Rash around a child's mouth. Causes 2-3, 5-6 years, how to treat, what Komarovsky advises

Causes of rashes around the mouth in children

A rash around the mouth in a child of different ages occurs for several reasons:

• excessive salivation;
• violation of hygiene;
• infectious diseases;
• dermatitis;
• helminthic infestation;
• influence of external factors.

A rash around a child’s mouth can be caused by many factors that are important to identify for proper treatment.
Many of these causes are associated with vitamin deficiency and the use of hormonal drugs to treat certain diseases. The impetus for the spread of the rash can be a disruption of the digestive tract. This is both an imperfection of the enzymatic system and functional disorders.

Children of different ages go through several growth spurts. These are the stages of maturation of internal and endocrine organs. Therefore, a rash may appear for some period of time and go away on its own.

Environmental factors

Rash and irritation around a child's mouth often occurs if the skin is exposed to:

• wind;
• ultraviolet radiation;
• humid hot climate.

A baby's skin is very delicate, so it needs to be protected from open sunlight. The result of insolation is the appearance of red spots and rashes. If a child has increased salivation and is outdoors, then when there are gusts of wind, the skin may become chapped, reddened, and covered with dermatological elements.

The increase in symptoms occurs gradually: from the first hours, dry skin appears, then it turns red, and blisters with watery contents appear. When the climate changes or vacations in hot countries, the elements appear due to the onset of excessive work of the sebaceous glands.

Coxsackievirus in children: herpangina and hand-foot-mouth disease

Authors : Medscape Medical News

Among enteroviral diseases, the two most common forms are hand-foot-mouth disease and herpangina.

Atypical manifestations of enterovirus rashes are much less common and can imitate rubella, scarlet fever, Kawasaki disease, sudden exanthema and many other diseases, however, even with an atypical course, upon closer examination the child still has aphthae in the mouth or pharynx, and/or typical dense blisters on flexor surfaces of the palms and feet. It is these typical manifestations that allow a correct diagnosis to be made.

The subject of our consideration will be the typical forms of manifestation of these enteroviral diseases.

HAND-FOOT-MOUTH DISEASE

The name of this disease comes from the English Hand, Foot and Mouth Disease (HFMD).

Hand-foot-mouth disease (HFMD) is caused by the Coxsackievirus, a member of the enterovirus family. HFMD most often affects children under 10 years of age, but people of any age can get the infection.

Symptoms

The disease is manifested by fever (high temperature) and red spots with blisters in the center. Most often, the rash with HFMD is located in the mouth (tongue, gums), arms and legs (hence the name of the disease), but can also affect the buttocks, especially the perianal area, and appear as single elements on any part of the body. Typically, HFMD lasts about 10 days, with incidence typically peaking in late summer and fall.

Contrary to popular belief, your child cannot get HFMD from animals.

Treatment

• There are no antiviral drugs that can suppress enteroviruses.

  
  The body copes with this disease on its own. The essence of treatment is to alleviate the child’s symptoms, prevent dehydration and identify complications.

• A child's fever can be relieved with drugs based on ibuprofen or paracetamol, and they can also be taken to relieve pain in the mouth. You just need to consult your doctor about the optimal dose and method of administering the drug.

Never give your child aspirin without a doctor's permission - aspirin provokes the development of an extremely serious disease - Reye's syndrome.

There are recommendations for the use of lidocaine gels for local anesthesia of ulcers and inflammation in the mouth.

Daily regime

If your child feels tired or sick, you should allow him to rest as much as possible. If the child is energetic and cheerful, then you should not insist on rest; let him play and spend the day as usual.

Nutrition

If a child has painful mouth sores, he or she will likely eat less or stop eating and drinking completely. It is important not only to relieve pain from the rash, but also to offer him pureed, easily digestible foods that do not irritate the oral mucosa. These include yoghurts, puddings, milkshakes, jellies, purees, etc. It's best to eat these foods cool or at room temperature, not hot.

Do not give your child spicy, salty or sour foods. There is no need to feed him citrus juices and carbonated drinks. These fluids can make your child's mouth feel worse. Offer to drink from a cup rather than a bottle—negative sucking pressure also increases pain and promotes mucosal trauma and bleeding. Drinking through a straw is safe - it can be a complete alternative to a bottle, especially for aphthae on the lips and tip of the tongue.

Children's institutions

The child can return to the children's group after normalization of body temperature and general condition, but the main indicator will be the disappearance of elements of the rash. Until this moment, going out in public is not advisable, since the child may be contagious to others.

