabolism and temperature rise. The disease is characterized by a long chronic course.

Diagnostics

The disease is diagnosed by a dermatologist after visual inspection and also conducts histological, cytological and immunological analysis. With viral pemphigus in children, numerous wounds appear that spread on the soles, in the area of \u200b\u200bthe palms, fingers and toes. Small sores form in the oral cavity, provoked by an intestinal pathogen that spreads easily during coughing and sneezing. According to statistics, viral pemphigus most often occurs in girls under the age of 10 years.

Peculiarities

In children, viral pemphigus is much easier than in adults, gradually the blisters dry up and burst. Usually, before the appearance of formations and erosions, a rash begins, which is not manifested by itching, but is accompanied elevated temperature. The virus is easily transmitted from a sick child to a healthy child through the fecal-oral route. The main reason for contracting the disease is non-observance of personal hygiene rules and too weak immunity child.

Treatment

If the parents detect the symptoms in time and turn to a specialist, then the treatment of the disease is not delayed for more than 10 days. The virus persists in children's feces, and may well show up after a few weeks or months, when the blisters have already completely healed. Malignant viral pemphigus carries great complications, so it is important timely treatment disease at an early stage.

The treatment of pemphigus is a complex process, so self-administration of drugs is out of the question. The disease progresses rapidly, affecting large areas of the skin, and provoke a malfunction in the functioning of vital organs.

Treatment of pemphigus is carried out only in a hospital under the supervision of dermatologists. Hormone therapy is indicated, where corticosteroid drugs are included in high dosages. Important for children constant control urine sugar, blood pressure and hygiene. A special diet is shown, the diet of which does not irritate the affected oral mucosa. The development of a secondary infection is excluded if the child is often changed underwear and bedding.

Treatment with drugs is carried out until the rashes on the skin stop. If therapy gives positive results, the drugs are not canceled, because the abrupt withdrawal of corticosteroids can lead to an exacerbation of the disease. In addition to hormone therapy, symptomatic treatment facilitating the manifestation of the disease at different stages.

The causative agent of the disease is the Coxsackie virus. Viral infection in most cases it develops in young children under 10 years of age.

The disease is very common and affects most of the Salysh. The virus is easily transmitted from one child to another by airborne droplets and by contact, a child can become infected through toys, household items.

Cases of the disease are more often recorded in summer and autumn.

You can get infected in any crowded places. Most often, children catch the infection in kindergartens, less often at school.

There is no need to even contact with a sick child, the disease can be transmitted through toys, surrounding objects, unwashed hands. Babies with reduced immunity are more likely to get sick.

Unlike other children's infectious diseases viral pemphigus does not provide strong immunity, and the baby can be re-infected with another strain of the Coxsackie virus.

Viral pemphigus is caused by Kosaki ecterovirus. You can get sick with it in the following cases:

with a weakened immune system after past illness;
if personal hygiene is not observed;
when eating from common dishes;
with an exacerbation of a chronic disease;
when communicating with a carrier of this infection;
with poor heredity.

Being in the same conditions children's body react differently to viral pemphigus. Doctors explain that the reason for this is the formation of autoaggressive bodies, which, at the slightest disruption in the body, appear as watery blisters on the skin or mucous membranes (as in enteroviral vesicular stomatitis).

Clinicians cannot name the exact etiology of viral pemphigus. But now there is an assumption about the autoimmune origin of the disease.

Types of pemphigus that occur in children

Dermatologists distinguish several types of childhood viral disease:

vulgar,
foliate,
vegetative,
erythematous.

Pemphigus, like most dermatoses, has many various forms and species that distinguish symptoms, external signs of the rash, severity of the course and outcome of the disease. Viral pemphigus in children can develop in such forms as:

Vulgar (common)

Pemphigus vulgaris is the most common type of the disease. Diagnosed regardless of the age of the child, it occurs even in children of the first month of life. Provoking factors, after which pemphigus develops in children, are:

Thermal and chemical burns;
Prolonged exposure to direct sunlight;
Treatment uncontrolled by a doctor with antibiotics, hormonal and antihistamines.

Signs of this type are indicators such as:

Primary formation of blisters filled with a transparent substrate and having an easily damaged coating;
When the shell is ruptured, erosion is formed, causing severe pain;
The surface of the erosion does not heal, cracks for a long time and bleeds from the slightest movement;
While maintaining the integrity of the bubble, central part after a certain time, it becomes covered with a crust, and growth and distribution continue along the perimeter.
The form has no priority in localization, both skin tissues and mucous membranes are affected.

Pemphigus vulgaris in children with the spread of affected areas causes symptoms such as:

Severe pain with every movement, swallowing and talking, if the localization is in the oral cavity;
Damage to the skin disrupts sleep and negatively affects the nervous system.
The child becomes moody, irritable and quickly loses weight.

Viral pemphigus in children of the vulgar type is severe and dangerous form illness. In most cases, its course acquires a malignant, progressive character.

If an adequate competent treatment, then develop dangerous complications in the endocrine and nervous systems. And a child can die from serious injuries metabolic and extensive purulent processes.

vegetative

Vegetative form A characteristic distinguishing feature of this species is the development of vegetations on the skin with a benign course. Skin symptoms form limited foci, not prone to growth.

