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Viral skin lesions (viral dermatoses)

In children, the most common viral skin diseases such as: herpes, warts, molluscum contagiosum, genital warts. In infancy, skin diseases of a viral nature are observed more often after 6-8 months, when antiviral antibodies transmitted by the transplacental route from the mother begin to disappear. Most often, viral dermatoses are observed in children aged 5-8 years. In adults, viral skin diseases account for 3-4%, in children - up to 9.5% of dermatoses.

The pathways of the virus are numerous: through the skin, infected objects, mucous membranes, by airborne droplets. In the absence or reduced immunity, the incubation period ranges from several days to 2-3 weeks.

Shingles (herpes zoster)

The disease causes a neurotropic virus that is identical to the causative agent of chickenpox. Cases of children with chickenpox after contact with a patient with shingles confirm the proximity of these strains. It happens that an adult becomes ill with herpes zoster after contact with children with chickenpox. Overcooling, intoxication, severe blood diseases (leukemia, lymphogranulomatosis), tuberculosis, and diabetes contribute to the disease.

In infants, herpes zoster is rare and leaks easily. But sometimes there are severe generalized forms, accompanied by meningeal phenomena. This is observed if the mother before delivery did not suffer from chickenpox or shingles and transmission of antibodies through the placenta did not occur.

Disease of the mother during pregnancy can lead to intrauterine infection of the fetus and the death of his or her newborn baby.

Clinical manifestations. The incubation period is 7-8 days. Prodromal phenomena are general malaise, itching, burning or pain, a slight increase in temperature, which at the time of the rash rises to 38–39 ° С.

Dermatosis is manifested by rashes of vesicles located on a hyperemic background in areas of the skin, respectively, along the branches of nerves.

The resulting vesicles are strained, with a transparent serous content the size of a pea. After the bubbles merge, lesions with fine-scalloped edges are formed. Vesicular rashes are located asymmetrically along the branches of the affected nerve, most often the location is one-sided.

The following clinical varieties are distinguished:

1) generalized herpes zoster (bilateral, generalized rashes);

2) hemorrhagic lichen, when first the transparent contents of the vesicles become purulent, and then hemorrhagic with a deeper spread of the process into the dermis. With this form, after the completion of the process, cicatricial changes occur;

3) mild (abortive) form;

4) a bullous form, which is characterized by the appearance of large bubbles.

Herpes zoster can be located anywhere on the skin, i.e.
any nerve can be affected. The most common placement is the skin of the head, forehead, eye area and other parts of the face, neck, neck, chest, abdomen, shoulders, hips and buttocks.

An isolated disorder of the oral mucosa is rare, but it is one-sided, which makes it possible to differentiate herpes zoster from simple. Rashes are accompanied by neuralgic pains, which often precede rashes. Bubbles are usually localized on the mucous membrane of the palate, cheeks, lips, tongue.

The greatest danger is the location of the process in the eye area, which leads to ulceration of the cornea and panophthalmia. In children, a severe form with eye damage is not observed.

Other serious complications are paralysis of the trigeminal or facial nerve, and hearing loss. The disease is complicated by meningitis, encephalitis. In people who are weak or suffering from a serious illness, a gangrenous form may appear, in these cases, ulcers form on the site of the rashes, which leave scars.

Affecting people of any age, herpes zoster is rare in young children.

Immunity to herpes zoster, secondary herpes does not occur. But in individuals who suffer from serious diseases that lead to a strong decrease in immunity (cancer, leukemia, AIDS), relapses and common forms can occur. Healing usually occurs by the end of 2-3 weeks, island-inflammatory signs subside, the vesicles turn into brownish-yellow crusts. Subsequently, spots, a decrease in skin turgor or scars remain.

Pain in the rash site does not always correspond to the severity and spread. Soreness is severe, for example, with herpes zoster in the region of the first branch of the trigeminal nerve. In older people, it lasts for months and even after the disappearance of skin rashes.

The disease is differentiated with simple vesicle lichen, herpetic eczema.

Treatment. Prescribe painkillers - analgesics and salicylates simultaneously with vitamins B1, B2, B12 (parenteral); inside - immunostimulants (pentoxyl, methyluracil, sodium nucleinate); y-globulin injections. External treatment is the same as with vesicular lichen. Effective iodoxyuridine in the form of a 0.1% solution or 0.5% ointment for keratitis. Outwardly - 1-2% alcohol solutions of aniline paints, disinfecting ointments, oxolinic, florenal or tebrofenovoe ointment. In severe cases, acyclovir is prescribed orally or intravenously, famciclovir, interferon.

The contact of healthy children with shingles can cause an epidemic outbreak of chickenpox in a children's team.

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Viral skin lesions (viral dermatoses)

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