Contact your doctor if:

• The blisters filled with pus or became sharply painful. This may be a sign of a secondary infection.
• Your child's mouth sores are so painful that he won't open his mouth and completely refuses to eat or drink.

See a doctor immediately or call an ambulance if:

• Your child is dehydrated due to complete refusal to eat or drink. We can talk about dehydration if: the child has not urinated for more than 8 hours
• the baby can feel a sharply sunken fontanel on the head
• baby crying without tears
• his lips are cracked and dry.

GERPANGINA

Herpangina is a viral disease that is caused by the same Coxsackie viruses and is manifested by the formation of painful ulcers (ulcers) in the throat and mouth, as well as severe sore throat and fever.

Herpangina is one of the common childhood infections. It most often occurs in children aged 3 to 10 years, but can affect people in any age group.

Herpangina symptoms:

• Fever
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• Headache
• Loss of appetite
• Sore throat: constant or only when swallowing
• Ulcers in the mouth and throat, which may also be accompanied by isolated rashes on the legs, arms and buttocks (as in hand-foot-mouth disease).
• Aphthae usually range in size from 1 to 6 mm, are white or whitish-gray in color, with a red border around the edges. They can be very painful.

Usually no additional diagnostic methods are required - the doctor makes a diagnosis based on a physical examination and medical history.

Treatment

Treatment and care are similar to those described for hand-foot-mouth disease. Herpangina usually goes away within a week.

As with hand-foot-mouth disease, and with herpangina, the main complications are considered to be dehydration and aseptic meningitis. Therefore, you should closely monitor your child for signs of dehydration and headache levels, and consult a doctor immediately if you suspect complications.

Fortunately, complications are quite rare and most children recover within 10 days.

During a child’s illness, all family members must maintain careful hygiene: wet cleaning more often than usual, using dishes separately, frequently washing their hands and treating them with antiseptics.

published 08/08/2017 07:00 updated 10/08/2017 — Infectious diseases

Neonatal acne in newborns

Newborns include children up to 28 days of life. Some mothers notice irritation on the baby's skin during this period, which makes them worry. This condition is typical for 20-30% of children and refers to physiological phenomena.

A rash around a child’s mouth is a consequence of hormonal changes in the body, which begins to live independently.

The second reason for the phenomenon is the proliferation of yeast-like fungi on the surface of the body, which need sebum for nutrition. Externally, it is not difficult to determine that this is acne of the perinatal period. The elements are pointed, with a white shaft in the center. The contents of the vesicle are viscous, which distinguishes clear discharge from herpes infection or dermatitis.

Unlike other causes of its appearance, newborn acne migrates over the face and neck and is not typical for other parts of the body, as with urticaria and miliaria. In addition, there are no signs of intoxication, which would indicate an infectious process.

Streptoderma in children

Streptococcal impetigo in children

The favorite localization of inflammation in children is the skin of the face, hands and other open areas of the skin.
The disease begins with the appearance on a hyperemic background or externally unchanged skin of the primary morphological element of streptoderma - phlyctena with a diameter of 1 to 2-3 mm, surrounded by an inflammatory rim. At first, phlyctena is a tense vesicle, which soon becomes flabby, and its contents turn from light serous to cloudy or purulent. Subsequently, the conflicts dry out into honey-yellow crusts, after peeling off which a pink spot remains. Individual conflicts can be isolated from each other by areas of healthy skin or increase in size due to growth along the periphery and merge. The development of the elements is accompanied by severe itching, which is why children scratch the skin, spreading the infection to healthy areas where new conflicts form. The duration of streptoderma in children is 3-4 weeks.

Slit-like impetigo in children

This form of streptoderma in children is also called seizure or angular stomatitis. Phlyctens are usually localized in the corners of the mouth, less often - at the wings of the nose or in the corners of the eyes. In place of the opened blisters, shallow cracks, covered with yellowish crusts, form.

This type of streptoderma in children occurs with itching in the mouth, drooling, burning, and pain when eating. The protracted course of slit-like impetigo is promoted by caries, rhinitis, conjunctivitis, and the habit of licking lips. The infection is easily transmitted through kissing and sharing utensils, so familial cases of the disease are common.

Lichen simplex in children

This form of streptoderma in children belongs to the dry variety of streptococcal impetigo, i.e. it occurs without the formation of conflicts. The infection affects the face (perioral area, cheeks, chin), and less commonly, the skin of the trunk and limbs.

In this case, in the lesions, delimited lesions of a round or oval shape, white-pink in color, covered with small dry scales are formed. After exposure to the sun, the elements decrease or disappear completely, but the affected areas of the skin are less pigmented, which is why the skin takes on a mottled appearance.

