Introduction: Acute febrile neutrophilic dermatosis, also known as Sweet syndrome, is a reactive skin disease characterized by fever, increased number of white blood cells, red papules, nodules and plaques, and neutrophil infiltration, which pervades the upper dermis. The cause is unclear, but it is more common in middle-aged and older women, but can also occur in infants and even newborns. Predominantly fever, acute episodic pain, red papules, plaques or nodules. The disease is mainly treated with drugs, and some patients can relieve their symptoms on their own.
First, what symptoms may be shown by the affected population of the disease? Most patients may not be very serious
(1) Review of symptoms
The typical symptoms of acute febrile neutrophilic dermatosis are acute onsets of red to purple papules, nodules, and plaques on the face, neck, upper part of the trunk, and extremities. It is accompanied by symptoms such as fever, arthralgia, myalgia and so on. The four different clinical presentations are very similar.
(2) Characteristic symptoms
1. Classic or specific hairstyle
Lesions on the face, neck, upper body and extremities are better. May be asymmetrically distributed, single or multiple. Manifests as clear red to purple painful papules, nodules, plaques in a rapidly developed state. Papules and nodules gradually expand and increase, fuse to form plaques, deepen in color, increase pain, flattened and raised, 2 to 10 cm in diameter, clear and steep edges, and flaky or coarsely granular dermis, such as pseudo-blisters. As neutrophils enter the epidermis, the surface of the local plaque is scattered, forming needle-tip-sized blisters or pustules, with scars on the surface but no erosions or ulcers, which are hard to the touch and tactile. After 1 to 2 months, the lesion resolves spontaneously, there is no scar on the part, and temporary pigmentation may be seen.
2. Pregnancy-related types
Skin lesions mostly occur on the head, neck and trunk, the upper limbs are less common, the lower limbs may appear nodular erythema, which can disappear automatically, and the next pregnancy can be re-pregnancy.
3. Accompanying symptoms
(1) Most patients are accompanied by fever and discomfort.
(2) Some patients may be accompanied by joint pain and muscle pain.
(3) The disease can be combined with conjunctivitis or superficial scleritis, and can also affect the kidneys, manifested as proteinuria, hematuria, and granular casturia.
(4) Comorbidities include arthritis, multifocal aseptic osteomyelitis, etc.
Second, after suffering from this disease, what kind of treatment does our body need to receive? Here are a few things to keep in mind
(1) Expected inspection
The patient has red to purple painful papules, nodules, plaques on the face, neck, trunk, upper limbs and other parts, accompanied by fever, and needs to seek medical attention in time. After the consultation, the doctor will first perform a physical examination of the patient to observe the skin condition, and then may recommend that the patient have a blood test, a urine routine, an X-ray, a CT and a pathological examination to further clarify the diagnosis.
(2) Physical examination
1. Visual consultation: Physicians mainly observe the color, shape, size, quantity and location of skin lesions through the naked eye.
2. Palpation: After hand disinfection, warm your hands for palpation examination, mainly check the skin texture, whether there is tenderness, etc.
(3) Laboratory examination
1. Blood test: the number of peripheral blood leukocytes increases significantly, the proportion of neutrophils increases, platelets decrease, and the rate of sedimentation rate is accelerated.
2. Urinalysis: renal damage may cause proteinuria, hematuria, and granular cast abnormalities.
(4) Analysis principles
The physician will ask the patient's medical history to find out whether the patient has an infection, whether he has medication experience, or a history of tumors, and according to the patient's clinical manifestations, combined with blood tests, urinalysis, X-rays, CT, pathological examinations and other auxiliary examination results, in order to confirm the diagnosis.
(5) Treatment principle
Acute febrile neutrophilic dermatosis, which is mainly based on drug therapy, usually has poor efficacy of antibiotic therapy, and the systematic use of glucocorticoids is more effective. Some patients have symptoms that resolve spontaneously and do not require treatment.
(6) Drug treatment
1. Glucocorticoids
Frequent oral medications resolve with fever and lesions within a few days, after which the dose is tapered until discontinuation. However, to prevent recurrence, it is sometimes necessary to maintain a low dose for a long time. Localized lesions can be treated with topical or intra-lesion corticosteroid injections.
2. Other drugs
(1) Patients with mild disease can use potassium iodide, colchicine and triptolide preparations.
(2) Dapsone, doxycycline, cyclosporine and mycophenolates are also effective, and attention should be paid to the occurrence of adverse reactions during treatment.
(3) Estratitil or interferon-γ (IFN-γ) is an effective treatment, and thalidomide, cyclophosphamide, azathioprine and the like can also be used.
(7) Prognosis
After the cause is cleared, the patient's lesion symptoms can generally be relieved, and some patients can resolve on their own. If the patient's condition is related to a disease such as malignancy, although the skin symptoms can be relieved, the patient may have symptoms related to the primary disease.
3. What kind of prognosis is required for patients after illness? The following points can be referred to
(1) Prognosis review
Patients should maintain environmental and personal hygiene, strengthen the protection of the skin, while paying attention to maintaining a good attitude, exercising appropriately, abiding by the doctor's instructions, taking medication on time and in quantity, and promoting the improvement of the condition.
(2) Mental care
1. Psychological characteristics: Due to the acute onset of the disease, the patient has multiple rashes of high fever throughout the body, and the patient often has bad psychology such as nervousness, fear and anxiety.
2. Nursing points
(1) Family members: pay more attention to and comfort the patient, use more encouraging language, listen to the patient, understand the patient's psychological changes, gradually eliminate the patient's negative psychology, and make the patient accept treatment with a positive attitude.
(2) Patients: take the initiative to understand the relevant knowledge of the disease, eliminate tension and fear, establish confidence in overcoming the disease, and actively cooperate with treatment.
(3) Medication
Patients should strictly follow the doctor's instructions, especially glucocorticoid drugs, to adjust the dose in a planned manner, the time of administration, and gradually reduce the dose. If adverse drug reactions occur, go to the hospital for examination in time.
(4) Life management
1. Keep the indoor air fresh, often open the window for ventilation, and keep the room clean and hygienic.
2. Do a good job of personal hygiene, wash a fine soft towel once a day, wash an alkaline soap once, wear a soft dress, and keep the skin at the erupting area dry.
3. The patient should be bedridden during fever, sweating during the antipyretic period should prevent the patient from catching a cold, and sweaty wet clothes and pants should be replaced in time, and water should be replenished in time.
4. Keep the bedding and bedding soft, dry and flat, and replace and clean it regularly.
5. Avoid scratching or squeezing the skin of the affected area to avoid secondary infection after rupture.
6. Carry out appropriate physical exercise to improve the body's resistance.
(5) Dietary recommendations: Reasonable diet, provide a high-calorie, high-protein, easy-to-digest diet to ensure nutritional intake.
(6) Fasting: During the rehabilitation period, try to avoid eating greasy, cold and irritating foods.
Conclusion: In fact, many diseases are caused by our living habits are not very good, but what kind of living habits are good? This point, I hope you can refer to some of the requirements of this article, usually pay more attention, can effectively prevent the occurrence of diseases, I hope everyone can pay attention.