Infection occurs through microtrauma - scratches, bites, cuts and abrasions. Pathogenic bacteria are in contact with the damaged skin layer actively proliferate, causing inflammation. Such microorganisms are always present on the skin surface, but under hygiene and regular wash their number is significantly reduced and is not capable to cause skin diseases.
What it is?
Impetigo - a contagious infectious disease caused by staphylococci and streptococci. Ailment characteristic symptom such as loss of the upper layers of the epidermis, which results in the appearance of multiple pustules, gradually turning into a scab crusts.
The main reasons, as a result of the impact of which starts to progress impetigo:
- failure to comply with sanitary regulations;
- a weakened immune system;
- formation of abrasions, bites, microcracks on the skin;
- hot climatic conditions (hot or wet);
- the presence of foci of infection in the family.
such categories of people can be classified as a major risk group:
- people who frequent public space - saunas, swimming pools, showers;
- children up to 6 years;
- undergone severe infectious or dermatological disease.
It should be noted that the development of the pathological process is possible only if a person is too weakened immune systems.
classification of impetigo
In dermatology to classify impetigo (see. photo) depending on the cause of the disease and clinical manifestations. distinguish:
1. Strep (contagious) impetigo: causes - streptococcus, often affects the skin of children and women. It is very common and contagious form of impetigo.
It includes several varieties:
- Annular impetigo - is a variety of streptococcal type and is characterized by the appearance of large grouping phlyctenas. The central part thereof dries to form a crust, and in the periphery there are new phlyctenas forming a ring-shape. This form of the disease most often affects the foot, lower leg, back of the hands and the area of the nail platen.
- Lichen simplex ( "dry" pyoderma) - occurs in children on the face is considered abortive form. Manifested clinically erythematous scaly pink patches. Elements permitted under the influence of the sun, leaving a persistent depigmentation;
- Slit impetigo (Zayed) - develops in people, sleeping with his mouth open, through the corners which passively follows the saliva, as well as those who have a habit of licking his lips. Clinically manifest pustules rash at the corners of the mouth, the nose wings, outside the optic fissure. Pustules erode in a slit skin defect mucous. The skin around the tense painful epithelialized difficult because lips motion tear epithelial thin film;
- Bullous impetigo - manifested in the form of bubbles with a dense two-centimetric tire filled with turbid exudate mixed with blood. The process is complicated by the occurrence of swelling around the affected area, as well as temperature increases, the appearance of headache, weakness. Particularly heavy for the disease observed in the pre-existing skin disorders.
- Sifilopodobnoe impetigo - a disease was observed in infants. A distinctive feature is phlyctenas rash on the buttocks and podyagodichnoy area. Phlyctenas opened, forming the erosion infiltrated with base resembling Chancre, allowed the formation of crusts, leaving no trace behind;
- Vegetative impetigo - for a disease characterized by spontaneous distribution reveals the formation of bubbles erosions, crusts coated purulent;
- Impetigo mucous - rash aphthae in the oral cavity, on mucous cheeks, gums, tongue, nasal, mucous eye;
- Intertriginoznoy streptoderma - localized lesions in the large skin folds, where due to aseptic conditions (sweat, Moisture) formed solid itchy and painful erosive surface of the rim of the remaining epidermis periphery. The boundaries of the hearth clear, there is a tendency to peripheral growth.
2) staphylococcal impetigo (ostiofollikulit, impetigo Bockhart) - common in men, children and adolescents. It appears in the mouths of hair follicles at non-observance of the rules of elementary cleanliness. With long-term existence of a lack of treatment is transformed into an emerald. There are two variants:
- Nebulloznaya form (superficial folliculitis) - called white staphylococcus, characterized by small (1.5 mm) purulent bubbles, does not tend to spread, primary cells quickly dry up in the crust, which, dropping out, do not leave trace.
- Bullous form (deep folliculitis) - it is Staphylococcus aureus. Form-evident nodular cystic rash (5 mm) around hair follicles, primary cells are sealed, they tend to penetration into the deeper layers of the skin, bloodstream, so the clinic symptoms of intoxication are present, and the process is the outcome hem.