Dry streptoderma in children usually occurs in the fall or spring, often in the form of epidemic outbreaks in children's groups.

Streptococcal diaper rash in children

With intertriginous streptoderma in children, inflammatory elements are located in the folds of the abdomen, inguinal-femoral, intergluteal, axillary region, and behind the ears. Primary elements - conflicts - merge into wet, eroded surfaces. The lesions have a bright pink color, scalloped borders and a rim along the periphery. Around the main focus there are screenings in the form of individual elements at different stages of evolution (vesicles, pustules, crusts).

Painful cracks and erosions often form in the skin folds, dramatically affecting the child’s well-being. This clinical variant of streptoderma in children is prone to chronicity and is often aggravated by the addition of a secondary fungal infection.

Vulgar ecthyma in children

Vulgar ecthyma in children refers to deep streptoderma of the skin. In most cases, it develops in weakened and often ill children, with poor hygienic skin care, and itchy dermatoses. Elements of streptoderma are localized on the legs, thighs, buttocks, lower back, and less commonly, the upper limbs and torso.

Initially, a phlyctena or pustule with serous-bloody or serous-purulent contents forms at the site of infection, which quickly dries into a soft yellowish-brown crust. When the crust is removed, a deep, painful ulcer is exposed, the bottom of which is covered with a dirty gray coating. After 2–4 weeks, a pigmented scar forms at the site of the ulcer.

Severe forms of ulcerative streptoderma in children include perforating and necrotic (gangrenous) ecthyma: in these cases, ulcers can penetrate deep into the dermis and subcutaneous fat.

The forms of streptoderma discussed above in children are often accompanied by a disturbance in the general condition, fever, and regional lymphadenitis.

Irritation from drooling in infants

Starting at approximately 4 months, the baby begins a period of hypersalivation. Parents notice that the child has a lot of saliva, which hangs like ropes from his mouth. This is due to the start of the salivary glands, although it often coincides with the period of teething.

Physiologists believe that this is a protective mechanism that allows you to get rid of microorganisms that get into your mouth with your hands. Due to the constant damp environment, redness and irritation appear on the chin. Mechanical removal of viscous secretion does not produce results.

Hypersalivation can be caused by pathological conditions:

• oral candidiasis;
• helminthic infestation;
• otitis;
• diseases of the central nervous system;
• intoxication as a result of exposure to heavy metal salts.

If a large amount of saliva appears, pathology must be excluded. You need to blot the skin with a disposable or reusable clean scarf.

Scarlet fever - symptoms and treatment

Early complications

In the case of a severe course with a toxic form, a terrible complication develops - toxic shock .
Purulent-septic complications may occur: peritonsillar (next to the palatine tonsil) abscess, neck phlegmon, purulent otitis and mastoiditis (inflammation of the mastoid process of the temporal bone), sinusitis and sepsis. In these cases, immediate resuscitation and surgical actions are needed. But the most disabling complications are associated with autoimmune reactions when acute rheumatic fever . The full picture includes five symptoms: inflammation of the tissues of the heart, migratory polyarthritis, chorea, annular erythema and rheumatic nodules on the skin. It develops more often in children 7-15 years old, this is due to the epidemiology of scarlet fever and streptococcal infections. In adults, chronic forms are more often detected. According to the State Statistical Report in Russia in 2014, the prevalence of rheumatic fever is:

• 1.8 per 100 thousand children from 0 to 14 years - acute forms;
• 11.8 per 100 thousand children and 118.4 per 100 thousand of the total population are chronic forms [12].

Late complications

Late complications include diseases that are not directly related to the pathogen and are caused by impaired immune response: carditis, arthritis, chorea and glomerulonephritis.

Carditis occurs with inflammation of the heart valves, the mitral and aortic valves are most often affected, valvular insufficiency and regurgitation develop (backflow of blood through the valves). On examination, an organic systolic murmur is heard. Treatment with anti-inflammatory drugs does not always lead to improvement, and in some cases chronic heart disease develops. Against the background of blood volume overload, the symptoms of heart failure intensify. Then the patient requires surgical treatment with valve surgery.

Arthritis is an inflammation of mainly large joints, accompanied by pain, swelling, and stiffness in movement. It is characterized by damage to several joints, most often the knees and ankles, and migratory inflammation. Good response to anti-inflammatory therapy. In case of inadequate treatment and genetic predisposition, a chronic course of arthritis develops with repeated attacks and joint deformation.

