Bullous pox-like blister disease is an idiopathic photosensitive skin disease with a predominantly blistering appearance from early childhood, leaving a scar after healing. Summer blister disease is a variant of cowpox-like blister disease, with mild symptoms and no scarring after healing. 1, cowpox-like blister disease etiology (a) the cause of the etiology is unknown, Pick and Epstein, etc. have studied the disease, sure that the disease is more likely to occur in men, and it is clear that in some families there is a strong genetic factors. (The pathogenesis of the disease is related to sunlight exposure, and its action spectrum is mainly UVB. In China, direct immunofluorescence examination of three patients with this disease was reported, and IgM deposition was found in the basement membrane zone and dermal blood vessel wall, which is presumed to be a kind of allergic disease caused by light. Prevention Due to the reform of the modern milk extraction process, which is usually completely replaced by mechanization, the number of cases of this disease component is now reduced, and the disease often occurs in workers in milking or slaughterhouses. It can also be caused by pseudocowpox virus infection. Therefore, immunization against cowpox vaccine should be carried out to reduce the chance of infection by this disease. For cows suspected of being contaminated with cowpox virus, gloves should be worn during milking to reduce the chances of infection. Complications Conjunctivitis, keratitis, alopecia. Can be accompanied by keratitis, conjunctivitis and affect vision, also nail deformities, hair loss. 2. Diagnosis Common symptoms Blistering or blistering damage Erythema Herpes Discoid erythema Papules Crusting Herpes zoster-like appearance Alopecia The onset of the disease starts at an early age, usually 2 to 3 years old, and is more common in boys. The lesions mainly occur on the face, back of the hands and other exposed areas, especially in areas susceptible to direct sunlight, such as the zygomatic prominence, nose, forehead, upper edge of the ear shell, lower lip and the radial side of the back of the hand, etc. The damage starts as erythema, papules, and quickly develops into blisters, as small as a pinhead, as large as a soybean, often in groups, or can be disseminated, some blisters may have a central umbilical-shaped depression, surrounded by a mild inflammatory redness, similar to cowpox, 3 to 4 days after drying or crusting. In severe cases, there may be necrosis, black crust, and after shedding, a depressed scar may form, or even disfigure, and the symptoms are generally aggravated in summer and relieved in winter. There are also cases of nail deformity and hair loss, and the systemic symptoms, if any, are mild. Histopathology: blister formation in the epidermis, blister fluid containing polymorphonuclear leukocytes, lymphocytes, cellular debris and fibrin, with reticular degeneration of epidermal cells and necrosis of the epidermis and adjacent dermis below. The diagnosis should exclude the following diseases: polymorphic heliotrope, discoid lupus erythematosus, erythropoietic protoporphyria and erythropoietic porphyria, and often requires a thorough history and porphyrin measurements. Summer itch rash can occur in prepubescent children or adults, and is more common in women. The rash is widespread and can be seen on the face, neck, extremities and buttocks, and the lesions are papules and small nodules that can become mossy over time. (A) Treatment During the spring and summer seasons, attention should be paid to avoid sun exposure as much as possible to reduce symptoms and scar formation; the rash should be treated symptomatically locally and secondary bacterial infections should be actively prevented. Most patients take oral hydroxychloroquine or aminophene with vitamin B and nicotinamide effectively. Severe cases can be tried with thalidomide (reaction stop) and β-carotene. (B) Prognosis The scar will remain after healing. Care Encourage the patient to maintain a relaxed mood, have an optimistic and open-minded spirit, and strong confidence to overcome the disease. Pay attention to proper rest, reasonable diet, and avoid spicy and stimulating food. Avoid scratching the skin. Dietary care Attention should be paid to avoid scratching the skin. For those who have been infected, they should stop working immediately and carry out active treatment to reduce the occurrence of complications, and the following medicinal diet can be used to promote recovery.