How Do I Recognize Pus from Herpes?

Herpes impetigo is a severe skin disease that often occurs in pregnant women. The basic damage is the appearance of aseptic pustules on the basis of erythema, often with severe systemic symptoms. Gradually relieves after childbirth, relapse can relapse. Although the disease is rare, it is more serious and can be life-threatening. In severe cases, there are more obvious systemic symptoms, hypocalcemia, and hand-foot convulsions. Herpes-like pustular disease, pustular psoriasis, and continuous acral dermatitis are generally considered to be the same aseptic pustular disease.

Basic Information

English name

impetigo herpetiformis

Visiting department

dermatology

Multiple groups

Pregnant woman

Common locations

skin

Common causes

Endocrine disorders such as hypoparathyroidism may be related

Common symptoms

Sterile pustules on the basis of erythema

Causes of herpes-like impetigo

The cause is unknown, and pregnancy may be the predisposing factor. Because of the typical hand-foot convulsions caused by hypocalcemia, it is speculated that the pathogenesis may be related to endocrine disorders such as hypoparathyroidism. This disease is also seen in taking compound norethindrone tablets (also known as short-acting contraceptives I for a long time). No., consisting of ethinyl estradiol and norethisterone), is not a disease specific to pregnant women.

Clinical manifestations of herpes-like impetigo

The disease mostly occurs 3 months after pregnancy, and the condition gradually relieves after childbirth. It can also recur when pregnant again.

Sudden onset of disease, initially in the skin folds (such as the axilla, lower breasts, groin, umbilicus, limb flexion, external genitalia, etc.), a large area of acute inflammatory erythema suddenly appeared in the epidermis, and then clustered, superficial small Pustules are pinpoint to millet-sized, yellow-white, often arranged in a flower-like, semi-ringy, or map-like pattern. Simple lesions can also merge with each other to form a large area of pus lake. The skin lesions were mildly itchy, and the pustules became dry and crusted for several days and days, and new skin lesions appeared around the old lesions. Once the crusts fall off, moist, red and shiny areas, namely genital wart-like skin lesions, are eventually cured by deep pigmentation in epithelial repair. In severe cases, it can be seen that the skin lesions are widespread throughout the body, accompanied by chills, relaxation-type fever, Vomiting, diarrhea, delirium and other systemic symptoms can affect the buccal mucosa, tongue, pharynx, and esophageal mucosa are often affected, forming pustules or erosions, gray patches, and sometimes affect eating due to severe pain in swallowing.

Herpes-like impetigo examination

Histopathology showed pustular psoriasis. Peripheral white blood cell count increased, erythrocyte sedimentation increased, hypocalcemia and hypoproteinemia.

Diagnosis of herpes-like impetigo

According to pregnant women in late pregnancy, most of the yellow-white clusters of pustules in a flower-like arrangement appear on the basis of erythema at the skin folds, accompanied by more severe systemic symptoms, combined with pathological changes of the skin tissue, and no difficulty in diagnosis.

Differential diagnosis of herpes-like impetigo

It should be noted that herpes-like pustular pustules are sterile, which distinguishes them from pustules caused by other causes during pregnancy. Sometimes it is not easy to distinguish from pustular psoriasis, which is characteristic of the hands and fingers, and has a tendency to desquamation. It should also be distinguished from pemphigoid, which is a pea-to-walnut-sized blister that appears on the normal skin surface and is easy to identify. In addition, it should be distinguished from pregnancy herpes (polymorphous rash, mainly blister, no systemic symptoms).

Herpes-like impetigo complications

Onset during pregnancy, persistent high fever is extremely detrimental to the fetus, often leading to miscarriage, premature delivery or even stillbirth and stillbirth. Severe cases of pregnant women can also die due to long-term high fever, heart failure, kidney failure, and general failure.

Herpes-like impetigo treatment

Active treatment to protect the fetus and reduce its mortality. For patients with herpes-like impetigo, special care should be given and changes in the condition closely monitored. Suffering pregnant women should focus on supportive therapy, and those with high fever should promptly replenish fluids and heat energy; transfusion of plasma to enhance the body's resistance; patients with hand-foot convulsions who have been diagnosed with hypocalcemia by laboratory tests should be given a slow intravenous injection of 10% gluconate Calcium, if necessary, slowly intravenously after 4 hours. Hypoproteinemia, body fluid loss and infection should be treated accordingly.

Treatment is mainly given orally with glucocorticoids. Corticosteroids have a good effect on this disease, but pregnant women should not be used as the drug of choice, unless the condition is severe, prednisone can be used, and gradually reduced after the condition is controlled.

Due to the serious damage to the mother and child, and the high mortality rate of the mother and child, once the onset should be considered abortion or induction of labor and early termination of pregnancy. Pustules can gradually resolve after childbirth, and termination of pregnancy itself is also a treatment.

Herpes-like impetigo prognosis

Pregnant women can often have miscarriages, stillbirths, or deaths within a few days after birth. Postpartum illness recovers, and the next pregnancy can recur.

Herpes-like impetigo prevention

Strengthen oral care and skin care for sick pregnant women to prevent complications. Although the pus in the pustules is sterile, prophylactic broad-spectrum antibiotics are still used.