Chorea sometimes occurs after 6 months. A person develops gait disturbances, involuntary, uncontrolled movements of the arms, legs, body, and facial expressions, which are usually excessively expressed. From the outside, the condition resembles dancing, hence the name. On examination, muscle tone is reduced, reflexes are animated, sweating is pronounced, temperature is unstable, and excessive emotionality is present. Long-term antibiotics, anti-inflammatory and anticonvulsant drugs are effective in treatment.

PANDAS syndrome stands for Pediatric Neuropsychiatric Autoimmune Disorder. The complication was discovered relatively recently, at the end of the 20th century. The characteristic symptoms of this disorder are obsessive-convulsive seizures. The patient develops obsessive thoughts and movements, motor or vocal tics, emotionality and memory impairment may appear. With antibacterial and immune therapy, improvement occurs, but with repeated streptococcal infection or a stressful situation, the symptoms return.

Glomerulonephritis is an autoimmune kidney disease. Characteristic symptoms are edema, dysuria (impaired urination), hematuria (blood in the urine), increased blood pressure, and renal failure. Assessing a general urinalysis helps in diagnosis, especially with mild symptoms. In therapy, water and salt are limited, antibiotics, diuretics, antihypertensive, anti-inflammatory drugs are used, and in case of renal failure - dialysis [12][13].

Atopic dermatitis or infantile eczema

Atopic dermatitis is a reaction to hazardous foods. Redness can occur on the body in the chest area, arms and neck. If the allergen is not excluded, the elements open up, begin to get wet, and the skin becomes very itchy.

Five foods that cause atopic dermatitis

Genes responsible for predisposition to the development of the disease have been identified. But it can be realized only with an initially low state of immunity. Often, manifestations of pathology begin under the influence of a stress factor. If there are inflammatory skin diseases, traumatic injuries, then this is the entrance gate for infection and allergens.

The cause of the development of dermatitis can be food, respiratory antigens, or the body’s reaction to long-term use of antibiotics.

Tips for proper treatment of atopic dermatitis:

Worms

If a child or parents do not follow hygiene rules and allow contact with street animals, then there is a high probability of worms appearing. This phenomenon is typical not only for children from the category of dysfunctional families, due to their activity and great desire to learn about the world around them. This period usually occurs after 1 year.

You can suspect that the rash is associated specifically with worms by the long-lasting rash, which does not decrease even under the influence of medicinal drugs. After therapy, the phenomena disappear on their own, without additional help. As worms multiply, they cause intoxication. It manifests itself as local allergic reactions.

Children are most often characterized by the appearance of 3 types of helminths:

• pinworms;
• roundworm;
• whipworms.

All these parasites belong to the category of nematodes. With helminthiasis, the rash most often has the appearance of acne.

Allergy

Inflammation of the skin around the mouth often appears as a result of allergies. You can suspect this cause if the child has moved from infancy to the junior preschool group, teeth have already erupted, and the rashes are periodic. This means that the body reacts to certain foods , the rest of the time the immune system functions quietly.

Allergens are divided into several categories, depending on the route of entry. Often with this form of the disorder other symptoms appear: lacrimation, runny nose, swelling of the mucous membranes. The use of anti-cold medications has no effect.

Manifestations and stages

Cheilosis is a common inflammatory problem. When the lip tissue is damaged, signs such as increased dryness and redness, the development of wounds and ulcers, and pain appear. Often develops due to poor ecology, irritation caused by food or chemicals. In some cases, it is caused by other diseases, that is, it acts as a symptom.

The following types of lesions are observed in children:

• traumatic;
• exfoliative;
• contact;
• meteorological;
• grandular and angular cheilitis in children;
• microbial.

The traumatic form occurs due to mechanical, chemical and other influences, after which infection develops. Swelling appears, the mucous membrane becomes tense, and lip movements become limited. In some cases, this type of cheilitis is caused by herpes in the acute stage. For treatment, antibiotics, antiseptics or anti-inflammatory drugs are prescribed.

The exfoliative type of the disease is accompanied by increased dryness and peeling. The reason is a lack of vitamin B, ascorbic or nicotinic acid. The problem arises with dysfunction of the endocrine or nervous system, impaired lip closure, or mouth breathing. Therapy is prescribed depending on the cause of the lesion; multivitamins and softening creams are often used.

Allergic, or contact, cheilitis in most cases develops in adolescents. The causes are chemicals and other external factors. Manifestations of the disease include itching or burning, blisters on the surface, and dryness. To eliminate the problem, you need to avoid contact with the substance that caused the allergy and take antihistamines.

