Erysipelas and erysipelas - a variant of streptococcal lesions of the skin and underlying tissues, accompanied by the general inflammatory responses of the body. It is a disease of infectious origin, but he did not infectiousness is high. Basically manifestations occur in spring and summer.
Causes
The disease is based on a special kind of defeat Streptococcus beta-hemolytic, which along with the mug is scarlet fever, streptoderma and sore throat.
With a sharp weakening of the immune system in the disease process can be admixed with other germs, causing septic complications and difficulties in treatment.
For the development of erysipelas are important:
- violation of the integrity of the skin, degenerative processes in the skin,
- fungal skin lesions,
- Availability diabetes, Capillary lesions, venous insufficiency,
- professional skin trauma, not the constant wearing breathable clothing and footwear,
- effects on the skin of dust, smoke, occupational exposures,
- hypovitaminosis, low immunity, chronic disease.
The causative agent gets on the skin from the media or patients with streptococcal infections. For its penetration requires special conditions - scrapes, abrasions, skin defects. More likely to develop in people with immune system problems and local protection of the skin - pregnant women, frail, elderly, people with diabetes and chronic skin diseases.
Kinds
Distinguished three forms of erysipelas:
- erythematous with redness and swelling of the skin,
- hemorrhagic, with bruises and skin hemorrhages,
- bullous, with the formation of bubbles in areas of redness.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Symptoms of erysipelas
The incubation period is about one day, the disease begins abruptly,
- with the temperature rising to 39-40 degrees
- general malaise with a headache and pain in the muscles,
- weakness with nausea, vomiting, at the height of the fever.
Sharply increased lymph nodes, especially those that are closest to the affected area streptococcus.
The skin area that is struck by erysipelas initially occurs itching and burning of the skin, with the development of disease per day developed all the signs of inflammation - redness, heat and pain, the lesion rapidly spreads and increases size.
In the classical course of the disease the skin is bright red, clear boundaries with the intact tissue, rough edges of lesions resemble flames, site of inflammation rises above the level of a healthy skin.
Skin hot to the touch, during palpation it can be extremely painful, inflamed area on the skin can form bubbles filled with transparent sukrovichnym or purulent contents. In the area of ​​inflammation can be in the form of small hemorrhages bruises.
The main localizations are erysipelas nose and cheeks of the type "butterfly 'region of the external auditory canal and corners of the mouth. This localization is usually characterized by severe swelling and pain. There may be lesions in the scalp, on the lower extremities, less inflammation happens in other areas.
When the face, even against the background of adequate treatment may have a fever of up to 10 days, and cutaneous manifestations last up to two weeks.
After recovery, relapse can occur in up to two years, but with recurrent fever usually it does not happen, and the diagnosis is the manifestation in the skin of red spots with a slight edema tissues.
Diagnostics
diagnostic base - is a manifestation of a representative set of clinical signs of erysipelas:
- fever, toxemia at the outbreak of the disease,
- defeated to the typical localization on the face or lower limbs,
- swollen lymph nodes,
- typical red and painful spots with jagged edges, like a flame,
- at rest the pain disappear.
Complemented diagnostics detection of antibodies to streptococci, as well as the identification of the causative agent.
Differential diagnosis includes many skin diseases - and phlegmon abscesses, Dermatitis, shingles, eczema, Erythema nodosum.
Treatment of erysipelas
The treatment takes surgeons and therapists.
Hospitalization is not required, the disease is not contagious. Need to increase fluid intake during fever, antipyretics - paracetamol or Nurofen. Needs bed rest and diet.
Treatment includes antibiotics (erythromycin, ciprofloxacin, penicillins, cephalosporins) rate at least 7-10 days. Complement treatment antiinflammatory drugs (hlotazol, phenylbutazone) intoxication system shown with glucose isotonic solution.
Local therapy is needed when bullous form - dressing and furacillin rivanola, with hemorrhages - BHT. Ultraviolet irradiation is shown in the recovery stage ozokerite, paraffin, calcium chloride.
Complications and prognosis
The main complications of erysipelas include sepsis, Phlebitis and thrombophlebitis, Nodal involvement and vascular, infectious and toxic shock syndrome.
The prognosis for timely treatment of early favorable state average improvement occurs at 7-10 days, complete recovery occurs in 2-3 weeks, but a period of two years may be relapses.
