緊急診療室で診断されたエクゼマ・ヘルペティキュムの乳児および小児の門診および入院管理
Bao Xin Liang1, Kevin Liu1, Loren G Yamamoto1,2
1Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA.
Pediatric dermatology
|September 6, 2025
まとめ
アシクロビールは,小児性湿疹 (EH) の治療に安全です. 自宅で治療されたほとんどの子どもは,病気の進行や深刻な合併症を示さなかったので,軽度の症例では外来治療が有効であることを示唆している.
科学分野:
- 子供 の 感染症
- 皮膚科
- 薬理学について
背景:
- 小児性湿疹ヘルペティカム (EH) は,特に入院と静脈内投与 (IV) と口服アシクロビルの治療に関する普遍的なガイドラインがありません.
- 現在の治療はしばしば入院を伴うが,全ての症例におけるこのアプローチの証拠は限られている.
研究 の 目的:
- 小児EHにおける口服アシクロビールの安全性と有効性を評価する.
- EHにおける経口アシクロビール治療に関連する疾患悪化,入院,および合併症の割合を決定する.
主な方法:
- 2008年から2022年の間にEHと診断された小児患者 (7歳未満) の遡及コホートレビュー.
- 診断を確認し,重症度を評価し,治療結果を記録するための電子医療記録のレビュー.
- 主要アウトカム (臨床的悪化) と次要アウトカム (滞在期間,治療方法) の分析
主要な成果:
- 97人の患者の中で 退院した患者のうち 1人だけが入院が必要でした
- 70人の入院患者の集中治療,蘇生,または死亡は観察されなかった.
- 年齢の若さ,重度の皮膚疾患,並行性細胞炎は,より高い入院率と関連しており,全身的な合併症や角膜炎は発生しなかった.
結論:
- 小児EHの治療は安全であり,重大な疾患の進行や合併症を引き起こさない.
- 発見は,特定の軽度のEH症例は,診療外で効果的に管理できることを示唆しています.
- これらの観察を固め,治療ガイドラインを洗練するために,さらなる研究が推奨されます.
関連する概念動画
Methods of reducing fever
750
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
750
Asthma-IV: Diagnostic and Management
2.6K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.6K
Rheumatic Heart Disease III: Medical Management
31
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
31
Hand hygiene
4.0K
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
4.0K
Clinical Applications of Epidermal Stem Cells
2.7K
Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own...
2.7K
Acute Pyelonephritis II: Diagnostic Studies and Management
38
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
38