In addition, there are:

• atopic cheilitis in children, which is accompanied by peeling, swelling, erythema and edema;
• hypovitaminosis, characterized by cracks, soreness, the causes are bad habits, for example, frequent licking of lips;
• Eczematous cheilitis is not an independent disease, but one of the symptoms of an inflammatory process affecting the skin.

Perioral dermatitis

Perioral dermatitis occurs mainly in young people, under 20 years of age. People who use hormonal-based cosmetics are at risk. In children, the disorder appears in no more than 5% of all cases, followed by peeling and the appearance of small dotted elements with a white dot in the center. Localization of manifestations is the chin, nasolabial triangle.

As the elements spread, they merge with each other and infection occurs. The rash does not cause significant discomfort or itching. If treatment is not started at an early stage, the skin becomes rough and may change color to brown. Subsequently, the restoration of the normal pale pink color of the cover does not occur.

This type of irritation occurs for several reasons:

• decreased immunity;
• the use of hormonal agents to combat dermatitis;
• allergy;
• hormonal changes;
• skin damage from bacteria;
• vitamin deficiency;
• diseases of the gastrointestinal tract;
• use of fluoride-containing paste;
• disruption of the nervous system;
• prolonged exposure to the sun.

The border between diseased and healthy skin is defined as a thin white film.

Treatment of stomatitis and cheilitis in children

Among diseases of the red border of the lips and oral mucosa in children, the most common are aphthous stomatitis and cheilitis.

Stomatitis, in turn, is divided into acute, subacute and recurrent. The pathological process can be represented by erythematous, vesicular-erosive, ulcerative or necrotic forms. The etiological and pathogenetic causes of stomatitis are very different, including mechanical damage to the oral mucosa.

However, as some authors note, aphthous stomatitis, which has an infectious-allergic nature, is more common. Clinically, it is manifested by the appearance of a round (up to 1 cm in diameter) inflammatory element in the form of a spot with a bubble on the surface, which eventually opens and forms erosion with rounded outlines, very painful, grayish-white or yellowish-gray in color.

The erosion is surrounded by an inflammatory ring; it heals within 1-7 days, leaving no traces. When the infiltrate is located around the salivary gland, the aphtha is represented by an ulcer with infiltrated edges and bottom; it heals within 2 months, leaving behind scars. Relapses of the disease often occur in the spring and autumn. The severity of the disease can increase over time: the number of aphthae increases and the duration of their healing reaches 2-4 weeks, relapses become more frequent. In children, this process is often accompanied by gingivitis and periodontitis.

Cheilitis is more common in children suffering from atopic dermatitis. The process involves the red border of the lips and the skin of the perioral area - this lesion is called atopic cheilitis. The area of ​​the corners of the mouth is most affected, but the process never affects the oral mucosa. Patients initially experience itching, erythema with clear boundaries and swelling of the red border of the lips. Crusts may appear at the site of scratching. The symptoms of acute inflammation quickly subside, giving way to lichenification of the lips. The surface of the red border of the lips peels off with small scales and is cut by thin radial grooves; the skin in the corners of the mouth remains infiltrated for a longer time, which leads to cracks.

Treatment of this pathology, especially in children, should be comprehensive; Particular attention should be paid to the sanitation of foci of chronic infection in the oral cavity. Local therapy should include analgesics, antiseptics and epithelializing agents. Since the effectiveness of conventional drugs used in the treatment of aphthous stomatitis and atopic cheilitis is not high enough, we tried to find a drug that increases the effectiveness of therapy and is approved for use in children. Tablet forms of metronidazole have long been used in the complex treatment of gastritis, gastric and duodenal ulcers in pediatric practice, as well as in the treatment of amoebic dysentery, to stimulate reparative processes. The effectiveness of these drugs is explained by the possibility of influencing Helicobacter pylori and the gastritis caused by it [1].

The effectiveness of metronidazole in the treatment of periodontal diseases has been reported by a large number of authors. The drug turned out to be effective in the treatment of diseases associated with anaerobic flora, protozoa and bacteria; in addition, normalization of obligate flora in the oral cavity was noted [2, 3]. Good tolerability of topical oral metronidazole in combination with systemic antibiotics has also been reported in many studies.

The composition of the Metrogil Dent gel includes metronidazole, which has the above properties, as well as the antiseptic chlorhexidine, effective against gram-negative and gram-positive flora, lipophilic viruses, yeast and dermatophytes [4]. This combination explains the high effectiveness of the gel in the treatment and prevention of infectious diseases of the oral cavity. And since one of the reasons for the occurrence and recurrence of aphthous stomatitis is infection and, in addition, the duration of cheilitis, as a rule, depends on the addition of a secondary infection, the choice of this drug in the treatment of these diseases is the most optimal.

