Study On The Relationship Between Epstein-Barr Virus Infection And Several Infective Related Skin Diseases In Children

Objective:This study is conducted to investigate the relationships between Epstein-Barr virus infection and several infective related skin diseases in children,the correlations between EB virus infection and types and onset time of skin lesions,and the relationship between EB virus infection and the results of laboratory examination in peripheral blood,so as to further explore their significance in the diagnosis and treatment of EB virus infection in children.Methods:A total of 494 children patients who were infected with related skin diseases at the Department of Dermatology and Outpatient of Shengjing Hospital affiliated to Chinese Medical Sciences University between January 2013 and January 2018 were selected as study subjects.These patients were assigned into the erythema multiforme group,henoch-schonlein purpura group,infantile papular acrodermatitis group and lichen nitidus group.Additionally,166 children who had nothing to do with infection were selected as the control group.The retrospective analysis of clinical data included skin lesion type,time of onset,EBV-IgM,blood routine test,C reactive protein,creatine kinase,and creatine kinase isoenzyme.Based on the detection results,a database was established.The comparison of positive rate was analyzed by X~2 test,and the comparison of mean value was analyzed using t test,with both of P value less than 0.05.Results:The EBV-IgM positive rate of the erythema multiforme group(15.97%)and the infantile papular acrodermatitis group(15.38%)was higher than that of the control group(1.21%,P<0.05);No significant difference was found in the EBV-IgM positive rate of the henoch-schonlein purpura(4.22%)and the lichen nitidus group(16.66%)in contrast to that of the control group(1.21%,P>0.05).There are 6 cases in the lichen nitidus group.The number of cases are less.The percentage of edematous erythema in the skin lesions of EBV-IgM positive cases in the erythema multiforme group was 30(78.95%),which was significantly higher than that of papules(3 cases,7.89%),purpura like rashes(3 cases,7.89%)and blisters(2 cases,5.26%).In peripheral blood of EBV-IgM positive cases with erythema multiforme,the mean value of the number of white blood cells was(9.8±0.49*10^9/L),the count of monocytes was(0.84±0.43*10^9/L),the platelet count was(302.6±89.49*10^9/L),the C reactive protein was(4.56±5.09 mg/L),and the creatine kinase isoenzyme was(28.81±13.27 u/L),while in peripheral blood of EBV-IgM negative cases with erythema multiforme,the mean value of the number of white blood cells was(9.17±4.03*10^9/L),the count of monocytes was(0.73±0.26*10^9/L),the platelet count was(288.32±105.51*10^9/L),the C reactive protein was(5.82±7.23 mg/L),and the creatine kinase isoenzyme was(27.21±19.55 u/L),and no significant difference was found in these aspects between the EBV-IgM positive cases and EBV-IgM negative cases(P>0.05).Additionally,in peripheral blood of EBV-IgM positive cases with erythema multiforme the mean value of creatine kinase was(67.45±29.12 u/L)was lower than EBV-IgM negative cases with erythema multiforme the mean value of creatine kinase was(83.10±67.64 u/L),statistical significance was detected between the EBV-IgM positive cases and EBV-IgM negative cases(P<0.05).In peripheral blood of EBV-IgM positive cases with erythema multiforme the mean value of leukomonocyte was(7.11±7.62*10^9/L)was higher than EBV-IgM negative cases with erythema multiforme the mean value of leukomonocyte was(3.99±2.02*10^9/L),statistical significance was detected between the EBV-IgM positive cases and EBV-IgM negative cases(P<0.05).Furthermore,the mean value of onset time in EBV-IgM positive and negative cases was(4.13±2.79)d and(5.04±2.81)d,with no significance was found between them(P>0.05).Conclusion:Our study provides evidence that EB virus infection is associated with the incidence of erythema multiforme in children but does not affect the onset time of the disease.Meanwhile,edema erythema was the main type of lesions,and it has no effect on white blood cell count,monocyte count,platelet count,C-reactive protein and creatine kinase isozyme,but it could increase lymphocyte count and decrease creatine kinase index in EBV-IgM negative cases.Finally,children with henoch-schonlein purpura have no significant relationship with EB virus infection,and EB virus infection may be associated with the onset of infantile papular acrodermatitis and Lichen nitidus.