If vegetative pemphigus in children is left without qualified treatment, then it will gradually develop into a vulgar form.

Two types of the vegetative form of the disease are known, these are:

Pemphigus Apollo, which is distinguished by such features as:
- The formation of pustules (blisters with purulent filling), and the formation of vegetation from them;
- The opened pustule leaves a wound weeping surface with an unpleasant odor;
- It has high risk accession of a secondary bacterial infection.

Most often, this vegetative form of Apollo occurs in children after long-term treatment corticosteroids.

Pemphigus Neumann, differs in localization in places such as the armpits, the genital area, the skin on the head under the hair. hallmarks are:

Formation of vegetation (growth) directly on the erosive surface of a burst bubble. The growths are reminiscent of appearance cauliflower.
Erosions practically do not heal;
The place of drying erosion resembles a flat wart.

Exfoliative (leaf-shaped) form

In medicine, several classifications of the disease are used, which are based on the manifestation of the pathological process, its varieties, the characteristics of the course of the disease, as well as the severity.

Basic forms:

true or acantholytic pemphigus. It combines several types of diseases that are the most dangerous for humans, and can provoke the progression of complications that are dangerous not only for health, but also for human life;
benign or nonacantholytic pemphigus. Is less dangerous pathology. It flows relatively easily.

Depending on the characteristics of the course of the disease and the severity:

mild degree. Pathological elements on the skin are formed gradually. The number of foci is minimal;
moderate. This form is characterized by the formation of blisters on the skin and oral mucosa. The number of foci increases;
heavy. Amazed most of skin cover. Ulcers can be found in the mouth. The foci of inflammation merge and form large conglomerates. Associated pathologies develop.

Varieties of true pemphigus

Pemphigus ordinary. This type of pathology is diagnosed in patients more often.

Blisters form on the skin, but there are no signs of inflammation. If the treatment of pemphigus is not carried out on time, then pathological elements can spread throughout the skin.

It is worth noting that they can merge and form large lesions.

The main signs of viral pemphigus

Parents can notice viral pemphigus in their child by several signs:

Before the appearance of blisters characteristic of the disease, the baby may complain of weakness, increased drowsiness, headache.
After about three days, vesicles filled with serous contents appear in the child's oral cavity, on the arms, legs, and less often on the buttocks.
The rash in some children is accompanied by fever, but usually it does not last long.
The blisters quickly open and in their place remain small wounds or sores that are painful, especially in the oral cavity.
Some children have mouth ulcers so painful that they force them to refuse to eat.

Symptoms

Modern dermatologists distinguish the following forms of the disease:

vulgar;
foliate;
vegetative;
brazilian;
erythematous;
paraneoplastic.

The infectious process begins after a short (from several days to a week) incubation period. The first symptoms of the disease are similar to those of a cold or SARS:

Photo of viral pemphigus in the mouth in a child

The first symptoms of viral pemphigus in children begin to appear 3-6 days after infection. Usually parents do not attach importance to these symptoms because they are nonspecific. The first symptoms include:

drowsiness;
fast fatiguability;
poor appetite;
sudden change of mood;
heat.

AT rare cases the child may have:

runny nose;
cough;
vomit;
headache;
diarrhea.

All of the above symptoms manifest themselves in the region of 12-36 hours. Then symptoms specific to viral pemphigus become apparent. These are watery blisters that may appear on the palms, feet (soles), in the mouth, or on the genitals.

The blisters themselves have the following characteristics:

elongated or oval shape;
itching and pain;
clear or whitish liquid inside;
redness around;
erosion after the bubble bursts;

If the disease affects the oral cavity, then blisters appear in the mouth yellow color with a red rim around it and the heat will rise. Along with blisters, bad breath appears.

The bubbles hurt even if they are not touched, while the pain increases when swallowing, as well as when eating food. In order not to once again irritate the oral mucosa, doctors advise avoiding cold, hot, sour or spicy foods during this period.

Viral pemphigus of the oral cavity is easily confused with a sore throat, since the symptoms are identical in appearance. Therefore, at the first signs of the disease, it is best to immediately contact medical institution for help.

A timely diagnosis will help avoid prescribing antibiotics, which can cause an additional rash on the body.

In severe disease, blisters appear on the knees, elbows, buttocks, and perineum and may enlarge. The lymph nodes on the neck. If blisters have formed on the feet or palms, then the consequence may be peeling of the nail plate.

The peeling process itself is painless, and the nails begin to grow back after 2 weeks. With viral pemphigus, the high temperature lasts no more than 5 days.

After this time, the temperature returns to normal, and the child begins to feel better. From the onset of the disease to complete recovery takes about 10 days.

But it should be noted that after recovery for another 3 months, the Kosaki ecterovirus will come out with the feces.

Basically, viral pemphigus manifests itself with a number of symptoms. But there are times when it can be asymptomatic. And there are just a few pitfalls.

Firstly, such a course of the disease is fraught with complications, because the treatment will not be prescribed on time. And secondly, the disease will manifest itself already at the most severe stage and much more serious treatment will be required.

The main symptoms (signs of manifestation) include:

Viral pemphigus in children and adults is a disease that has similar symptoms, regardless of its type. A feature of acantholytic and non-acantholytic pemphigus is an undulating course. If you don't provide timely help, the patient's condition will deteriorate rapidly.