The convenience of using the gel in children is also due to the fact that the auxiliary substances included in its composition are menthol and sodium saccharin, which give the gel a pleasant sweetish menthol taste, and therefore the application of the gel does not cause negative emotions in children.

We use Metrogyl denta gel in the treatment of aphthous stomatitis in children. We observed 19 children with recurrent aphthous stomatitis aged 5 to 16 years. The drug was prescribed 3 times a day for aphthae. After applying the gel, patients were not recommended to rinse their mouths or eat food for 30 minutes. The effect was observed on the second day and was expressed in a decrease in pain and inflammation. Epithelization was observed within 3-5 days. As a rule, the process occurred against the background of diseases of the gastrointestinal tract and oral cavity, most often it was biliary dyskinesia and gingivitis. Thanks to the administration of Metrogil Denta gel for 10 days, 1 time at night, on the gums in 11 children, there was no relapse of the disease for 6 months. In 5 patients, the drug was used for primary aphthous stomatitis against the background of skin pyoderma, the effect was observed on the 3-4th day.

For cheilitis, the drug was prescribed to 15 children aged 5 to 15 years.

The drug was applied to the areas of inflammation 2 times a day, epithelization of the cracks occurred on the 4-5th day, after which the drug was taken once a day in combination with ceralin for 2 weeks. This combination of drugs made it possible to quickly stop acute manifestations of cheilitis, reduce itching and infiltration in the corners of the mouth, which made it possible to avoid the reappearance of cracks.

All patients had good tolerability of the drug, no side effects were observed, and in children of the younger group, application of the drug did not cause any negative emotions.

Based on the above, we can conclude that the use of Metrogil denta gel in the treatment of aphthous stomatitis and atopic cheilitis in children allows you to quickly and effectively cope with the acute manifestations of this pathology, avoid frequent recurrences and the addition of a secondary infection. In this regard, the drug can be recommended for use in pediatric practice as a highly effective remedy for the treatment of stomatitis and cheilitis.

Literature

1. Guide: diagnosis and treatment of internal diseases. Medicine, 1999, vol. 3, p. 88.
2. Ainamo J., Lie T., Ellingsen BH et al. Clinical responses to subgigival application of metronidazol 25% gel compared to the effect of subgigival scaling in adult periodontitis // J. of Clinical Periodontology. 1992. 19P12/: 723-9.
3. Pedrazzoli V., Killian M., Karring T. Comparative clinical and microbiological effect of topical subgigival application of metronidazol 25% dental gel and scaling in the treatment of adult periodontitis // J. of Clinical Periodontology. 1992. 19/9P12/: 715-9.
4. Baby N., Al Jasser N. Subgingival irrigation effect of chlorhexidine or sunguinarine and gingivitis in orthodontic patients // J. of Clinical Pediatric Dentistry. 1996 Spring. 20 (3): 225-8.

Herpes

Decreased immunity can be caused by viral and bacterial infections. Often a sign of unstable functioning of the protective system is a herpetic rash. These are small elements with watery contents. The appearance of herpetic elements in an infant is a very unfavorable sign.

As a rule, infection occurs through direct contact with close relatives during an exacerbation period.

Since immunity is just being formed, innate immunity and protective factors contained in breast milk protect for up to 6 months, herpetic eruptions may indicate congenital pathologies with an immunosuppressive effect.

An exacerbation of the infection is typical after the age of 3 years , when the child begins to visit kindergartens, come into contact with various bacteria and viruses, and enters the social sphere.

Other causes of rash around a child's mouth

If there are no signs of allergies, dermatitis or enterovirus infection, then the appearance of irritation may be associated with individual characteristics of digestion. In this case, the child has unstable stools, a tendency to constipation, and particles of undigested food in the stool. This may occur due to inappropriate nutrition for the child's age.

The most common cause of the disorder is infection. The aggressive factor is staphylococcus, an element of normal microflora. With hypothermia and decreased immunity, it begins to multiply on the skin, causing a pustular rash on the face and other parts of the body.

Fungal flora also reacts to decreased immunity. If the mother had thrush during pregnancy, which was not completely cured at the time of birth, then candida remains on the surface of the body and can appear at any time. A sign of a fungal infection is the presence of white or yellowish patches that peel off when rubbed.

If there is a strong wind outside and the face is not protected, then foci of peeling appear on the chin and in the perioral area. This is caused by chapping of the surface of the skin.

