Cause of pyoderma in a newborn, prevention of pustular rashes

A newborn baby is a big responsibility for young parents. When visiting a pediatrician, parents usually ask a lot of questions. Especially if the child is the first. In my personal top list, feeding and colic take first place. Second - rashes!

In photographs on social networks, babies have clean, rosy cheeks and an angelic smile. And in life, redness, pimples, peeling and other unexpected things appear on the skin. Moms are not ready for this. They get scared and start looking for the reason. Neighbors advise you to follow a diet, grandmothers complain about “bad milk.” If you are unlucky, the doctor will scare you with allergies or prescribe tests, half of which will turn out to be unnecessary.

Let's try to figure out which skin problems in infants do not require treatment and are normal in infancy, and which do not. Let’s agree right away: any rash should be examined by a doctor in person. A diagnosis cannot be made from a photograph, because the doctor examines the elements of the rash, touches it by touch, and sometimes special diagnostic tests are needed. In doubtful cases, the pediatrician gives a referral to a dermatologist.

The information below is given so that young mothers stop being afraid of every pimple, understand conditions that do not require medical attention, and understand when to take their child to the pediatrician.

What does a newborn look like?

If the birth goes well, immediately after the birth of the newborn baby, the mother is placed on her stomach. His skin can be bright pink, or it can be pale, his hands and feet have a bluish tint. This scares young mothers if they have heard or read something about hypoxia and cyanosis before. But if the doctors in the delivery room are calm and do not provide resuscitation measures, then this is a variant of the norm. A healthy child can be like this in the first minutes of life. In addition, the newborn's body is covered with vernix - the baby looks as if it has been smeared with cream cheese. And this is also normal, although unattractive. Lubricant plays an important role in protecting the skin from germs, so the baby’s skin is only lightly blotted without being completely wiped.

5-10 minutes after birth, the newborn’s skin becomes bright pink, almost red. This is a normal condition - physiological erythema . The air pressure is less than the pressure of the fluid in which the baby was in utero. When the skin ceases to experience resistance, blood actively flows to it. The body gets used to the new form of life. Gradually, the blood vessels will narrow, and the skin will become its usual pink color by the end of the week in full-term babies and after 2-3 weeks in premature babies.

How to make an appointment with a doctor

The pediatric department of JSC "Medicine" (clinic of academician Roitberg) in Moscow offers European-level services for the diagnosis, treatment and prevention of boils in children. To receive highly qualified medical care, you must make an appointment with a pediatrician who will conduct an examination and comprehensive medical examination of the child. If necessary, the pediatrician will consult with or refer other specialists.

To make an appointment with a specialist in the pediatric department of JSC "Medicine" (clinic of academician Roitberg), use one of the following methods:

• quick registration form on the website;
• by telephone 24/7;
• using a mobile application.

Our clinic is located in the center of Moscow at the address: 2nd Tverskoy-Yamskaya lane, 10, a five-minute walk from the Mayakovskaya metro station, as well as not far from the Belorusskaya, Tverskaya, Chekhovskaya and Novoslobodskaya metro stations.

Marbled leather

During the first month of life, a baby's skin sometimes looks marbled. A uniform mesh pattern of white, purple, and reddish spots is the reaction of skin vessels to cold. Therefore, this phenomenon is most often noticed during swaddling. If the marbling is symmetrical and disappears when warmed, then there is no cause for concern. In other cases, it is worth discussing this symptom with your pediatrician so as not to miss the early diagnosis of diseases of the heart, lungs or skin itself.

Peeling

On the second or third day after birth, the newborn’s skin begins to peel off. Peeling is observed in everyone, but to varying degrees of severity. Most severe if the baby is post-term. The reason is the same restructuring of the body to exist in the air. The skin loses moisture, and the top layer gradually peels off. Physiological peeling does not require treatment and goes away on its own within a few days.

If the peeling is profuse and leads to deep cracks, the skin is lubricated with special moisturizers - emollients. In case of pronounced peeling, it is necessary to exclude congenital skin diseases such as ichthyosis, hyperkeratosis and others.

