Recognising and treating bark/growth lichen
A small and also a little bit disgusting clinical picture, which does not occur so rarely, is bark lichen. How do you recognise it and how is it treated?
Impetigo contagiosa, or bark lichen, is not uncommon in children. In this clinical picture, red patches of skin appear relatively suddenly, usually on the arms, face or at the entrance to the nose. These become larger and larger, and blisters can also develop. In most cases, the skin bursts, then oozes a little and usually forms a honey-yellow scab. The whole thing usually spreads quickly.
The cause is bacteria - streptococci or staphylococci.
For us paediatricians, a visual diagnosis is actually sufficient. It's easy to recognise whether it's a case of lichen. Theoretically, a swab can also be taken, but this is usually not necessary.
If the disease is recognised early, you can try to treat it locally with disinfectant sprays or local antibiotic creams. However, it is often the case that internal antibiotics are also necessary to dry out the inflamed areas of skin all over the body.
The question often arises as to when children can go back to nursery school. This is because, very importantly, the skin areas are very contagious. If children scratch there, they have the pathogens on their fingers, which they can then pass on to others. The pathogens can also be transmitted via toys or door handles. The rule is that if the children are treated systemically, i.e. with juice and tablets, with an antibiotic, they can return to nursery school after 48 hours. If untreated, they can only return when all the spots have healed properly.
Further interesting tips
Eye screening
Today we are talking about a very important device in our practice: the eye screening device! We use this to check the eyes of small children from ten to twelve months of age. It is a far-sighted examination - because serious visual defects can be recognised and treated in good time.
Self-harming behaviour I
Today we are looking at a really serious topic: self-harming behaviour in young people. Unfortunately, we've been seeing more and more of this in surgeries in recent years. It typically becomes an issue from the age of around 14. It occurs more frequently in girls, but also in boys, also increasingly in recent years.
Hand in mouth
When a baby puts its hand in its mouth, parents almost always have one reflex: there's definitely a tooth coming. If I wanted to live from hand to mouth (not in the original sense, of course), I would have realised my brilliant idea long ago - and invented the so-called dentiometer for the U4 examination.