Theiler M, Schwieger-Briel A, Weibel L
Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz.
Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz.
Hautarzt. 2017 Oct;68(10):774-783. doi: 10.1007/s00105-017-4036-y.
Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed.
To illustrate frequent pediatric skin infections and pitfalls in view of imitators and differential diagnoses.
A photo quiz is presented with the discussion of a selection of acute pediatric skin infections in comparison to their infectious or noninfectious differential diagnoses.
The following infectious skin conditions and imitators are described and clinical clues for differentiation highlighted: eczema herpeticum and bacterial superinfection of atopic dermatitis; exanthematous hand, foot and mouth disease and varicella infection; erythema chronicum multilocularis and anular urticaria; Gianotti-Crosti syndrome and Gianotti-Crosti-like reaction; bacterial folliculitis of the scalp and kerion celsi and eosinophilic pustular folliculitis of the scalp; cutaneous Leishmaniasis and idiopathic facial aseptic granuloma; allergic and bacterial lymphangitis; bullous impetigo contagiosa and nonaccidental scalding.
Careful anamnesis and skin examination with attention to the here illustrated differential diagnoses are essential to avoid pitfalls in the evaluation of acute pediatric skin infections.
皮肤感染占小儿皮肤科急诊就诊病例的40%。及时识别可能出现并发症的皮肤感染并开始治疗非常重要。然而,一些特征性的皮肤表现可能会模仿皮肤感染,常常被误诊。
鉴于模仿者和鉴别诊断,阐述常见的小儿皮肤感染及陷阱。
通过图片测验,对一系列急性小儿皮肤感染与其感染性或非感染性鉴别诊断进行讨论。
描述了以下感染性皮肤疾病及其模仿者,并突出了鉴别诊断的临床线索:疱疹样湿疹和特应性皮炎的细菌重叠感染;斑疹性手足口病和水痘感染;慢性多形性红斑和环状荨麻疹; Gianotti-Crosti综合征和Gianotti-Crosti样反应;头皮细菌性毛囊炎、头皮凯尔西蜂窝织炎和嗜酸性脓疱性毛囊炎;皮肤利什曼病和特发性面部无菌性肉芽肿;过敏性和细菌性淋巴管炎;大疱性脓疱病和非意外烫伤。
仔细询问病史并进行皮肤检查,注意此处所示的鉴别诊断,对于避免急性小儿皮肤感染评估中的陷阱至关重要。