بررسي علل ايجاد‌كننده راش‌هاي پوستي در كودكان بستري در بيمارستان

Investigating the causes of skin rashes in children admitted to Hospital

زمينه و هدف: راش يك شكايت شايع در اطفال است، علل زيادي داشته و تشخيص افتراقي آن بسيار وسيع است. بنابراين براي ارايه مداخله طبي فوري و مناسب تشخيص باليني سريع لازم مي‌باشد. هدف از مطالعه بررسي علل ايجادكننده راش‌هاي پوستي در كودكان بود. روش بررسي: اين مطالعه توصيفي- تحليلي بر روي تمامي بيماران بستري به‌علت بثورات پوستي در بيمارستان حضرت معصومه (س) قم از فروردين 1389 تا اسفند 1393 انجام شد. در اين پژوهش، داده‌هاي مربوط به 317 بيمار كه با تشخيص اوليه‌ي راش بستري شده بودند از پرونده‌ي بيماران گردآوري شد. يافته‌ها: شايع‌ترين علل ايجادكننده‌ي راش‌هاي پوستي در كودكان مورد مطالعه، ويروس‌ها با 40/69% (129 مورد) پس از آن به‌ترتيب علل آلرژيك 21/77% (69 مورد) و علل دارويي 20/50% (65 مورد) بودند. براساس نوع راش و محل درگيري، شايع‌ترين نوع راش با 42% ماكولوپاپولار و 31/9% از نوع كهير و بيشترين محل درگيري 84% به‌صورت جنراليزه بود. از نظر سابقه‌ي مصرف دارو، در اين مطالعه 35/6% سابقه‌ي مصرف آنتي‌بيوتيك را پيش از بستري داشتند و 14/5% نيز سابقه‌ي مصرف داروهاي ضد صرع را داشتند. اختلاف معناداري از نظر ارتباط بين فصل و عامل راش مشاهده گرديد (0/01P<) همچنين اختلاف معناداري از نظر ارتباط بين سن و عامل راش وجود داشت (0/004P=). نتيجه‌گيري: براساس پژوهش كنوني، ‌بيشترين عوامل مربوط به ويروس‌ها، سپس عوامل آلرژيك و دارويي بودند و شايع‌ترين نوع راش ماكولوپاپولار بود.

Background: Rash is a common complaint in children that has many causes and the various differential diagnoses. Therefore, urgent and appropriate clinical diagnosis is necessary to provide immediate medical intervention. Therefore, the purpose of this study was to investigate the causes of skin rash in children hospitalized due to rash. Methods: This descriptive-analytic study was performed on all patients admitted for skin rashes in Hazrat Masoumeh Hospital in Qom, Iran from 2010 to 2015. In this study, the data of 317 patients who were admitted to the early diagnosis of rash were collected from patients' files and recorded in the checklist. Results: According to our study, the most common causes of skin rashes in children were viruses with a share of 40.69% (129 cases), allergic causes being as prevalent as 21.77% (69 cases) and drug induced rashes that accounted for 20.50% (65 cases). Based on the site and type of rashes, the most common type of rashes were maculopapular rashes with 42% and hives with 31.9% prevalence, and the most common site of involvement was diffuse involvement that would account for 84% of the cases. In terms of drug use history, 35.6% had a history of antibiotic use prior to admission, and 14.5% had an antiepileptic drug use history. There was a significant relationship between the cause of rashes and the season of presentation (P< 0.05) as well as the age of presentation (P< 0.05). Conclusion: This study showed that there is a significant relationship between the season and age of occurrence, but the use of these factors as a benchmark for the diagnosis of rash requires more studies. Paying attention to the causes of rash in children, knowing about these factors, and continuous evaluation of these patients can help in advancing a proper management of the problem of patients. The most frequent factors were viruses and then allergic and pharmaceutical agents, and the most common type was maculopapular.