General symptoms:

loss of appetite;
weakness;
symptoms of cachexia increase;
erosion epithelialization slows down.

Symptoms of the disease, depending on which form began to progress in a person.

With pemphigus vulgaris, blisters of various sizes form on the skin. They have a sluggish and thin-walled shell.

First they are localized in the oral cavity. Usually, a sick person, after discovering pathological elements, goes to see a dentist, but in fact, a dermatologist is also involved in the diagnosis and treatment of pemphigus vulgaris.

The main complaints: pain when talking and eating, an unpleasant smell from the oral cavity.

Symptoms of the disease persist for 3-12 months. If during this period you do not do treatment, then pathological formations will begin to spread and move to the skin. In severe cases, there is intoxication syndrome and accession of a secondary infection.

The size of the blisters in the erythematous form is relatively small. The walls of the bladder are thin and sluggish. Formations can spontaneously open. It is very difficult to diagnose such pemphigus in children and adults.

The leaf form affects mainly the skin, but sometimes spreads to the mucous membrane. Its main difference from other forms is the simultaneous formation of pathological blisters and crusts that overlap each other.

With such a disease, the development of sepsis is possible, which often leads to the death of the patient.

Diagnosis of pathology

Viral pemphigus is fairly common and the diagnosis is not difficult. However, the symptoms of the disease may be similar to those of chicken pox and other skin diseases.

For accurate diagnosis, an immunological study of the baby's blood is carried out, which shows the presence in the blood of specific antibodies to the antigens of the Coxsackie virus.

A dermatologist diagnoses pemphigus in children by visual examination of the skin and oral cavity of the child. Having established the diagnosis of viral pemphigus, the infected child is placed in a hospital. The doctor conducts a histological, cytological and immunological examination and treatment.

the use of antipyretic drugs, which contribute not only to lowering body temperature, but to alleviating painful symptoms;
the use of glucocorticosteroid and immunological drugs;
apply antimicrobial antiseptic ointments to the resulting wounds;
in order to avoid dehydration of the body, observe a frequent drinking regimen;
Frequent change of linen helps to prevent the development of re-infection.

Preparations for the treatment of pediatric pemphigus are prescribed throughout the entire period of the rash on the skin and mucous membranes of the child. To prevent the disease from aggravating, the use medicines do not cancel, even if there is a positive result in the treatment, until complete recovery.

Careful and prolonged treatment contributes to a long stage of remission.

Treatment

Treatment of any type of pemphigus in a child of any age contains systemic and local funds. Complex medical measures appoints a doctor, any changes must be agreed with him. The use of various folk remedies can cause irreparable harm to the health of the child.

Systemic therapy

This type of treatment begins after the detection of the first bubble elements on the skin of the child, the sooner the better. For the treatment of vulgaris and other types of pemphigus are prescribed:

systemic glucocorticosteroids (prednisolone) in high and medium age dosages for several weeks;
immunosuppressive drugs (azathioprine, cyclophosphamide, cyclosporine);
plasmapheresis sessions;
antibiotics with a wide range exposure (cephalosporins of the 3rd and higher generation) in the presence of complications.

Local treatment

This type of therapy has a number of features depending on the form of the disease.

For the treatment of vulgaris and erythematous pemphigus are prescribed:

local means with a drying effect (aniline dyes);
after that - ointment dressings for speedy healing (Levomekol).

Treatment for the vegetative form includes:

the actual vegetation is removed only surgically(laser ablation or with triamcinolone suspension);
local treatment consists in drying and applying antimicrobial ointments (Miramistin).

Pemphigus foliaceus is eliminated by the following local remedies:

general baths with anti-inflammatory drugs;
astringent additives (oak bark);
ointment dressings with glucocorticosteroids;

Only in the presence of a thorough and prolonged treatment, the absence of provoking factors, this form of pediatric pemphigus can go into a long stage of remission.

With all variants of pemphigus, special rehabilitation is not required.

Treatment of pemphigus is a rather complicated process. Self-medication is unacceptable. The disease progresses quite quickly and, affecting large areas of the skin, and can lead to disruption of the internal organs.

Treatment must be carried out in a hospital. Corticosteroid medications are given to relieve symptoms.

Initially, they are taken in large doses. Blood and urine sugar levels, blood pressure and hygiene rules are monitored.

It is necessary to change bed and underwear more often to prevent re-infection.

Treatment is combined with anabolic steroids, as well as ascorbic acid, calcium and potassium. Reception medicines continues until the complete disappearance of the rash. In the case of a rapid improvement, in no case should you stop treatment, so as not to cause an exacerbation.

Prevention of pemphigus

If the child has already had pemphigus, then it is necessary to maintain hormone therapy. Healthy children should be taught about the need for personal hygiene, especially washing their hands after going to the toilet and before eating. The room should be regularly ventilated and wet cleaned.

benign pemphigus

Benign familial pemphigus is a disease that affects adolescents and young adults. To date, the reasons causing it are not fully understood.

Members of the same family do not always get sick. It is this fact that caused the disease to have several names.

It is called benign pemphigus dermatitis herpetiformis. The disease is unpredictable.

