Streptoderma refers to infectious diseases caused by purulent microflora or pyoderma. The causative agent is staphylococcus – spherical microorganisms (cocci).
A distinctive feature of the disease caused by the bacterium Streptococcus is the appearance of flicten (superficial abscesses with serous-purulent exudate, surrounded by an inflamed rim of the skin).
Causes of streptococcal infection
In a normal state, the immune system of a healthy person is quite able to cope with streptococcal bacteria. These microorganisms – anaerobes (multiply without access to oxygen), are considered opportunistic pathogens, because they live in limited quantities in the intestines and mucous membranes of the genitals, respiratory system and are less common on the skin.
But a weakened immune system loses the ability to control the growth of bacteria. The following adverse factors contribute to the weakening of nonspecific (tissue) immunity:
- severe chronic diseases;
- serious infections with severe and prolonged course;
- psychological trauma;
- overfatigue;
- Bad Habits;
- hormonal disorders (obesity, diabetes);
- chronic dysbacteriosis;
- renal failure;
- temperature fluctuations (overheating and vice versa, supercooling);
- contact with the skin of a large number of “foreign” coccal flora.
Human skin is infected as a result of contact with household items strewn with bacteria or as a result of direct contact with the patient. Incubation usually lasts 7 days, and then develops a vivid clinical picture. In some cases (nail lesions, bites in the corners of the mouth) incubation can last up to 3-4 months.
At transition of a disease to an active phase, symptomatology is shown quickly. Literally within half a day the first rashes will clearly appear on the body. With a long course, illiterate treatment of streptoderma regenerates into microbial eczema.
At defeat of respiratory tracts infection is possible by an air-drop way. In this case we are talking about hemolytic streptococcus and sore throat. We will not describe this pathology in the framework of this article.
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The disease is classified on several grounds. By the nature of the protruding neoplasms pyoderma is divided into:
- Moknuchu;
- Dry.
According to the depth of the lesion there are forms:
- Surface;
- Deep.
Wet form streptoderma is accompanied by periodic appearance on the skin of the patient wet flicten of various kinds. These may be small ulcers, inflamed pimples, abscesses, large rashes. At their opening or peeling the dense crust of brown color with a treasure or purulent masses is formed.
At the initial stage of the disease, the rash is accompanied by mild itching, which is exacerbated by combing and damage to abscesses.
Dry form so called because there is no exudate and maceration of the skin (tissue exfoliation, as a result of destruction of intercellular substance). This form is almost asymptomatic and does not cause inconvenience to the victim, as the structure of the skin remains intact.
Leading signs of the dry form are considered to be pale pink peeling spots and small (not more than 1 cm in diameter) thin lamellar scales. They pass quickly with the death of the upper layer of the epidermis, followed by hygienic care of the affected area.
Favorite place of localization of dry streptoderma:
- facial skin (wings of the nose and chin);
- skin of the neck.
During treatment, temporary depigmentation of the affected area remains at the site of the rash.
Superficial lesion characterized by inflammatory processes on the surface and in the upper layers of the skin. It can occur in both wet and dry form. Areas of the face (60% of cases), neck (12%), inguinal folds (10%), buttocks (8%), buttocks (4-5%), legs (2%), etc. are mainly affected.
With drug exposure, all signs of the disease pass within a few weeks. Lack of proper care can lead to complications. The disease can take a deep form, in particularly advanced cases, possible necrosis and tissue death.
Deep shape Streptoderma affects the lower layers of the epidermis, soft mucous tissues, the surface of internal organs. In the vast majority of cases it is a complication of the superficial course of the disease.
In this form, various painful abscesses can form on almost any area of the skin, to form areas of intense accumulation of flicten. Bursting from physical exposure, they can provoke lesions (ulcers or merge into deeper ulcers) in the deeper layers of the skin. In this form, the rash may appear even on the internal organs.
Based on the specific localization, strepdoredmia can also be classified as streptococcal:
- ecthyma (rash appears in the buttocks, rarely in the extremities);
- flatulence or intertrigo (mainly appears in the groin, in the ear folds, the collision of the buttocks, in the armpits);
- call (strictly in the corners of the mouth);
- bullous impetigo (on the extremities: in the hands and feet, sometimes legs);
- tourniquet (nail plaque lesions, superficial panaritium);
- impetigo (occurs on the face, especially often in the area around the nose, torso, less often – on the extremities).
With proper care, medical treatment in an inpatient setting, all negative symptoms can be eliminated within two months to six months. After drying and exfoliation of particularly large and deep foci on the patient’s body may remain scars that can be treated with corrective cosmetic procedures.
At the first signs of the disease, washing and combing (and preferably not touching with bare hands at all) of the affected areas of the skin is strictly prohibited. This only spreads pathogenic microflora over the entire surface of the skin, provoking the emergence of new foci of infection.