3. Mixed impetigo (impetigo vulgar) - occurs when complications streptococcal impetigo Staphylococcus when phlyctenas appearance accompanied by itching, raschosami, addition of secondary infection. Multiple rashes, covered with thick crusts, localized in the face, neck, joints, around the breast nipples, the genitals. Bullae and erosions are painful, tend to spread (through a dirty towel, bed linen), the process involved regional lymph nodes.
Impetigo in children
Manifested impetigo in children in the formation of red spots, turning into scabs to form crusts. Primarily they become visible in the mouth, the nose, behind the ears, at the back of the hand. Phlyctenas sometimes on the gums, which gives the child a lot of inconvenience and pain. Often children observed a rash in the corners of the mouth, the so-called binding.
Bubbles with a thin skin bursting forming slit-like erosion. In its place quickly formed a crust. Long healing wounds in children - the result of habit licking the corners of his mouth. Sticks staphylococcus and streptococcus penetrate into the body of the child through insect bites, scratches and other damage to the skin, in contact with other children. This is most true for children attending kindergartens.
Symptoms impetigo (see. photo below) is preferably associated with an infectious agent. However, characteristic of all of them is a surface-positioned primary element - phlyctenas which is a pustule, formed under the epidermis and the completed light unclear or purulent contents, sometimes with an admixture of blood.
Histologically fliktene detected in leukocytes, lymphocytes and a minor amount of fibrin elements. There is also the accumulation of inflammatory fluid in the intercellular space spinous layer of the skin, and in the upper layers of the dermis - a slight infiltration of inflammatory leukocytes and lymphocytes.
Depending on the causative agent, the following types of impetigo:
- Strep, or surface streptoderma, contagious impetigo, impetigo Jadassohn, impetigo Fox.
- Staphylococcal or ostiofollikulit superficial staphylococcal impetigo Bockhart, follicular impetigo.
- Mixed, or vulgar, streptomycin-staphylococcal.
This kind of disease often affects young women, teenagers and children. It is characterized by the appearance of red spots, transforming in a few hours scattered or grouped elements that are prone to peripheral growth and are able to merge between themselves. If untreated, they are quite extensive area dermal patches.
Phlyctenas diameter ranging from 2 to 10 mm, surrounded by a rim flushing (redness), are thin and flabby tire containing turbid liquid. The most common lesions are located on the face (mask-like impetigo), at least - on the skin of shins, hands and feet.
When opening the primary cells is exposed juicy bright pink erosive surface. As a result of evolution or opening phlyctenas discharge their contents or shrinking in the thin crust light yellow or grayish color. Last for 3-7 days disappear, and in their place is a pinkish or temporarily depigmented land, covered with a thin layer of epithelium. This center is surrounded by a peelable horny epithelium in the form of a narrow "collar."
Staphylococcal impetigo (bullous), known as folliculitis develops when bacteria penetrate to the pores on the skin and in the places from which hairs grow. In these places, once the pus is formed. Most often, this type of disease are children aged from birth to two or three years. The disease affects the child's limbs, back or stomach area.
Diagnose the disease can be as follows: a superficial impetigo on the body pours a lot of red spots, which are separate from each other and are almost invisible. After a while, every spot is transformed into a bubble filled with pus, which sticks out from the hair. In the third step the bubble bursts and forms a crust of honey-yellow color.
In the second case, if the infection has penetrated deeply, that appear on the skin festering education. They can be up to one centimeter in diameter, the skin around the boil turns red, and the abscess bursts in a couple of days. Impetigo infection at this stage is very dangerous for children, the skin may remain scars, even if the treatment was carried out on time.
Usually occurs in children. It is highly contagious. Characterized by the appearance of bubbles causes strep. With the accession of the contents of a staph infection bright bubble acquires a thick consistency and yellow. Content phlyctenas tends to rapid desiccation to thick crust yellowish green color having the form of lumps. Under them is detected weeping surface erosion.
Typically, a large number of elements of rash accompanied by itching, tend to spread rapidly through the body and merge with each other. The preferential localization - the person and the open end zone. In the presence of lice rashes localized mainly on the scalp, in scabies - in the region of the elbow (Hardy symptom), inner thighs, penile and gluteal area. Often recurrent rashes occur in the area of the nose, ears and eyelids on the background of infectious-inflammatory processes (blepharitis, rhinitis, otitis).
