Vesiculopustosis refers to pyoderma, that is, to pustular skin lesions.
As a rule, the disease develops in infants, more often in the first days of life.
With vesiculopustosis, eccrine sweat glands become inflamed. The disease usually develops as a result of untreated chilli in a child.
Vesicular disruption is caused by both gram-positive (staphylococcus, streptococcus) and gram-negative (Klebsiella, Proteus, E. coli) bacteria.
Recently, cases of fungal vesiculopustosis have become known.
In almost 80% of cases, the causes of the disease are staphylococcus. Carriage of staphylococcal infection is widespread among both puerperas and among medical personnel.
Predisposing factors for the development of vesiculopustosis include:
- prematurity (weakened immunity);
- bottle-feeding (through the breast milk, the baby receives antibodies that protect against infections);
- excessive wrapping of the child;
- improper child care (ironed diapers, improper skin treatment);
- overheating and high humidity.
The skin of a newborn baby is too tender and thin; any of the above factors lead to their damage, followed by the addition of infection, and, consequently, to the development of vesiculopusculosis.
Depending on the time of occurrence of the disease, 2 types of vesiculopustosis are distinguished:
Manifestations of vesiculopustosis occur on the first or second day after birth. Accordingly, the infection of the child occurred from the mother with chronic or untreated infections, in utero or in the process of delivery.
Acquired vesiculopustosis develops on the 5-7 day of the baby’s life due to the presence of predisposing factors.
The first manifestation of vesiculopustosis is a pinkish-red rash, which is initially regarded as prickly heat.
In the absence of treatment in the area of the mouths of the sweat glands bubbles appear, ranging in size from a millet seed to a pea, which are filled with a clear liquid.
Bubbles are edged with hyper-immobilized (reddened) roller and after 1-2 days their contents become turbid (purulent) – this is the stage of pustules or pustules.
After a few more days, the pustules either spontaneously open, and sores form in their place, or they dry out and become covered with a crust.
With appropriate treatment after the discharge of crusts and the healing of ulcers, scars or depigmented spots are not formed.
As a rule, pustules are localized in places where there is practically no natural ventilation (in the armpits, in the inguinal and gluteal folds, on the scalp in the occipital region). Pustules tend to proliferate and merge.
The general condition of the child practically does not suffer.
Perhaps a slight, up to subfebrile numbers (37.2-37.3 ° C), an increase in temperature.
With adequate treatment, vesiculopustosis goes away after 7-10 days.
Diagnosis of vesiculopustosis is not difficult (characteristic clinical picture and history).
But in order to ascertain the type of microorganisms that caused vesiculopustosis, they are sowed on nutrient media of biological material (blood, feces, pustules, breast milk). After identification of the pathogen determine its sensitivity to antibiotics.
Serological blood tests and PCR (polymerase chain reaction) method are allowed. But these analyzes are not always reliable and expensive.
The pediatrician deals with the treatment of vesiculopustosis in children.
With the development of complications, the child is hospitalized in an infection ward, where the treatment is already carried out by an infectious diseases doctor.
Uncomplicated vesiculopusculosis is performed on an outpatient basis.
It is strictly forbidden to bathe a child in order to prevent the spread of infection to healthy skin. Skin not involved in the pathological process is treated with weak antiseptic solutions (potassium permanganate solution, furatsillin).
Pustules and sores are burned with aniline dyes (brilliant green or methylene blue) and smeared with antibacterial ointments (lincomycin, heliomycin).
With a common process, penicillin antibiotics are prescribed in age dosages, immunity stimulants, vitamins B, C, A. The entire treatment period takes 7-10 days.
In the case of intractable vesiculopustosis, specific immunomodulators are shown (antistaphylococcal toxoid, gamma globulin, antistaphylococcal plasma).
Physiotherapeutic treatment also has a good effect (ultraviolet radiation, UHF-therapy).
Possible complications of the disease:
- omphalitis (inflammation of the umbilical wound);
- otitis media (inflammation of the middle ear);
- phlegmon (distribution of the process into the subcutaneous fat);
- pseudofurunculosis (purulent inflammation of the sweat glands);
- septicopyemia and sepsis.
The prognosis of vesiculopustosis is favorable and in almost 100% of cases the patients recover.
To prevent the development of the disease it is necessary to observe the following measures:
press diapers on both sides;
baby skin care and baby’s daily toilet (bathing);
stick to breastfeeding;
Do not wrap the child to prevent excessive sweating.