Erythema toxicum

By the second or third day of life, 70% of full-term newborns develop a small red rash on the skin. Rarely, this condition occurs in premature babies. First, spots appear, and within an hour a yellow bump 1-2 mm in size forms in the center. Elements of the rash are located on the face, torso, arms and legs, and can merge with each other. The cause of erythema toxicum is unknown, but the rash goes away without treatment in 1-7 days and is not dangerous.

If the clinical picture is atypical or other symptoms are present, the doctor will prescribe additional examination to rule out other causes of the rash, such as infection.

Probable pathological diseases

The following types of possible diseases are distinguished:

1. Staphylococcus aureus causes blistering rashes from 1 to 2 weeks of life. Papules with liquid sometimes reach 1-2 centimeters. When they burst, erosion occurs. The little one becomes restless. The doctor prescribes antibiotics and anti-inflammatory ointments. Lack of treatment leads to pneumonia, otitis, and abscesses.
2. Intestinal dysbiosis is characterized by large pimples on the face of a baby. When the disease is eliminated, the ulcers go away on their own.
3. Airborne diseases occur in children in the same way as in older children. You don’t have to leave the house to become infected; anyone can bring the infection, including the baby’s mother or father.

Newborn acne

20% of newborns develop a rash similar to teenage acne from the third week of life. Small pustules surrounded by a red halo. They are located on the face, head, chest, shoulders, and less often on the stomach. The condition is called “acne,” although in the literature the term “cephalic pustulosis” (from the words “cephalo” - head and “pustule” - abscess) or “neonatal pustulosis” is more often used. The main two reasons are the influence of maternal hormones during breastfeeding and the colonization of the skin by microorganisms. Elements of the rash resolve without treatment after 1-3 months. This condition is not dangerous, does not cause discomfort to the child and leads to independent recovery, so there is no need to prescribe medications. The exception is severe cases when the rash is profuse, leads to secondary infection or heals with the formation of scars.

Types of rashes

A purulent rash covers the body of a newborn if pathological microorganisms penetrate his body.

• Pathological. The main factor in their appearance is various kinds of infections that have entered the baby’s body. Purulent pimples appear on the newborn’s face, on the back and tummy, and under the arms. They are absent only on the child’s palms and feet. A pustular rash caused by pathogens is characterized by an increase in pimples and their transformation into blisters. Fluid-filled blisters often burst and develop into erosion. Such rashes need to be treated with medication.
• Toxic acne. Small red acne occurs in infants due to hormonal imbalances in mothers during pregnancy or due to increased oil production by the sebaceous glands. Red, white and yellowish small pimples appear on the baby's head, face, and palms. A white pimple resembles an abscess, like in adults and teenagers. Such pustules on the face go away without intervention, but with sufficient care they disappear on their own after a few days.

Infant acne

The same rash in children after three months of age is called infant acne. It persists as persistent acne of newborns or reappears at 2-3 months. It differs from newborn acne only in the age of the children and the duration of the rash. Self-resolution occurs within 6-12 months. Infantile acne may be a risk factor for acne during adolescence.

Prickly heat

Develops in children from the second week of life when overheated. The rash has different manifestations: small red spots, nodules, pustules or blisters in the thickness of the skin. Miliaria can occur on any part of the body: in the folds, on the face, scalp, torso, arms and legs. The cause of the rash is blockage of the sweat glands.

There are several factors contributing to this:

• high room temperature;
• increased body temperature in a child;
• thick clothing, non-breathable fabric, for example, an oilcloth mattress cover;
• lying in one position for a long time.

Treatment consists of general care:

• daily bathing without soap and other chemicals;
• using lighter and looser clothing;
• maintaining the air temperature in the room at 22-24 degrees C;
• ventilation.

When these conditions are met, prickly heat disappears within a few hours. The recommendations listed above also apply to prevention.

For walks outside, the child is dressed like an adult plus one layer of clothing. No need to re-wrap. There is also no need to wear a cap in warm weather.