Violation of personal hygiene rules is an additional factor in changes in the condition of the protective cover. If you touch your mouth with unwashed hands, bacteria begin to multiply on the mucous membrane.

Other reasons may be:

• allergy to the latex from which the pacifier is made;
• consequence of vaccination;
• insect bite

The main sign indicating the category of rash is the nature of the rash and the presence of auxiliary symptoms.

What does the color and type of rash indicate?

All types of rash are different. Therefore, the external manifestations of the elements can tell the doctor a lot. A pinpoint rash often indicates an infectious process and intoxication. If it is filled with fluid, it is caused by the herpes virus.

When the rash is detected only in one place, the cause is most often local in nature . If elements appear on the back, arms, neck, then the matter is in internal processes.

Based on the appearance of the manifestations, one can suspect the cause of the phenomenon:

When redness and peeling are observed, this is a sign of the allergic nature of the disorder. If the affected area is large, the specialist suspects toxic erythema. The purulent contents of the vesicle indicate infection, a bacterial complication.

Regardless of the type of rash, they occur on initially intact skin. The intensity and location of the process determine the type of elements. Each characterizes a disruption in the functioning of the entire organism.

Diagnostic methods

A rash around a child’s mouth is classified as belonging to a specific type using the same type of research according to the algorithm:

• general blood analysis;
• immunological study for antibodies to the suspected infection;
• general urine analysis;
• prick allergy test;
• stool analysis for worm eggs.

Since a number of conditions are caused by contact with an allergen, conducting a test reduces the time to search for the type of pathogen. An important type of diagnosis is to examine the nature and color of the rash. He tells you what microorganisms it is caused by.

Symptoms of diathesis

Inflammation of the skin during diathesis is the body's reaction to contact with an allergen. The main way an allergen enters a child’s body is food, but a reaction to contact with the skin of the allergen is also possible (the allergen, for example, can be components of washing powder that get on clothes during washing, plant pollen, dust, animal hair, etc.).

Diathesis in children under 3 months of age

The first manifestations of diathesis most often appear at the age of 2-3 months. This:

• diaper rash that does not disappear even with careful care;
• profuse prickly heat with mild overheating;
• sebaceous crusts of gray-yellow color on the head in the hairline area (seborrhea).

Diathesis in children aged 3 months and older

In older children, a typical manifestation of diathesis is red spots on the cheeks. As the condition worsens, the skin becomes crusty. The crusts become wet, the child experiences discomfort, itches, becomes excitable, sleep and appetite may be disturbed, and loose stools may appear.

Treatment with drugs depends on the cause of the rash

A rash around a child’s mouth is treated taking into account the cause that caused it. There is no universal remedy that would help in all cases.

Some measures help prevent the development of the disorder:

• compliance with hygiene rules;
• early contact with a doctor;
• for dry skin, you need to use nourishing creams;
• before going outside during the cold period, you need to apply a protective cream;
• use only children's clothing and body care products;
• reduce the time a child spends outdoors in the open sun in summer.

Therapy for the disorder must be comprehensive. These are local and systemic remedies. At all stages of treatment, it is necessary to monitor whether the patient’s condition improves. Once the type of pathogen is determined, etiological treatment is prescribed. It involves antibacterial or antiviral treatment that is active against this pathogen.

In most cases, physiotherapy methods are included in therapy. They help improve local blood flow and have an anti-inflammatory effect. The possibility of using alternative medicine should be checked with a doctor.

Methods of treating diathesis

When dealing with diathesis in a young child, the main thing is to choose the right diet, excluding foods that may cause an allergic reaction.

For a child in his first year of life, it is very important to receive breast milk.

The proteins of human milk are easily broken down by the baby's enzymes and are completely devoid of allergic properties. However, a nursing mother must also follow a diet excluding fish, poultry, tomatoes, chocolate, smoked meats, spices and other allergenic foods.

When mixed feeding, the child should not be given some juices: orange, carrot, tomato. Introduce any new product carefully - from a small amount. It is important to prevent an allergic exacerbation, and at the same time, to give the baby’s body everything it needs for its development.

Specialist consultation

The Family Doctor pediatric allergist-immunologist will help you deal with your child’s skin problems, determine the cause of allergies, and also build a rational diet that is suitable specifically for your child.

Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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Folk remedies for treating rashes around a child’s mouth

Traditional medicine has proven itself to be a simple, inexpensive and safe way to cope with various types of problems. It is not always acceptable for young children, due to the high likelihood of allergies to herbs. When a rash appears around the mouth, products with anti-inflammatory and antiseptic effects help.

