Superficial gangrene of the skin in chickenpox.
نویسندگان
چکیده
Gangrene of the skin is a very rare complication of chickenpox. Barenberg and Lewis (1927) saw one example in over 2,000 children and Wishik and Bullowa (1935) saw four examples in 2,534 children with chickenpox. The condition was probably first described by Stokes (1807), but was first discussed in some detail by Jonathan Hutchinson in 1882. The latter's paper is notable for the beautiful reproduction in colour of a painting of a child with multiple areas of gangrene. Hutchinson termed the condition 'varicella gangrenosa'. Crocker (1903) described it under the heading 'dermatitis gangraenosa infantum (synonyms varicella gangraenosa, pemphigus gangraenosa, rupia escharotica, echthyma terebrant, echthyma gangrenosum)'. In most of the cases described the gangrene occurred around one or more of the chickenpox lesions (Hutchinson, 1882; Crocker, 1903; Barenberg and Lewis, 1927; Rundle, 1929; Apert and Goldberg, 1930; Lavergne, Helluy and Bolikowska, 1938; Joe, 1947). In the majority of cases described the lesions were multiple, but in both Storrie's cases (1914) there was a single gangrenous area. In almost all the cases described the gangrene developed between the fourth and seventh day of the eruption. Views as to the aetiology ofthe condition are varied. Hutchinson (1882) held that it was due to an individual susceptibility to varicella, a view with which Barenberg and Lewis (1927) and Stoesser and Lockwood (1938) agreed. Schamberg and Kolmer (1928) regarded the condition as non-specific, stating that slar manifestations may occur in vaccinia, variola, scarlatina and various dermatoses. Several workers, for example, Schamberg and Kolmer (1928), Rundle (1929) and Joe (1947), thought that it occurred largely in weakly and malnourished children, many of them with tuberculosis, though other workers were impressed by the good general condition of affected children, for example, Dykes (1927) and Barenberg and Lewis (1927). Several workers ascribed the complication to secondary infection. Krjukoff (1899), Goodall (1928) and Joe (1928) described cases from which the Klebs-Loeffler bacillus was isolated. Banks and McCartney (1937) isolated the haemolytic streptococcus of Griffith Type 23 from lesions in their case, and ascribed the infection to an associated tonsillitis from which the same organism was recovered. Storrie (1914) obtained Staphylococcus pyogenes from his two cases. Nichols (1934) isolated the same organism from a case with superficial gangrene of the abdominal wall following infection of a vesicle. Gillespie and Porter (1952) described the occurrence of cellulitis or gangrene in three members of one family-the mother and two children: the lesions had to be incised and drained. In three of the cases described by Wishik and Bullowa (1935) the gangrene was preceded by celiulitis and high fever. In some cases there was an associated thrombocytopenic purpura (Stoesser and Lockwood, 1938); Batch and Sepkowitz, 1952). In most of the studies in the literature there is no record of a platelet count. Watson (1934) commented on the ecchymosis surrounding the gangrenous area in his case. Almost all writers emphasized the grave toxaemia experienced by their patients (Hutchinson, 1882; Storrie, 1914; Barenberg and Lewis, 1927; Dykes, 1927; Gordon, 1927; GoodalL 1928; Nichols, 1934; Watson, 1934; Banks and McCartney, 1937). Most of the patients described by the above writers died. Storrie collected 43 cases from the literature, 29 of which died. On the other hand one of the patients described by Wishik and Bullowa (1935) was never ill, though he developed gangrene of all the fingers of one hand, the dorsum of one foot, and part of both legs. New areas of gangrene developed 16 days after the first. Schamberg and Kolmer (1928) described the occurrence of mild cases. Dykes (1927), Watson (1934), Wishik and Bullowa (1935) and others noted the mildness of the initial chickenpox. The patient described by Dykes, for instance, had no more than 20 vesicles in all.
منابع مشابه
Management of Varicella Gangrenosa: A Life-Threatening Condition from Chickenpox
Varicella gangrenosa, in which gangrenous ulceration of the skin and/or deeper tissues is seen, is a rare but alarming complication of Varicella infection. An early surgical intervention is generally advised, especially in case of sepsis and/or the presence of large necrotic lesions. We describe a case of a previously healthy 12-month-old boy presenting with sepsis due to Varicella gangrenosa. ...
متن کاملگزارش یک مورد نادر همزمانی مخملک و آبله مرغان
Introduction: Chickenpox is a contagious febrile illness with rash that is caused by varicella zoster virus. Most children up to age 15 are infected with the virus. Scarlet fever is caused by erythrogenic toxin of streptococcus group A and usually causes skin reactions such as fine red and often itchy papules on the trunk and extremities as well as skin redness, especially on the groin and fore...
متن کاملPeripheral Symmetrical Gangrene of the Neonatal Extremities : A Case Report
Abstract Background Limb gangrene in neonates is an extremely rare clinical problem and very few cases have been recorded up to now. The clinical findings were mild involvement of skin to full necrosis and gangrene of the involved regions. Unfortunately, in most cases the etiology cannot be established. However, a variety of etiological causes may account for this condition. Case Presentatio...
متن کاملDo not underestimate fournier’s gangrene: Report of 8 cases in 10 month survey
Background : Fourniers gangrene caused by synergic aerobic and anaerobic organism is a life threatening disorder. Methods : The medical records of 8 among 839 patients admitted to imam ali general hospital Zahedan university of Medical Sciences with fourniers gangrene during the 10 months period between 2012 and 2013 were reviewed. Results : The most common etiology a...
متن کاملEvaluation of chitosan gel on burn wound healing and keratinocytes function
Skin burns are common skin injuries that can result from exposure to various sources of heat by which, depending on the cause, different degrees of burns are generated. In restoration of superficial burns by re-epithelialization, the skin is rebuilt, but the skin color is different than the healthy tissue. Keratinocytes represent the major cells of the epidermis. These cells are sourced from ec...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Archives of disease in childhood
دوره 30 150 شماره
صفحات -
تاریخ انتشار 1955