During the cold season, undress your child during a long stay in a store, shopping center or other premises. While awake, place your baby on his stomach and hold him vertically in your arms to diversify his movements.

Causes of boils

The skin has a lot of sebaceous, sweat glands, and hair follicles. Hair follicles are surrounded by subcutaneous fatty tissue. If an infection gets into the skin, then the development of an acute inflammatory process begins, which is expressed as a boil. If a boil appears not in one, but in many places, then this process is called furunculosis. A boil can occur in parallel with diseases such as hypovitaminosis, diseases of the digestive system, diabetes, malnutrition, a weakened immune system, and frequent hypothermia.

Diaper rash

A more serious skin reaction to overheating is diaper rash. Occurs in natural folds. It looks like redness, sometimes with weeping and erosion. With a long process, a bacterial or fungal infection may develop, then the surface of the affected skin is moist, bright red, with clear or purulent discharge. Prevention measures are the same as for prickly heat.

The skin in the folds is treated with powders. If normalizing the microclimate and caring for the newborn does not lead to a reduction in diaper rash, you should see a doctor. If complications occur, antibiotic therapy or topical steroid ointments may be needed.

Symptoms

Gingivitis has a main symptom by which it is easily identified - inflammation affecting the child’s gums. The process begins with a slight redness that quickly gains strength. This signal often goes unnoticed by parents, and children go to the dentist with an active inflammatory process, bright red swollen gums, burning, and pain. These signs indicate that the disease has entered an acute phase.

Children suffer most from the catarrhal form of this disease, which can be chronic or acute. In the first case, the symptoms are not pronounced, pain occurs only when brushing, there is slight swelling, redness, and cyanosis of the gums.

A sign of an acute form of the disease is intoxication of the child’s body. It manifests itself as headache, nausea, lethargy, and fever.

The most complex type of disease, ulcerative gingivitis, manifests itself as follows:

• the inflammatory process progresses;
• their structure changes;
• there is an unpleasant odor from the mouth;
• lymph nodes in the neck enlarge;
• saliva is produced profusely;
• the skin turns pale.

If these signs are left unattended, an ulcerative-necrotic form of the disease may occur, when necrotic areas with a gray-green coating and a putrid odor appear on the gums, saliva becomes viscous, body temperature rises and the general condition significantly worsens.. All this indicates severe intoxication in organism.

During puberty in a teenager or if he has problems with hormones, hypertrophic gingivitis occurs. It occurs due to improper orthodontic treatment of dental anomalies. The inflammatory process is accompanied by increased growth of gingival tissue, which leads to partial closure of dental crowns. This form of the disease is usually localized. One or two gums are affected, sometimes the affected area expands. The most common location is the lower anterior incisors and canines.

Atrophic gingivitis does not have a pronounced inflammatory process and occurs without pain, although over time it can be complicated by periodontal disease.

Diaper dermatitis

The distinctive feature of this rash is that it appears only in the area under the diaper, other areas of the body remain clean. The reason is increased humidity and irritating feces.

The rash is found in the buttocks, thighs, lower abdomen in the form of individual elements or continuous areas of changed skin. The elements of the rash are varied: red spots, bumps, pustules or peeling.

To alleviate the condition, you need to change the diaper and wash the baby immediately after bowel movement. While changing clothes, you can arrange air baths, that is, leave the child to lie naked, you can cover it with a regular dry diaper. Lubricate the skin with a special diaper cream.

Change the diaper every 3 hours, even if it is only slightly full. More often when very full. If these measures are ineffective, you should consult a doctor. Local glucocorticoid agents may be needed.

Seborrheic dermatitis

Appears in infants soon after birth and lasts up to a year. Yellow scales and peeling are most often located on the scalp and behind the ears, but can also be in other folds - axillary, elbow, inguinal. In everyday life they are called “milk crusts”. Because of its similarities to atopic dermatitis, seborrhea is sometimes considered a manifestation of allergies. The causes of this condition are not fully understood, but the relationship with allergies has not been identified.