For example, the following can cope with perioral dermatitis:

• a decoction of string, St. John's wort, chamomile or sage in the form of lotions on the affected areas every 4-5 hours.
• lubricating the elements with propolis boiled in a water bath;
• using a mixture of honey, flax and onion juice, taken in equal volumes, boiled for 10 minutes. and cooled to room temperature;
• using lotions with soda solution (1 tsp per 1 cup of warm water);
• lotions with pulp or juice of fresh pumpkin;
• application of oak bark decoction topically.

Before using any product for the first time, you need to do a sensitivity test. To do this, apply a decoction to an inconspicuous area of ​​skin and wait for 2 hours for the appearance of inflammation.

The following remedies can also help with atopic dermatitis:

• A mixture of rice starch, glycerin and milk, taken in equal proportions and mixed until smooth. Use as an ointment at night and store in the refrigerator.
• Raw, finely grated potatoes, used as a lotion.
• Mix 2 parts of crushed Kalanchoe leaves with 1 honey and stir. The paste is applied 2-3 times a day to the affected areas of the body. This method is effective, but is used with caution due to the high allergenic properties of honey.
• Celery root juice with salt and a few drops of vinegar is applied as a lotion to the skin 3-4 times a day. After 3 years, it is allowed to take 20 ml orally 2 times daily.
• Cucumber juice is applied every 2-3 hours, which helps moisturize the area and relieve inflammation.
• If 1 tsp. Boil chamomile in a water bath with the addition of 100 g of vegetable oil, then the resulting composition can be lubricated on the rash areas up to 3 times a day.

  
  Tar, celandine, mash, potatoes are folk remedies that are used in the fight against atopic dermatitis

If your child has chapped lips and the skin around them, you can try to relieve the pain by using vitamin masks. They are used for shallow damage to the epidermis.

The available means are:

• chamomile ointment prepared at home;
• a mixture of liquid honey, vitamin A and E;
• mask made from sour cream or cream with a high degree of fat;
• Vaseline oil mixed with sea buckthorn and apricot oil.

A rash around the mouth, in the area of ​​the nasolabial triangle in a child often occurs as a result of a combination of several factors. Monitoring the child helps to quickly determine the cause of the disorder, which helps avoid unpleasant consequences and complications.

Author: V.L. Dyleiko

Design: Anna Fleyman

Symptoms

The main signs of the disease are:

• swelling, cracks;
• races forming in the corners of the mouth;
• peeling and dryness, a burning sensation;
• yellow or gray crusts;
• soreness, development of blisters from which pus can be released.

Diagnosis and treatment

The disease has a code of 10–K13.0, which determines the probable causes and symptoms. When the first signs appear, you should contact your dentist and pediatrician, which will help to identify problems in a timely manner, conduct a diagnosis and begin treatment. Early treatment allows therapy to be effective and to avoid worsening.

Treatment of angular cheilitis in children requires complex measures. Depending on the severity of the condition, antibacterial ointments or gels, immunostimulating agents, and multivitamin complexes are prescribed. The diet is adjusted to include more dairy products, fruits and vegetables. If persistent wound formation is observed, antibiotics are required. If there is no improvement, an additional appointment with specialized specialists, for example, a gastroenterologist, dermatologist and others, is recommended. For candidiasis, antifungal drugs are prescribed.

The treatment regimen usually includes:

• topical agents, gels or oil compresses on the affected area;
• anti-inflammatory drugs;
• ointments based on hormonal agents;
• sanitation of the child’s oral cavity;
• antibiotics;
• vitamin complexes;
• eliminating the causes of the disease;
• exclusion of factors that have a negative effect on tissue.

Prevention

The process of inflammation can be prevented by removing or minimizing negative external factors. It is necessary to teach the child to stop licking the corners of the mouth and lips, and to use hygienic lipsticks or gels when dry. For dry skin, it is permissible to use creams intended for children and adolescents.

As a preventive measure, you need to adjust your diet. It is recommended to exclude from the diet sour and spicy foods, too salty dishes that irritate the mucous membrane. It is necessary to increase the amount of non-acidic fruits and vegetables, foods with a high content of riboflavin and iron.

About Us

My Ort Dental Clinic offers services for the treatment of diseases in children. We provide the following benefits:

• offices equipped with modern technical equipment;
• comfortable conditions for Patients of any age;
• qualified children's specialists;
• comprehensive services, including diagnosis, treatment and monitoring of achieved results;
• favorable price.

You can visit us at the address: St. Petersburg, st. Yesenina, 1, building 1. We work seven days a week, you can make an appointment using a convenient form on the website or by phone.