The disease has an undulating course, in connection with this, treatment should be selected depending on the symptoms and the activity of the process. Pemphigus is a disease in children that, if left untreated, can be life-threatening.

It gets worse quickly, so it needs to be treated by a professional. After the defeat of a large area of the skin, internal organs are involved in the process.

Children's pemphigus requires the conditions of a dermatological hospital. For treatment, it is necessary to use hormonal, cytostatic drugs, as well as agents that can improve the condition of the baby and transfer the disease into a controlled form.

For this, high doses of medication should be used at the beginning of therapy.

In addition, special attention is paid to personal hygiene, change of bed and underwear. In the process of treatment, it is necessary to control the level of glucose in the blood and urine and blood pressure. Maintaining cleanliness prevents further infection.

The treatment regimen includes the use of corticosteroid drugs, anabolic steroid hormones, calcium, potassium and vitamins. The duration of taking the drugs depends on the presence of blisters and their regression.

When the baby's condition improves, do not immediately cancel corticosteroid drugs, as this can cause an exacerbation. Therapy implies control over the patient's condition by putting him on a dispensary record.

Outpatients should not be subjected to strong physical exertion and nervous strain.

FROM therapeutic purpose appointed hormonal preparations inside and outside. Doses of steroids should be reduced every week by a few milligrams. The decrease must continue until it reaches minimum dose which provides a supportive effect.

A positive result is observed when using a complex of drugs: hormones, cytostatics and immunosuppressants. Even after disappearing skin manifestations do not stop taking immunosuppressants for another few months.

In addition, it is necessary to carry out blood purification by hemosorption and plasmapheresis. This is especially true for children who have concomitant pathology such as diabetes or an overactive thyroid.

A diet for a disease involves the use of hypoallergenic foods, cereals and protein foods. To avoid secondary infection, use herbal baths With oak bark, chamomile or a weak solution of potassium permanganate.

Erosion must be lubricated with weak disinfectant solutions, followed by lubrication with hormone-based ointment.

In order to reduce the temperature and improve the general condition, antipyretic drugs, except for aspirin, should be used. The treatment of pemphigus in newborns consists in isolating the baby in the pathology department. Bubbles should be lubricated antiseptic. Also widely used:

ultra-violet rays;
antibacterial agents;
detoxification and maintenance therapy in the form of infusion injections.

As antibacterial drugs use antistaphylococcal gamma globulin. In addition, the treatment of pemphigus of the newborn includes the transfusion of plasma and fiery elements.

In the presence of heart failure with edematous syndrome, cardiac glycosides and diuretics should be used.

Viral pemphigus is determined by an experienced pediatrician immediately after examining the skin and oral cavity of the child. Specific treatment the disease is not carried out, since there are no special preparations for neutralizing and removing the virus from the body. The doctor prescribes symptomatic treatment:

Antipyretics are used when the temperature rises - Nurofen, Paracetamol. These medicines also have an analgesic effect, which can reduce the soreness of mouth ulcers.
The gel, which is used when the first teeth erupt, also helps to reduce pain for babies. A small amount of gel must be gently rubbed into those places of the oral cavity where there are sores.
During the formation of ulcers, the child must be fed light food that does not irritate the mucous membranes. That is, it is necessary to exclude spicy, too hot and sour dishes.
A sick baby should drink as much and as often as possible, this will facilitate general well-being and prevent dehydration. The child must be forced to drink, even if it hurts him because of the presence of sores in the oral cavity.
It makes no sense to give antibiotics to a child. Viral pemphigus is caused by a virus and antibiotic treatment in this case is inappropriate.

At the time of illness, it is necessary to pay increased attention to body hygiene, you need to periodically change bed sheets, avoid scratching the bubbles. If a child combs the blisters with dirty hands, then secondary infection is possible, which will cause both a rise in temperature and the development of streptoderma.

For secondary infection, the doctor may prescribe antibiotics.

To relieve itching and irritation of the skin with blisters, ointments and lotions with anti-inflammatory components can be used. After the wounds have dried, it is recommended to use emollient creams, this will enhance tissue regeneration.

Soreness in the mouth relieves cool drinks. Treatment should be accompanied by periodic airing of the room, constant wet cleaning.

Viral pemphigus in a child usually resolves in a week or a little more. The blisters begin to dry up two or three days after opening, the temperature usually lasts only the first days of the disease.

If parents note that the vesicles do not heal well, the temperature does not decrease, and the child’s health does not improve, then you should consult a doctor for additional treatment.

Treatment of the disease is aimed at alleviating the condition of the child. After all, the disease, as a rule, goes away by itself after 10 days.

With the development of viral pemphigus in children, treatment is aimed at eliminating the symptoms of the disease and improving the general condition of the patient. Treatment of the disease is carried out with the help of external folk remedies.

Such drugs remove pain syndrome, have anti-inflammatory and antimicrobial action, contribute to the speedy healing of wounds and the regeneration of the mucous membrane and skin.

They also give the baby decoctions to strengthen immunity.

Accept antiviral drugs with this disease is not necessary, because the infection goes away on its own. The duration of the disease is in most cases 10 days. Antiviral drugs also have a negative toxic effect on the child's liver.