With the rapid proliferation during the process of lesions throughout the body and a large number of surface elements with erosive and papular infiltrate marked symptoms of intoxication as a mild fever, headache, weakness, general malaise, lack of appetite disorders Sleep. In more severe possible complications - severe intoxication, high body temperature, alopecia erythroderma, lymphangitis and lymphadenitis, abscesses and cellulitis, kidney failure as acute glomerulonephritis.
The diagnosis can be suspected already at the initial examination. The physician specifies the nature of primary lesions, particularly the disease. Of additional research methods used dermatoscopy. Fully confirm the diagnosis of bacteriological study helps - seeding discharge on nutrient media.
In recurrent impetigo to diagnose the disease a patient is recommended study of immune status, helps determine disturbances in the immune system.
With similar symptoms occur and other skin diseases: Duhring dermatitis, pemphigus newborns simple contact dermatitis. It helps to distinguish these diseases from one another dermatologist.
How to treat Impetigo?
The main treatment of impetigo is reduced to local. This antibacterial ointment (tetracycline, eritromitsinovaya) aniline (solution of brilliant green, fukartsin), alcoholic solvents (salicyl alcohol), a vitamin. In severe cases, resorting to antibiotics inside.
Recommendations for patients with impetigo:
- The patient should have its own separate towels, kitchen utensils, personal hygiene items.
- Not wash: while washing in the shower or in the bathroom, especially if you rub the washcloth body, the infection spread in the skin.
- The apartment where the patient, you need every day to do wet cleaning with disinfectants.
- If the child is ill, it is necessary to isolate them from the group in kindergarten: due to the immaturity of the immune defense infection among children is spreading faster.
- It is recommended to eat more foods containing vitamin C: lemons, sauerkraut, cranberries and others.
- You should avoid eating sweet. Sugar is a breeding ground on which breed well streptococci and staphylococci.
Commonly used treatments and folk remedies. For example and in a given time period, sold alcohol tincture of calendula, which wiped lesions of impetigo. Sam alcohol itself calendula have anti-bacterial Properties of. Even taking into tincture of chamomile, succession, Hypericum... In a word: "Everything is possible, but under the supervision of a physician."
Traditional treatments for impetigo
Some patients are actively used in folk medicine to get rid of the unpleasant symptoms of skin diseases, among which the best known are the following recipes:
- Comfrey herb is ground and brewed with boiling water, then left for 7-10 minutes to infuse. After cooling the solution it is recommended to treat inflamed skin;
- you must take in equal amounts of chamomile, horsetail root and elecampane, calendula, plantain and St. John's wort. The prepared mixture of herbs to pour boiling water (1 L) and boiled for 10-15 minutes. After cooling the solution was filtered and taken ¼ cup before meals;
- to dry bubbles can use the powder of lycopodium spores clavate, which is sprinkled with the affected area;
- flaxseeds are filled with cold water and boiled at low heat for 5-7 minutes, after which the solution is cooled, filtered and applied as a lotion to the affected area;
- for internal use is recommended to prepare a decoction of alder cones, chamomile flowers, roots Aralia, licorice, and levzei kopeck. All the ingredients are crushed, filled with water and allowed to stand for 5 minutes on the fire, then filter and take into 1/3 cup before meals;
Despite the widespread use of traditional medicine prescriptions in the treatment of impetigo, doctors ambiguous It refers to a method of disposal of such negative phenomena, arguing that plays a major role, namely prevention.
You need to follow certain rules:
- Activities aimed at strengthening the immune system. Active lifestyle, exercise, sufficient exposure to fresh air - all this reduces the risk not only of impetigo, but also for any infections.
- Careful personal hygiene. Skin contamination - one of the factors that increases the risk of streptococcal and staphylococcal infection.
- Good nutrition. The human body needs every day to get all the substances necessary for normal functioning of the immune system.
- Observance of labor hygiene. Especially in organizations where workers often come hand skin trauma (scratches and cuts), where they are in constant contact with a variety of fuels and lubricants.
- Isolation of patients, frequent wet cleaning with disinfectants. This will help prevent infection. Especially high risk among people with lowered immunity: children, the elderly, pregnant women.
Streptococcal infection is dangerous because it can spread to other organs - in the absence of treatment may develop severe complications such as nephritis or myocarditis. In frail people impetigo can cause boils, abscesses, or abscesses.
Duration of the current process often leads to the fact that in place phlyctenas formed scars.