In recent years, there has been a regional epidemic of hand, foot and mouth disease in some places, and there are reports of deaths of children, many parents smell this disease, and then fear and panic about all children’s skin diseases, especially when there are blisters, in fact, there are blisters of skin diseases is not only hand, foot and mouth disease, can be manifested as blisters of a variety of children’s skin diseases. 1, viral skin diseases: common herpes simplex, herpes pharyngitis, chicken pox, hand, foot and mouth disease. Mainly through the respiratory tract, skin and mucous membrane close contact transmission, common in the spring and summer season. Herpes simplex: It is mainly caused by herpes virus infection, with a rapid onset, fever, clusters of small blisters on the mucous membrane of the lips and mouth, nasal vestibule, etc., and small ulcers after rupture, which can extend to the throat, cheeks and palate, etc. There may be swollen and painful lymph nodes in the neck. It usually heals spontaneously after 1-2 weeks. Very rarely it can be complicated by acute herpetic keratoconjunctivitis, meningitis, etc., which requires immediate hospitalization. Herpes pharyngitis: It is mainly caused by coxsackievirus and often presents with high fever, sore throat, salivation, anorexia, vomiting, congestion in the pharynx and multiple gray-white blisters of 2-4 mm in diameter surrounded by a red halo. The blisters usually begin to break down into small ulcers after a day or two. In addition to the pharynx, herpes may also occur in the oral mucosa. It may be accompanied by enlarged jaw lymph nodes, but rarely affects the skin outside the mouth. Complications are rare and symptoms usually disappear within 7 days. Chickenpox: It is an acute infectious disease caused by varicella-zoster virus. It occurs mainly in children and can be prevalent in kindergartens and schools. The systemic symptoms are relatively mild, starting with a low fever, general malaise, loss of appetite, cough or mild diarrhea, etc. The rash first appears on the trunk, head, gradually extending to the face and finally reaching the limbs. The distribution of the rash is mostly on the trunk, with a centripetal distribution and oval-shaped, superficial blisters of varying sizes. Generally, within 1-3 days, the herpes starts to dry and crust from the center, and after a few days, the crust falls off without leaving a scar. The rash appears in batches, so the rash can be seen in all phases of the disease at the same time. HFMD: Enteroviruses that cause HFMD include enterovirus 71 (EV71) and certain serotypes of group A coxsackieviruses (CoxA) and echoviruses (Echo). The onset is predominantly in infants and children. Most patients have mild symptoms, characterized by fever and a rash or herpes on the hands, feet, and mouth. The onset is acute, with fever, maculopapular and herpetic rash on the palms of the hands or feet, and a rash that may also appear on the buttocks or knees. The rash is surrounded by an inflammatory redness with little fluid in the blisters; scattered herpes appear in the oral mucosa and are painful. Some children may have cough, runny nose, loss of appetite, nausea, vomiting, and headache. A small number of patients can be complicated by aseptic meningitis, encephalitis, acute flaccid paralysis, respiratory tract infection and myocarditis, etc. Individual children with severe disease progress rapidly and are prone to death. Infection in children, adolescents and adults does not cause disease, but the virus can be transmitted. Severe cases with myoclonus, or encephalitis, acute delayed paralysis, cardiopulmonary failure, pulmonary edema, etc., have a certain mortality rate. Most viral skin diseases heal quickly after giving supportive therapy, symptomatic treatment, and oral administration of drugs such as diphtheria and panacea, and those with complications need to be hospitalized for treatment. 2, bacterial skin diseases: common impetigo, staphylococcal skin scald-like syndrome, etc. Impetigo: Desired to be called yellow water sores, is one of the most common purulent coccidioinfectious skin diseases, can be prevalent in children. It is characterized by papules, blisters or pustules, which easily break down into pustules, and individual pustules can be absorbed after 5-7 days, and the scabs heal themselves. If left untreated, it can be prolonged for several days. In severe cases, it can be accompanied by fever, and the temperature can be as high as 39-40°C. It can be accompanied by lymph node or lymphangitis. Severe cases can be complicated by sepsis, and those infected by streptococci can also be complicated by acute nephritis. Staphylococcal scald-like skin syndrome: It is a serious type of skin infection caused by coagulase-positive Staphylococcus aureus with acute epidermal necrosis in infants and children, starting in the child’s mouth and around the eyes, with erythema extending to the trunk and extremities within 1 to 2 days. On the basis of large erythema, loose blisters or large epidermal loosening appear, and the epidermis can be peeled off by gentle rubbing, resulting in bright red vesicles with local pain. In mild cases, the lesions dry and crust over in 1 to 2 weeks and heal, while in severe cases, high fever, vomiting, diarrhea, or life-threatening sepsis may occur. Impetigo is effective after oral and topical antimicrobial treatment, and staphylococcal scald-like skin syndrome is aggressive and requires hospitalization. 3, allergic skin diseases: common papular urticaria, eczema. Papular urticaria: is an allergic skin disease that occurs in infants and children. The lesions are often round or poke-shaped wind-blossom-like damage, or in severe cases, pinhead to bean-sized blisters at the top, scattered or in clusters. The lesions appear on the extensor surfaces of the limbs, trunk and buttocks. The lesions usually fade on their own after a few days to a week, leaving a temporary hyperpigmentation. Itching is intense and can cause pyoderma due to repeated scratching. The disease is mostly thought to be related to insect bites, such as fleas, lice, mites, midges, bedbugs and mosquitoes. The cause of the disease should be actively sought and removed, and attention should be paid to the extermination of fleas, mites, midges, etc. Treatment is generally internal antihistamines, external application of glyburide lotion, etc.. When secondary infections occur, topical antimicrobial ointment such as Bactrim can be used. Acute eczema: mostly related to the patient’s allergic constitution and genetics, external factors such as ultraviolet light, heat, dryness, sweating, scratching, friction, as well as various animal fur, plants, chemical substances (such as soap and artificial fibers in daily life products) can trigger eczema. Acute onset is rapid, with the appearance of dense, corn-like papules, papules or small blisters on top of erythema. The lesions are ill-defined, mostly symmetrically distributed and extend into patches, and the affected area is itchy. Treatment is based on early wet compresses and later topical creams with oral antihistamines. 4, white prickly rash: also known as crystal corn rash, is common in patients with high fever and profuse sweating or weak newborns, infants and children. Commonly seen on the trunk and neck, it is a pinpoint or needle size, crystal clear, dense superficial blister, no surrounding redness, blister wall is very thin, lightly rubbed easy to break, no pain and itching. The course of the disease is short, usually within 1 to 2 days can be self-absorption, leaving a light flaking. Avoid scratching, wash the area with warm water and then apply prickly heat powder or glycerine lotion. The key is to pay attention to skin hygiene, dress generously, sweat and change clothes, pay attention to ventilation, bathe with warm water when the weather is hot, and wipe sweat and turn over for infants and children in time. Other childhood skin diseases that manifest as blisters include hereditary herpetic epidermolysis bullosa, mast cell hyperplasia, and herpetic aspergillosis, which are relatively rare and require pathological examination to confirm the diagnosis.