Seborrhea goes away without treatment, in most cases in the first year of life. Unlike atopic dermatitis, the rash does not cause itching and does not cause discomfort to the child. If for the sake of aesthetics you want to get rid of seborrheic crusts, before bathing the baby’s head is lubricated with oil and then combed out with a soft comb.

In doubtful cases, when seborrhea is located on the body, it makes sense to consult a doctor to clarify the diagnosis.

Causes of gingivitis in children

There are many causes for childhood gingivitis. The gums become inflamed due to the functional immaturity of their tissues. In babies under one year of age, the cause of the disease is often teething, when the gums become red and sore. Sometimes inflammation is caused by an allergic reaction to food.

In adolescents, the disease may manifest itself due to the eruption of a permanent tooth. When soreness during brushing does not allow this procedure to be performed efficiently, microbes multiply and gum inflammation develops.

The most common factors that provoke the development of gingivitis in older children are:

Action of microbes

In 90% of cases, the disease appears in a child due to insufficient oral hygiene, as a result of which microorganisms multiply intensively, plaque and tartar form, and stomatitis develops.

Mechanical injury

The integrity of the mucous cavity can be compromised by teething, cuts, scratches, burns, biting, improper brushing of teeth, and eating solid foods.

Foci of infection in the oral cavity

If children have carious teeth, there is a chance that they will develop infectious gingivitis, which affects the gums. Therefore, teeth that require treatment must be treated as soon as possible.

Excessive loads on the dental system

Other causes of gum damage in children may include:

• presence of malocclusion;
• poor nutrition with a lack of vegetables and fruits;
• uneven load on the dental system due to bad habits;
• defects of the oral cavity (short frenulum of the tongue, lips);
• the presence of caries, various infections;
• thermal burn from hot food;
• wearing braces.

Atopic dermatitis

This is a chronic inflammatory skin disease. It occurs in 15% of children, of whom two thirds experience the first symptoms before one year of age, sometimes even in infancy. The rash appears on the face, torso, and extensor surfaces of the arms and legs. There may be redness, peeling, crusts, and when scratching, infection and the presence of pustules may occur. Elements of the rash itch and bother the child.

Only 30% of children have atopic dermatitis associated with food allergies. Therefore, a nursing mother does not always need a diet.

The cause of atopic dermatitis is increased skin permeability. For treatment, first of all, creams that restore barrier function are used. They are called emollients. There are quite a few brands that produce such products. The choice is based on personal preference. From a medical point of view, there is no advantage to any particular drug.

If you suspect atopic dermatitis, you need to see a doctor to clarify the diagnosis and receive recommendations for treatment. You can contact your pediatrician or dermatologist. If the diagnosis is confirmed, keep in mind: treatment will be long. It includes skin care and constant use of emollients; in more severe cases, hormonal ointments may be needed; for food allergies, a diet. It is important to understand that with strict implementation of the recommendations, stable long-term remission can be achieved.

Treatment

Treatment for childhood gingivitis is practically no different from how adults are treated. Only medications used for them are softer and more gentle. Treatment begins with professional cleaning of hard deposits and plaque of tooth enamel - mechanical or ultrasonic.

If caries is detected during the examination, then therapeutic treatment is carried out. Gingivitis is then treated with medications with antiseptic and anti-inflammatory properties. Measures are taken to eliminate detected pathologies (bite, frenulum, etc. are corrected).

Ointments and gels are considered effective for children under 4 years of age. For example, Cholisal ointment has analgesic and anti-inflammatory properties, which makes it possible to prescribe it to alleviate the patient’s condition, especially when baby or permanent teeth are cutting. Ointments and gels are applied directly to the inflamed area.

Antibiotics in tablets or in the form of injections are prescribed to children in difficult cases (the presence of infections of bacterial origin in the body). At elevated temperatures, rinses, drinking plenty of fluids, antioxidants, antipyretic drugs for children, and taking vitamins are prescribed.

Prevention measures should include regular visits to the pediatric dentist, training in oral care rules, and parental monitoring of the development of hygiene skills.