Folk recipes

Means to strengthen immunity:

Mint and calendula. In a glass of boiling water, steam 1 tsp. dried or fresh marigold flowers and mint leaves. Give the child 50 ml three times a day.
Kalina. In 1 l. water brewed 250 g fresh berries viburnum, boil over low heat for 10 minutes, then cool and filter. Add 2 tbsp to the decoction. l. honey. Give the baby 50 ml three times a day.
Voronets. In a glass of boiling water, steam 1 tsp. this plant, insist an hour, then filter. Add honey to taste. Give the baby 50 ml 2-3 times a day.
Herbal collection. In 300 ml of boiling water, steam 1 tsp. chopped willow twigs, elm bark and birch buds, boil over low heat under a closed lid for 10 minutes, then cool and filter. Add honey to taste. Give the patient 1 tbsp. three times a day.

External funds:

Given the deceit and high danger dermatosis, treatment is carried out in a hospital according to an individual scheme, including systemic and local effects. Attempts to get rid of rashes on their own or treatment folk recipes can cost a child's life.

The diagnosis of viral pemphigus can only be made by an infectious disease specialist, and it is he who will prescribe the correct treatment. Therapy is aimed at eliminating the symptoms.

Therefore, for the treatment of viral pemphigus, external agents are used that have antimicrobial and anti-inflammatory effects. This method promotes the regeneration of the skin, due to which wound healing occurs faster.

At this time, the child should be given drugs that strengthen the immune system. Doctors do not advise taking antiviral pills, because after 10 days the disease goes away on its own.

The doctor is on site, without prescribing any additional tests, can immediately diagnose the disease and prescribe treatment, which will consist of:

Taking antipyretic and pain medications. For children, Nurofen is most often prescribed, which has both effects, Paracetamol
The use of special anesthetic gels, especially if blisters appear in the mouth. For this, the same gels are usually used as during teething. For example, Kalgel. A little gel is squeezed out and gently rubbed into the place where the sore has formed.
Taking hormonal drugs, but only if the disease has passed to a severe stage, and the child's condition has noticeably worsened
Drinking cool drinks that will positively affect the oral mucosa and relieve pain and itching

In addition, it is necessary to exclude salty and spicy dishes, which will only irritate the mucous membrane. For a while, it is better to switch to mushy food or mashed potatoes so that the baby does not hurt to swallow.

In the attached video you can learn about dermatitis.

Viral pemphigus is very common in children. And all because it is easily transmitted from child to child. It only takes one person to cough or sneeze, and the virus will spread to the next. Therefore, each parent should know the main symptoms of the manifestation of the disease, in order to immediately contact a specialist and not delay treatment.

To date, several methods are used to treat the disease:

drug therapy;
local treatment;
extracorporeal methods.

Drug therapy includes the appointment of the following groups of drugs:

antibiotics;
corticosteroids;
cytostatics.

Local treatment:

ointments containing corticosteroids;
baths with the addition of potassium permanganate;
irrigation of the surface of the mucous membrane and skin with anesthetic solutions;
use of aniline dyes.

Extracorporeal techniques:

hemosorption;
hemodialysis;
plasmapheresis.

Disease prevention

The main direction of prevention is to prevent the development of an exacerbation of the disease. For this, parents little patient necessary:

carefully follow all medical recommendations;
do not interrupt the course of treatment with glucocorticosteroids on your own, even if it is very long;
exclude the influence of provoking factors ( ultraviolet irradiation certain medications).

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An adult family member caring for the baby should take steps to reduce the chance of infection. That is, you must constantly wash your hands with soap and water, it is advisable to wear a disposable bandage, when applying the ointment to the skin, you must use protective gloves.

After a successful recovery, parents need to know that the Coxsackievirus remains active in feces for several more months, so it is necessary to take preventive measures that prevent the disease.

To prevent development and exacerbation, as well as to prevent the risk of infecting other people with viral pemphigus, you must:

follow and follow all the recommendations of a dermatologist;
protect the child from exposure to UV rays;
observe the rules of personal hygiene;
help improve immunity;
a parent who cares for a sick child and applies ointment to sore spots should use medical gloves. This will prevent the risk of infection yourself.

Treatment of pediatric viral pemphigus, regardless of the age of the child, is based on specialized drug therapy, and compliance with certain safety measures.

Therapy should never be avoided or interrupted. If the disease is started, and the drugs prescribed by the doctor are not used, this will lead to irreversible consequences.

And the infected child, having not received medical care may die. Therefore, when the first symptoms and signs of the disease appear, the parents of the child should urgently apply for qualified help to medical specialists.

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Pemphigus is a fairly rare dermatological disease that affects people of different age categories. However, more often this ailment is observed in adults 40-60 years old.

In this article, we will introduce you to the causes, varieties, symptoms, methods for diagnosing and treating pemphigus in adults. This information will be useful to you and your loved ones, and you can take action to combat this difficult to treat disease.

Pemphigus is accompanied by the appearance of blisters filled with exudate on the body and mucous membranes. They are able to merge with each other and grow rapidly, causing the patient a lot of suffering. The disease is difficult to treat, because it has an autoimmune nature. As such, there is no specific therapy for this disease, and this fact often leads to the development of complications and severe consequences in future.

The reasons

Bye valid reason development of pemphigus is unknown. Most experts tend to think that this disease is of an autoimmune nature.

