Purulent eczema

Patients with purulent eczema should pay attention to the cleanliness of their skin, change and wash their underwear frequently, and do not wash them together with other people's clothes, as this will cause secondary infection. Even if a lot of rashes grow on their skin, they must not scratch them with their hands, as this will only make their symptoms worse and may even cause purulent infection.

The rash is erythematous with clear borders, numerous blisters, pustules or folliculitis, and the surface is covered with purulent or serous secretions and crusts. There is significant inflammation around the lesions, which expands and spreads to the surrounding areas. Sometimes a circle of scales or scales that are about to peel off appears around them, with pus often underneath and swollen nearby lymph nodes. It has the characteristics of self-inoculation, and scratching can cause the lesions to be distributed in a linear manner. It may also occur in areas irritated by secretions, such as behind the ears, under the armpits, and under the breasts. There is itching but it is milder than eczema.

There is a chronic suppurative infection before the rash. The primary focus may be a blister or pustule, or an inflamed papule with scales or crusts, or a moist red spot, which often occurs symmetrically on the exposed part. Sometimes the earliest lesions are ruptured abscesses, furuncles, carbuncles, sinusitis, chronic otitis media, bedsores, fistulas, scabies, or ulcers, or they may be focal infections of the nose, eyes, or vagina. Often when local lesions worsen, erythema, papules, blisters, pustules, and scabs appear on the skin around the infection focus, and gradually spread outward to become patches of eczematous dermatitis that ooze serous pus and have scabs on the surface.

When symptoms are mild or inflammation subsides, the affected area becomes dry and scaly. In severe cases, the affected area may swell, erode, exude, and have obvious erythema, papules, small blisters, pustules and other acute eczematous changes on the periphery, becoming eczematous patchy skin lesions with irregular borders. Regional lymph nodes are often enlarged, and occasionally there is a fever. Generalized dermatitis may also occur elsewhere on the body due to autosensitivity reactions. Some patients often develop linear or strip-shaped eczematous dermatitis due to scratching. The rash is often asymmetrical and has severe itching, but is generally milder than eczema.

First of all, washing and scratching should be prohibited to prevent the lesions from expanding and spreading. Antibiotics are used to clear the primary infection lesions, and antibiotic sensitivity tests can be performed to select sensitive antibiotics. Corticosteroids such as prednisone and methotrexate can be used to quickly relieve severe acute inflammation and stop inappropriate topical medications.

In the case of acute local exudative state, 1:5000-1:8000 potassium permanganate solution or 1:20 compound aluminum sulfate solution (Buro solution) can be used for wet compress. When the exudate decreases, 1% gentian violet solution, gentamicin and other antibiotic solutions, lotions or emulsions can be applied externally. In the case of chronic dermatitis with little exudate, 10% ichthyol ointment, Bactroban ointment, erythromycin, chloramphenicol ointment, etc. can be used externally.