Mastocytosis

A rare disease that can appear at an early age, sometimes even from birth. Outwardly, it resembles allergic urticaria, but spots and blisters last longer, and when the exacerbation subsides, pigmentation remains. A typical diagnostic test is the appearance of blisters on the skin due to mechanical irritation of areas of pigmentation.

Treatment for childhood forms of the disease is not required; recovery occurs spontaneously within several months, sometimes several years. If itching is present, antihistamines are used.

Diagnostic methods

The diagnosis is made by a doctor based on the results of studying the medical history and life of the child in combination with a dental examination. The patient’s complaints, the presence of somatic diseases, and whether he is taking medications that may cause the development of gingivitis are clarified.

Then the doctor conducts an external examination, paying attention to maxillofacial anomalies, the condition of the teeth and gums, and makes a diagnosis. The dentist does not require the help of other specialists, since the disease clearly manifests itself externally and does not require instrumental examination.

Infantile hemangioma

Hemangioma is a benign tumor of endothelial cells (endothelium is the inner lining of blood vessels). It may be congenital or appear at 1-2 weeks of life. Superficial hemangiomas are bright red and protrude above the surface of the skin. Deep - blue-purple, sometimes warm to the touch. The element size ranges from a few millimeters to an entire anatomical area (hand, buttock, etc.). In the first 5-6 months, the hemangioma may increase in size and become brighter, then the growth ends and spontaneous regression begins.

Up to 90% of hemangiomas can resolve without treatment.

In this regard, surgical treatment is no longer used routinely. The child is observed by a pediatrician and a surgeon; if hemangiomas are located on the face and neck, in the genital area and near large vessels, conservative treatment is prescribed. The operation is indicated only if it is ineffective.

How to treat a purulent pimple

A surgeon treats abscesses in children. The difficulty for a doctor is to find a common language with a small patient and attract his attention.

The first stage of treatment is diagnosis. You need to donate blood and urine for tests. Afterwards, taking into account the patient’s well-being, the operation begins.

If the abscess is located in an internal organ, abdominal surgery is required. Such an intervention is difficult for the body to tolerate. Other removal methods have been developed. Using ultrasound, a needle is inserted into the cavity and the pus is removed. Afterwards enzymes or antibiotics are administered. But such operations are rarely performed; the classic version gives better results.

READ ALSO: How to distinguish a boil from other skin formations and diseases

The safest method in terms of complications is excision within healthy tissue. There is no infected wound, the skin is treated with antiseptics, the abscess is cut out without opening the pyogenic membrane. Then stitches are applied. There is no risk of infection spreading, the wound heals faster, and the cosmetic defect is less noticeable. When cosmetic stitches are used, the scars are almost invisible.

The tissues of the child’s body are plastic, wounds heal faster.

After removing the pus, general therapy is carried out. Various groups of drugs are prescribed: antibiotics, vitamins, blood substitutes.

In the case of furunculosis, when multiple abscessed pimples form, immunostimulating therapy is recommended. This is what an immunologist does. Before treating abscesses, a study of the immune status of the child’s body is carried out.

Vascular abnormalities

Congenital anomalies of vascular structure are varied

1. A simple nevus is a capillary anomaly. It appears as a pale pink spot or several small spots. The common name “stork bite” or “angel kiss” arose due to its location on the back of the neck and head, on the forehead, bridge of the nose and upper eyelids. The spots fade by the age of two, but can appear when crying or physical activity. No treatment required.
2. Port wine stain or flaming nevus. A dark red spot that looks like a hemangioma. It may be one of the manifestations of pathological syndromes. Lasts for a long time. Treatment is not necessary, but can be done if the spot creates a cosmetic defect.
3. Venous anomaly - blue-violet painful nodules under the skin. They can also masquerade as a hemangioma. Occur alone or in combination with other anomalies. The danger lies in the possibility of thrombosis of the altered veins. Treatment consists of wearing compression clothing and using aspirin to prevent blood clots. Surgical excision is possible.
4. More rare lymphatic, arteriovenous and combined anomalies are found as part of various pathological syndromes.