With pemphigus, disturbances in the activity of immunity, leading to an attack of one's own skin cells, occur as a result of exposure to external factors - aggressive environmental conditions or retroviruses. The defeat of the cells of the epidermis causes a violation of the connection between the cells and bubbles appear on the skin. So far, all the predisposing risk factors for the development of this disease have not been established, but scientists and doctors know that one of them is heredity, since studies of the family history of patients often reveal the presence of close relatives with pemphigus.

Varieties of pemphigus

There are several classifications of the variety of pemphigus, which reflect the manifestations of the pathological process.

The main forms of the disease:

acantholytic (or true) pemphigus- manifests itself in several varieties and is a more severe and dangerous form that can lead to the development of serious complications, health threatening and life of the patient;
nonacantholytic (or benign) pemphigus- manifests itself in several varieties, proceeds more easily and is less dangerous to the health and life of the patient.

Varieties of acantholytic pemphigus:

Ordinary (or vulgar).
Erythematous.
Vegetative.
Foliate.
Brazilian.

Varieties of nonacantholytic pemphigus:

bullous.
Non-acantholytic.
Scarring nonacantholytic.

Rare varieties of pemphigus:

Symptoms

Regardless of the type and form of pemphigus has similar symptoms. characteristic feature The course of this disease is undulating. In addition, in the absence of timely and adequate therapy, pemphigus is rapidly progressing.

Acantholytic varieties

Pemphigus vulgaris (or vulgaris)

With this type of acantholytic pemphigus, the blisters are localized throughout the body and have different sizes. They are filled serous exudate, and their surface (tire) is thin and sluggish.

Most often, the first blisters appear on the mucous membranes of the nose and mouth. Such a symptom leads patients for treatment to a dentist or an otolaryngologist, since formations cause them:

pain when talking, swallowing or chewing food;
increased salivation;
bad breath.

This period of the disease lasts about 3 months or one year. After that, the pathological process extends to skin.

Blisters form on the skin with a flaccid and thin cover. Sometimes they burst, and the patient does not have time to notice the moment of their appearance. After opening the blisters, painful erosions and areas of a tire that has dried into crusts remain on the body.

With pemphigus vulgaris, bright pink erosions form on the body, which have a glossy and smooth surface. Unlike other dermatological diseases, they grow from the center to the periphery and can form extensive foci. The patient has a positive syndrome (or test, phenomenon) of Nikolsky - with a slight mechanical effect on the skin in the affected area, and sometimes in a healthy area, the upper layer of the epithelium exfoliates.

During illness, the patient may feel general weakness, malaise and fever. Pemphigus vulgaris can last for years and lead to damage to the heart, liver, and kidneys. Even with adequate treatment, the disease can cause severe disability or death.

Erythematous pemphigus

This type of acantholytic pemphigus differs from the ordinary one in that at the beginning of the disease, blisters do not appear on the mucous membranes, but on the skin of the neck, chest, face and scalp. They have signs similar to seborrhea - clear boundaries, the presence of yellowish or brown crusts of various thicknesses. The blister covers are sluggish and flabby and break open quickly, exposing the erosions.

With erythematous pemphigus, Nikolsky's syndrome for a long time is localized, but after a few years it becomes common.

Vegetative pemphigus

This type of acantholytic pemphigus is benign, and many patients have been in a satisfactory condition for many years. On the patient's body, blisters appear in the area natural folds and holes. After opening, erosions appear in their place, at the bottom of which growths form with a serous or serous-purulent fetid coating.

Pustules appear along the edges of the formed erosions, and for correct setting diagnosis, the doctor has to differentiate the disease from. Nikolsky's syndrome is positive only in the area of the appearance of foci skin changes and does not affect healthy skin.

Pemphigus foliaceus

This type of acantholytic pemphigus is accompanied by the appearance of blisters, which in most cases are located on the skin. Sometimes they can be present on the mucous membranes.

A hallmark of this disease is the simultaneous appearance of both blisters and crusts. Bubbles with a leaf-shaped variety of pemphigus are flat and only slightly rise above the skin.

Such foci lead to the layering of similar elements of skin changes on top of each other. In severe cases, the patient may develop sepsis, leading to death.

brazilian pemphigus

This type of disease occurs only in Brazil (sometimes in Argentina, Bolivia, Peru, Paraguay and Venezuela) and has never been detected in other countries. The cause of its development has not yet been precisely established, but most likely it is provoked by an infectious factor.

Brazilian pemphigus is more common in women under 30 and only affects the skin. Flat blisters appear on the body, which, after opening, are covered with exfoliating scaly crusts. Under them are erosions that have not healed for several years.

The lesions cause the patient suffering - sensations of pain and burning. In the area of erosion, Nikolsky's syndrome is positive.

Nonacanotolytic varieties

bullous pemphigus

This type of disease proceeds benignly and is not accompanied by signs of acantholysis (i.e., destruction). Blisters appear on the patient's skin, which can disappear on their own, and there are no cicatricial changes in their place.

Neacantholytic pemphigus

This type of disease proceeds benignly and is accompanied by the appearance of blisters only in the oral cavity. On the mucosa, signs of an inflammatory reaction and ulceration are revealed.

