How to treat children's rashes?

Acute rash on children's skin during their growth and development period is a relatively common skin disease. Children's skin needs timely care and treatment after the acute rash appears. You should also pay more attention to the health and hygiene of the skin. Generally, children with acute rashes need to be treated in time. Ointment can be applied on the surface for treatment. Pay more attention to changes in children's skin.

What to do if infantile rash

1. Treatment with medication.

Roseola infantum is mainly caused by internal conflict between wind-heat and heat toxicity. Currently, hospitals mostly use Motrin suspension, which is a liquid and is more suitable for children under 1-2 years old. In addition, you can also take Chinese patent medicines such as Shuanghuanglian oral liquid, Yinqiao Jiedu granules, and pediatric Qingrejiedu oral liquid appropriately.

2. Massage therapy.

While using traditional Chinese medicine for treatment, massage therapy can be used on the child, which is also effective in treating various types of roseola infantum. It is painless and has no side effects, and is easy for children to accept. Parents can push down the Tianzhu bone (i.e. the cervical vertebrae, the technique is to push from top to bottom), rub the Fengchi point and temples, and push the Sanguan and Liufu. It usually takes 2-3 minutes, and massage of one acupoint takes 3-5 minutes. Because the child's skin is tender and easily injured, a certain medium is needed during massage. If the child has a fever, plain water, mint water or talcum powder can be used.

Clinical manifestations

The infection usually occurs in children under 2 years old, especially in children under 1 year old.

1. Fever

The incubation period is 1 to 2 weeks, with an average of 10 days. There are usually no prodromal symptoms and high fever occurs suddenly, with the body temperature above 39℃~40℃, and convulsions may be accompanied by high fever in the early stage. Except for lack of appetite, the general mental state of the children does not change significantly. However, a few children have nausea, vomiting, cough, scleritis, swelling around the mouth and hematuria. Very few have drowsiness and convulsions. The pharynx and tonsils have mild congestion and the head, neck and occipital lymph nodes are slightly swollen, showing high fever that is disproportionate to the mild symptoms and signs.

2. Rash

After 3 to 5 days of fever, the fever suddenly drops and the body temperature returns to normal within 24 hours. A rash appears at the same time or later as the fever subsides. The rash is red maculopapular, scattered, with a diameter ranging from 2 to 5 mm. It fades when pressed and rarely fuses. The rash usually occurs first on the face, neck, and trunk, and then gradually spreads to the proximal extremities. The rash disappears after 1 to 2 days, leaving no trace, no desquamation or pigmentation. Some children may develop erythema on the uvula in the early stage. The rash does not require special treatment and will disappear on its own.

3. Other symptoms

Including eyelid edema, bulging anterior fontanelle, runny nose, diarrhea, loss of appetite, etc. Some children have swollen lymph nodes in the neck.

examine

The diagnosis is mainly based on the detection of serum anti-HHV-6 and anti-HHV-7 antibodies. Virus isolation or PCR (polymerase chain reaction) detection of viral DNA can also be performed.

1. Routine blood test

On the first 1-2 days after the onset of the disease, the white blood cell count may increase, but it will decrease significantly after the rash occurs, while the lymphocyte count will increase, reaching a maximum of over 90%.

2. Virus Isolation

Virus isolation is the diagnostic method for HHV-6 and 7 infections. HHV-6 and 7 can proliferate in fresh cord blood mononuclear cells or adult peripheral blood mononuclear cells. However, substances such as phytohemagglutinin (PHA), IL-2, and dexamethasone need to be added to the culture medium. The infected cells show pathological changes in about 7 days, and the cells are pleomorphic, with karyopyknosis and multinucleated cells. Infected cells can continue to survive for 7 days after developing pathological changes, while uninfected cells die within 7 days of culture. Since virus isolation and culture is time-consuming and not suitable for early diagnosis, it is generally only used in laboratory research.

3. Detection of viral antigens

Viral antigen testing is suitable for early diagnosis, but viremia lasts for a short time, making it difficult to collect specimens in a timely manner. Immunohistochemistry is currently widely used to detect viral antigens in cells and tissues. A positive antigen result can be used as a basis for diagnosis.

4. Determination of viral antibodies

The ELISA method and indirect immunofluorescence method are currently the most commonly used and simplest methods for determining HHV-6 and 7 type IgG and IgM antibodies. Positive IgM antibodies, high titer IgG, and a four-fold increase in IgG antibodies during the recovery period can all indicate the presence of HHV-6, 7 infection. When IgM antibodies or IgG antibodies are detected in cerebrospinal fluid, it indicates the presence of central nervous system infection. IgM antibodies are generally produced 5 days after infection and can last for 2 to 3 weeks. IgG antibodies are produced 7 days after infection, reach a peak after 4 weeks, and can last for a long time. However, due to a certain amount of antigenic cross-talk between herpes viruses, infection with other herpes viruses can also cause an increase in antibodies, which can be identified using anti-complement immunofluorescence tests.

5. Viral nucleic acid detection

HHV-6 and 7 DNA can be detected by nucleic acid hybridization and PCR methods. Because HHV-6 and 7 both have latent infections, sometimes detecting viral DNA does not determine whether it is in a latent or activated state. Quantitative and semi-quantitative PCR can be used to measure the amount of DNA to determine whether there is active infection. High concentrations of viral DNA indicate the presence of active infection.

6. Other auxiliary examinations

No special examination is required for general cases. Chest X-ray, electrocardiogram and other examinations can be performed when necessary.