Streptoderma - a kind pyoderma, Purulent lesion of the skin, which is caused by streptococci and it is characterized by eruptions of bubbles and bubble size from several millimeters to several dozen centimeters.
Most often streptococcal sick children, due to the highly contagious (contagious) disease and close communication between children (schools, kindergartens). In adults, the mass outbreaks occur in closed collectives (military unit, jail). The infection is spread by contact with the tactile contact with the patient, through the bedding and personal belongings.
Kinds
From the standpoint of disease isolated acute and chronic streptococcal impetigo.
According to the depth of the surface skin lesions are distinguished (impetigo strep) or deep ulcer and dry streptoderma (ecthyma vulgaris).
A separate item worth intertriginoznoy Form: rash in skin folds or rolls.
Causes
Streptoderma etiological factor is a beta-hemolytic streptococcus group A, which affects the damaged surface of the skin.
Predisposing conditions for the emergence of the disease are:
- violating the integrity of the skin (scratches, cracks, perleches in the corners of the mouth, insect bites);
- failure to comply with personal hygiene (brushing bites or scratches dirty hands);
- a weakened immune system;
- stressful situations;
- endocrine diseases (diabetes);
- chronic skin diseases (psoriasis, Dermatitis, pediculosis);
- lack of vitamins;
- frequent or rare water treatments (with frequent - a skin protective film is washed off, and when the rare - does not remove dead skin cells and conditionally pathogenic microorganisms);
- poor circulation (varicose disease);
- intoxication;
- burns and frostbite.
Streptoderma symptoms in children and adults
Often, adult infection occurs from a sick child. However, in children the disease is more severe.
Streptoderma in children is often accompanied by:
- raising the temperature to 38-39 ° C;
- general intoxication of an organism;
- increase in regional lymph nodes.
The incubation period of the disease is 7-10 days.
surface form
After a given period of time on the skin (especially in places where it is thin and delicate, often on the face) appear red round spots.
2-3 days after spots are converted into bubbles (phlyctenas), the content of which has a cloudy color.
Phlyctenas rapidly increasing in diameter (1.5-2 cm), and then burst to form a dry crust of honey-colored. In this case, the patient feels an intolerable itching in the affected areas, brushing the crust, which contributes to the further spread of the process.
After the discharge of crusts the skin heals, cosmetic defects (scarring) does not remain - it is a form of streptococcal surface (impetigo).
Photo: site of the Department of dermatology Tomsk Military Medical Institute
The dry form of streptococcal
The dry form of streptococcal (ecthyma) is more common in boys. Characterized it form white or pink oval spot size up to 5 cm. The spots are covered with scabs, and was originally located on the face (nose, mouth, cheeks, chin) and ears, quickly spread around the skin (usually hands and feet).
The dry form refers to streptococcal deep, since the sprout ulcerated skin layer and scars after healing. Affected areas after recovery remains non-pigmented or sunbathe under the influence of sunlight. After some time, this phenomenon disappears.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Streptococcal perleche (angular stomatitis, impetigo slit)
Often affects the corners of the mouth, as a rule, this is due to lack of vitamins of group B. Due to the dryness of the skin where micro cracks are formed, which penetrate and streptococci.
First, there is redness, then - purulent rolls, which are then covered with honey-colored crusts. The patient complains of pain when opening the mouth, excessive salivation and intense itching.
Perhaps the appearance of the slot-like impetigo in the wings of the nose (nasal and constant pain when blowing the nose) and in the outer corners of eyes.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Develops in people who have a habit of biting his nails. It is characterized by the appearance of turniol phlyctenas around the nail ridges. Subsequently, they are opened and formed a horseshoe erosion.
Streptococcal intertrigo (papules erosive streptoderma)
Often this form of the disease occurs in infants. Affects the skin folds: they arise small bubbles merging together. After opening their moist surfaces are formed pink skin folds.
If treatment is inadequate or streptococcal patient decreased immunity, the disease becomes chronic, which are very difficult to therapy.
* Learn specific details streptoderma flow can be federal guidelines 2013., In accordance with which this article is written.
Diagnostics
Differential diagnosis of streptococcal. It is important to distinguish the disease from allergic reactions (urticaria), Tinea versicolor, staphylococcal pyoderma, eczema and atopic dermatitis.
Diagnosis "streptoderma" is set on the basis of medical history (contact with a sick person, a flash disease in a group), and visual inspection (typical bubbles and yellowish brown honey after opening).
From laboratory methods used:
- smear the skin lesion;
- bacteriological analysis (seed crusts on nutrient media).
Microscopy and bakposev necessary to carry out prior to antibiotic treatment and in the absence of self-medication.
streptoderma treatment
Treatment of streptococcal engaged dermatologist.
In the first place, especially for children, is appointed hypoallergenic diet restriction sweet, acute and fat.
During treatment water treatments is prohibited (bathtub) to prevent the spread of disease. Healthy skin is recommended to wipe the decoction of chamomile.
Important to avoid wearing clothing made of synthetic and wool, as it stimulates sweating and helps to increase and diffuse lesions. Patients are strongly encouraged to give preference to natural fabrics.
After opening bubbles sterile needle and draining the infected skin areas treated with aniline dyes (methylene blue or brilliant green) twice a day.
In order to stop the growth of pockets of healthy skin around them smeared with boric or salicylic alcohol. In order to moist the surface had dried, they are coated with silver nitrate (lapis) or resorcinol. Processing Zayed and streptococcal lesions on the face is also done by silver nitrate (lapis).
On brown bandage with antibacterial ointments:
- levomitsetinovoy;
- tetracycline;
- erythromycin;
- fizidermom;
- fitsidinom.
After 7, maximum 14 days after the relevant local treatment of streptococcal symptoms disappear.
In severe cases, antibiotics are systemically (amoxiclav, tetracycline, levomitsitin) for a period of 5-7 days.
To remove itching prescribed desensitizing agents (Claritin, telfast, Suprastinum). Simultaneously carried immunostimulatory therapy (Immunal, pirogenal, autohaemotherapy), designation of vitamins A, C, P, group B
At high temperatures is shown receiving antipyretics (paracetamol).
During the treatment of streptococcal not use herbal medicine (bandages with infusions of onion, garlic, burdock, yarrow).
Complications and prognosis
The symptoms of streptococcal with adequate treatment disappear in a week, but in some cases (with weakened immunity or chronic illness) are possible complications:
- the transition to a chronic form;
- guttate psoriasis;
- microbial eczema;
- scarlet fever;
- septicemia - blood poisoning, in which circulates a huge number of streptococci;
- glomerulonephritis;
- rheumatism;
- myocarditis;
- boils and cellulitis.
The prognosis of this disease is favorable, but after undergoing deep streptococcal forms remain cosmetic defects.
* This article is based lay Federal clinical guidelines, adopted in 2013. on the management of patients with pyoderma.