Scarring nonacantholytic pemphigus

This type of disease is more often detected in women older than 45-50 years. In the medical literature, you can find another name for this form of pemphigus - "pemphigus of the eyes." The disease is accompanied by damage not only to the skin and oral mucosa, but also to the visual apparatus.

Diagnostics

Diagnosis of the disease initial stages may be significantly hampered by the similarity of its manifestations with other dermatological diseases. For an accurate diagnosis, the doctor may prescribe a number of laboratory tests to the patient:

cytological analysis;
histological analysis;
immunofluorescent study.

Nikolsky's test plays an important role in the diagnosis of pemphigus. This method allows you to accurately differentiate this disease from the rest.

Treatment

Treatment of pemphigus is difficult because scientists cannot yet determine the exact cause of the disease. All patients should be registered with a dermatologist and they are recommended to comply with a sparing regimen: the absence of severe mental and physical activity, avoidance of excessive insolation, adherence to a certain diet and frequent change of bed and underwear to prevent secondary infection of erosions.

Medical therapy

The patient is shown taking glucocorticoids in high doses. For this, the following drugs can be used:

Prednisolone;
Metipred;
Polcortolon.

With the onset of regression of symptoms, the doses of these drugs are gradually reduced to the minimum effective.

Patients with pathologies of the gastrointestinal tract are prescribed prolonged glucocorticoids:

Depot medrol;
Metipred-depot;
Diprospan.

Possible complications in the treatment of glucocorticoids:

depressive states;
insomnia;
increased excitability of the nervous system;
acute psychosis;
thrombosis;
obesity;
angiopathy;
steroid diabetes;
and/or intestines.

With a sharp deterioration in the patient's condition while taking corticosteroids, the following measures may be recommended:

drugs to protect the gastric mucosa: Almagel and others;
dieting: limiting fats, carbohydrates and salt, introducing more protein and vitamins into the diet.

In parallel with glucocorticoids, cytostatics and immunosuppressants are prescribed to increase the effectiveness of therapy and the possibility of reducing doses of hormonal agents. For this, the following drugs can be used:

Methotrexate;
Azathioprine;
Sandimmun.

For the prevention of electrolyte imbalance, the patient is recommended to take calcium and potassium supplements. And with secondary infection of erosions - antibiotics or antifungal agents.

The ultimate goal of medical therapy is aimed at the disappearance of rashes.

Additional blood purification methods

To increase the effectiveness of treatment, patients are prescribed the following methods for purifying the blood:

hemosorption;
plasmapheresis;
hemodialysis.

These gravitational blood surgery procedures aim to remove immunoglobulins, toxic compounds and circulating immune complexes from the blood. They are especially recommended for patients with such severe concomitant diseases: hyperthyroidism, etc.

Photochemotherapy

The method of photochemotherapy is aimed at the inactivation of blood cells by irradiating the blood with ultraviolet rays and its parallel interaction with G-methoxypsoralen. After this procedure, the blood is again returned to the vascular bed of the patient. This method of therapy allows you to save the patient from toxic compounds and immunoglobulins accumulated in the blood, which aggravate the course of the disease.

Local therapy

The following remedies can be used to treat lesions on the skin:

ointments based on glucocorticoids;
sprays with local anesthetics(Lidocaine, Xylocaine);
products with aniline dyes: Fukortsin, alcohol solution brilliant green;
baths with potassium permanganate;
treatment of lesions with Curiosin to accelerate tissue regeneration.

Diet

In children under the age of ten, the disease "viral pemphigus" is quite common. It is infectious and, which is easy to determine by name, has viral nature. It is transmitted from sick children by a healthy Coxsackie virus, one of the varieties of enteroviruses.

The disease usually develops in mild form with minor symptoms but no proper treatment long-term complications may appear, especially in a small child. Outbreaks of the disease are more likely to occur during the off-season, as frost and heat can destroy the virus.

Viral pemphigus in children tends to spread rapidly, especially in children's groups.

The disease is contagious: the pathogen from saliva and secretions from wounds is transmitted by coughing, sneezing, through objects.

Bubbles appear on the skin and mucous membranes of the patient, filled with transparent liquid contents. Bubbles cover the mouth, feet, hands, buttocks, genital areas, cause itching, and can merge into larger formations.

A variant of pemphigus called pemphigus occurs in newborns and is bacterial in nature. The cause of skin damage is.

Forms of pemphigus

Enteroviral pemphigus (also called pemphigus vulgaris or pemphigus vulgaris) is not the only form of the disease.

Pemphigus occurs in several other forms:

foliate;
seborrheic;
vegetative.

All of these varieties are characterized common symptom- the appearance of blisters with liquid contents on the skin and mucous membranes.

Viral type

In the viral form of pemphigus, rashes cover the mucous membrane of the mouth, as well as the skin on the legs, arms, buttocks. The fluid-filled blisters itch and itch, then burst and turn into very painful sores. Within a week, the sores are tightened and covered with a crust. After ten days, the symptoms disappear, but the risk of re-infection remains up to several months.

