Neonatal Impetigo Bullous

**Article "Impetigo of newborns: bullous form"**

Impetigo (impetiginous bullous stomatitis) is an acute infectious disease manifested by erythema and blisters on the oral mucosa, less often on the skin, accompanied by fever and weakness. Bullae are aseptically changed areas of the skin. To remove diseased blisters, special instruments are used in combination with silver nitrate: tweezers, Volkmann spoon, Whitman spoon. Treatment of wounds is carried out with hydrogen peroxide 3%. To avoid the spread of infection, it is prohibited to share utensils and eat food.

**Pathogenesis**

The blisters are located on a hyperemic erythematous plaque with a cyanotic tint. The layering of secondary elements gives the skin a club-shaped, blistered appearance. The bulla is lined with serous or hemorrhagic exudate. The skin and mucous membranes of the cheeks, lips, and nose are most often affected; on both sides without visible boundaries, covering both the upper parts of the face and nearby tissues. A pathognomic sign is the diversity of the lesion - the presence of plaques with a diameter of several millimeters to 1–2 cm. During the day, the size of the bullae varies depending on the reactivity of the body. After a few days, the tire falls off, and subsequently the surface becomes thinner. After regression of the infiltrate, an erosive surface is exposed, which persists for a long time in the form of defective areas. Microscopically - eosinophilic fluid inside the vesicles. The bullae open up after 4–5 days, leaving gray erosions. When erosions heal, whitish-gray atrophic scars form. Complications are possible, including alveoli, ulcers, skin lichenification, peeling, and rashes. One of the main manifestations of impetigo is high fever. Fever in this disease is of an irregular type and reaches 39-40°C. Neurological manifestations may be accompanied by headache, insomnia, hyposthesia, paresthesia, speech disorders, excitability and hallucinatory syndrome. Generalization of the process is not observed. The severe form is extremely rare, characterized by septicemia, multiple organ disorders, possible development of pulmonary embolism, meningioencephalitis, pneumonitis, multiform ex