[新生儿皮炎:在阿比让一所大学医院收集的约 116 个病例]。

Le Mali medical Pub Date : 2022-01-01
Y I Kouassi, K C Ahogo, H S Kourouma, K A Kouassi, K M Koko, Kkp Gbandama, A S Allou, K Kouame, K Kassi, M Kaloga, E J Ecra, I P Gbery, A Sangare
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引用次数: 0

摘要

目的:确定新生儿皮炎的流行病学特征,并描述所观察到的新生儿皮炎的不同临床表现:研究在科科迪大学医院(阿比让)进行。该研究为横断面、描述性和分析性研究,在前瞻性招募的基础上进行。研究对象包括2018年4月4日至2018年8月23日期间在门诊或住院环境中就诊的新生儿,儿科医生在这些新生儿身上观察到皮肤和/或粘膜病变。诊断是在皮肤科医生的合作下做出的:在研究期间,共发现了 116 名新生儿。在儿科就诊的皮炎患者年龄从 1 天到 28 天不等,平均为 16.86 ± 8.4 天。中位年龄为 19 天。最具代表性的年龄范围(32.8%)为 24-28 天。性别比例(男/女)为 1。近三分之二的病例中,婴儿是足月出生的,29.3%为早产儿,5.2%为过期产儿。在儿科就诊的新生儿中,只有 3.4% 因皮炎而被转诊。就诊时皮损的年龄从 1 天到 26 天不等,平均为 06.19 天 ± 5.13 天。半数以上(53.5%)的病例皮损发展时间不足 5 天。一过性皮炎的发病率较高(51.7%),其次是感染性皮炎(32.8%)。新生儿短暂性皮炎主要是汗疱疹(40%)。感染性皮炎主要是霉菌感染(68.4%)和细菌感染(31.9%)。细菌性皮炎包括新生儿脓疱疮(83.3%)和毛囊炎(16.7%)。近一半(46.1%)的霉菌性皮炎以念珠菌性唇炎为代表,38.5%的病例伴有口腔念珠菌病。其他新生儿皮炎主要是尿布疹(64.3%)(照片 2)和先天性痣(21.5%)。半数以上(57.1%)的新生儿中毒性红斑发生在出生后第 6 到 10 天。近一半(41.6%)的淤血性红斑发生在出生后至第 5 天之间。超过一半(57.1%)的皮脂腺增生病例发生在出生后第 5 天之前。所有新生儿鳞屑和蒙古斑病例都是在出生后到第 5 天之间出现的。一过性皮炎患者的平均年龄为 14.31 天,而其他皮炎患者的平均年龄为 19.41 天。年龄差异具有统计学意义(P < 0.05)。短暂性皮炎主要发生在男新生儿身上,而其他皮炎主要发生在女新生儿身上,但性别差异无统计学意义(P > 0.05):结论:新生儿皮炎的诊断并不总是很明显,尤其是在黑色皮肤上,这方面的出版物很少。
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[Newborns dermatitis: about 116 cases collected in a university hospital in abidjan].

Aims: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis.

Procedure: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist.

Results: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05).

Conclusion: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published.

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