Leaf type

The leaf-like form is characterized by the fact that at the sites of erosion after the opening of the bubbles, layered crusts are formed, resembling leaves in shape. This type of pemphigus usually does not affect the mucous membranes, rashes are localized on the chest, back, scalp. This form of the disease is characterized by a longer period of healing of the formed erosions. The temperature may also rise and the water-salt metabolism may be disturbed.

seborrheic type

With seborrheic form, the vesicles are localized mainly on the scalp. The crusts that cover bursting blisters have a characteristic grayish-yellow color.

Vegetative type

With vegetative pemphigus, foci of rashes are located inside and around the mouth, around the nose, in the folds of the skin, on the genitals. Erosions have an unpleasant odor and serous or purulent plaque.

The blisters often coalesce and form extensive, inflamed areas on the surface of the skin.

Children get sick mainly with the vulgar form of pemphigus. accompanied by an increase in temperature, general malaise and weakness, possible sore throat. However, in severe cases, the disease can become chronic and lead to pathology of the liver, heart, kidneys.

Causes and ways of infection

Pemphigus infectious much more often affects children with reduced immunity(for example, after an illness). In the first ten years of life the immune system a person is in the formative stage, so the chances of getting infected at this age are higher.

A special disease - pemphigus, how it is transmitted, we will consider. Ways of transmission - airborne (coughing and sneezing), contact-household (through the use of shared toys, utensils).

There is also an oral-fecal route if elementary rules hygiene is not respected. The Coxsackie virus, which belongs to enteroviruses, has fallen into one of these pathways and triggers the symptoms of the disease.

In addition to infectious, medical scientists put forward other reasons for the development of pathology:

disturbed autoimmune processes in the body, which manifests itself in the production of antibodies to its own cells and the start of the reaction, affecting the skin and mucous membranes;
a genetic factor (since studies show that hereditary predisposition increases the likelihood of getting sick with viral pemphigus).

Symptoms and course of the disease

Three days after infection, the first symptoms of the disease begin in the form of weakness, lethargy, drowsiness, lack of appetite. After about a week, blisters appear filled with a clear serous fluid.

With their appearance, body temperature rises and can last up to five days. At the first signs of illness, you should consult a doctor.

According to its manifestations in the oral cavity, viral pemphigus is very similar to a sore throat, so accuracy in the diagnosis is important.

If pemphigus is started to be treated like a sore throat, with the help of antibiotics, then there is a possibility of complications in the form of a specific fine-grained rash.

Viral pemphigus begins with the appearance of rashes, mainly in the oral cavity and then spreads to the skin of the extremities. The rash on the hands most often affects the palms, on the legs - the feet. In a more severe form, the rash spreads over the entire skin, capturing the buttocks, perineum, elbows and knees. Bubbles tend to grow and merge, increasing wound surface, and when formed in the mouth lead to the appearance bad smell cause pain while eating.

The bubbles burst, turning into sores. The itching that the baby experiences at the same time makes him comb the wounds, and this threatens with infection. Gradually, during the course of the disease, the ulcers become covered with crusts, which disappear after 2-3 days, leaving practically no traces. With a mild course of the disease, recovery takes an average of ten days.

Diagnostics

The diagnosis is usually made on the basis of a visual examination of the rash at the appointment with a pediatrician, dermatologist or infectious disease specialist. When making a diagnosis, it is important to correctly identify the symptoms of viral pemphigus, separating them from similar manifestations of other viral or bacterial diseases. Coxsackie virus gives a rash with characteristic signs.

Helps clarify the diagnosis additional examination, namely:

cytological examination of scrapings from the affected skin;
a blood test for antibodies;
virological analysis of swabs from the pharynx and fluid taken from the vesicles.

It is important to conduct a thorough differential diagnosis.

Treatment

The treatment of viral pemphigus in children depends on the general condition of the sick child and on the nature of the infection. If the skin is slightly damaged, systemic antiviral drugs are usually not prescribed, and the disease itself goes away after a week and a half.

antipyretic at elevated temperature;
painkillers to relieve pain;
antiseptic gels for the treatment of sores in the mouth;
antihistamine tablets and agents for treating affected areas with severe itching;
solutions of antiseptics for rinsing the mouth;
antimicrobial agents for the treatment of vesicles.

During the period of illness, it is important to drink more (but the drinks should be non-acidic, non-carbonated, not containing a lot of sugar, and also cold).

Proven traditional medicine helps to relieve itching. These are, first of all, lotions for which it is used Fresh Juice from the leaves of plants - aloe, nettle, a mixture of wormwood, yarrow, plantain and lilac. Cotton pads are moistened with cool juice and applied to areas of skin covered with a rash.

Other forms of pemphigus require much more serious therapy. Complex treatment includes cytostatics, hormonal drugs, immunosuppressants. The attending physician may prescribe hemosorption or plasmapheresis (during these procedures, the blood is cleared of antibodies and toxic substances). Sometimes antiviral drugs are used.

Prevention

Contacts of healthy children with a sick child must be completely excluded. A sick baby should have his own dishes, a separate bed, a personal towel. Toys must be disinfected; it is necessary to ventilate the room more often and carry out wet cleaning in it. The rash must be treated only with gloves, after feces, use antiseptic soap to wash the baby.

It is important to teach children to observe the rules of personal hygiene. And most reliable prevention of this viral disease will be the hardening of the baby and other actions to strengthen the immune system. Then he will not be threatened reinfection pemphigus, or other infectious diseases.