Obesity and accompanying sweating, as well as diabetes are very often accompanied by streptococcal pyoderma. Obese people suffer more often because the anaerobic bacterium settles in places with minimal air access (armpits and folds, in women, the inner surface of the mammary glands and groin folds). With excess weight, fat folds actually block the access of oxygen to these places and create a comfortable microclimate for cocci who do not like air.
At a disease of a streptoderma, subjective sensations, except an itch, at patients are most often not observed. In rare cases, there may be a slight increase in lymph nodes, mild fever, dry mouth and skin.
Below are photos showing different forms of streptococcal pyoderma.
Diagnosis
At the first sign of suspicion of streptoderma, you need to go to the hospital immediately. In the absence of proper care, symptoms can develop into severe forms, as well as give rise to serious side effects (glomerulonephritis, rheumatism, etc.).
The main method of detecting pyoderma is the examination of the patient. To verify the diagnosis, swabs are taken from the affected area for microscopy. The standard procedure for diagnostic detection of pyoderma is 3 positions
- Collection of anamnesis. The doctor collects preliminary information about the current state of health of the patient (survey on complaints about health, the presence of bad habits, living conditions, etc.). The patient also finds out the possibility of a positive reaction and contact with various allergens. Since at the initial stage, before the onset of flicten, steptoderma can be easily confused with diseases such as urticaria, various atopic dermatitis, herpes zoster, eczema and others.
- Review. With the help of visual analysis and palpation, the doctor determines the anatomical features and characteristics of the skin, as well as establishes specific areas of localization and the type of protruding formations (whether redness, wounds, ulcers or flictens);
- Bacteriological examination. At this stage, the type of pathogen (which type of streptococcus caused the complication) and its susceptibility to antibiotics is identified. As a diagnostic base take the selection (pus) in the morning, which is a biological scraping.
These are not all tests. In addition, a number of tests are performed to rule out a rash that is not caused by streptococcal lesions.
| Additional laboratory tests | |
| Biochemistry | Wasserman reaction (study to detect syphilis) |
| Determination of the patient’s hormonal status | Urine examination (general analysis) |
| Test for AIDS (HIV) | Examination of feces for the presence of eggs of intestinal parasites (worms) |
A characteristic feature of streptoderma, detected by blood tests, is the rapid sedimentation of erythrocytes, leukocytosis, neutrophilia, high C-reactive protein.
Treatment
In the exacerbation phase and in chronic cases, it is desirable to go to the hospital. You can stay at home, but at the same time limit any contact with others. It is necessary to use only individual household items, to exclude acceptance of water procedures and as often as possible (at least 2-3 times a day to change bed linen, it is desirable from natural fabrics).
In the early stages, to avoid further creeping spread of inflammatory processes, the area of the primary lesion should be disinfected twice a day, with a mandatory change of bandage, boric or salicylic alcohol. Also at maturing of abscesses and formation of erosions various drying and antimicrobic compresses (1-2% resorcinol, 0, 25% silver nitrate well help). Apply them 3 times a day with breaks of 3-4 hours.
Opened abscesses and ulcers are treated with ointments with pronounced antibacterial action (streptocidal, tetracycline), exactly twice a day.
According to the doctor’s recommendation, suffering from streptoderma, the following drugs can be prescribed:
- Flemoxin Solutab.
- Amoxicillin.
- Clarithromycin.
- Ciprofloxacin.
- Augmentin.
Disinfectant ointments promote fast healing in place of flikten crust: Borno-zinc-naphthalene, erythromycin, rivanol.
Severe itching is relieved with antihistamines of the II-III generation, similar in action to telfax or Claritin.
Treatment of pustular lesions is carried out with antiseptic solutions:
- Potassium permanganate or manganese;
- Aniline dyes: methylene blue (blue), fucorsin or Castellana liquid, diamond green (green);
- Hydrogen peroxide;
- Salicylic acid;
- Silver nitrate for burrs.
Figure №17 Streptoderma in a child, treatment with fucorsin
As an auxiliary component of therapy, with the approval of a physician, physiotherapy procedures can be used:
- General irradiation of blood with ultraviolet light (systemic lesions, running and recurrent cases).
- Zonal irradiation of the affected areas of the epidermis.
At sluggish current process, for the purpose of support of immunity it is strongly recommended to drink a complex of vitamins.
Risk group
First of all, children and people with weakened immune systems due to age or bad habits.
Prevention
First of all, strict adherence to the rules of personal hygiene. It is especially important to watch children who, due to age, constantly try or bite their nails, or just put your fingers in your mouth. It is important from an early age to teach them to constantly wash their hands not only before eating, but also after any prolonged physical contact of foreign objects with the palm of the baby.
The following are universal guidelines for a healthy, active lifestyle and no addiction to bad habits.
Consequences
When mild, streptoderma can leave various marks on your skin in the form of scars and scars. It is easily treated with cosmetic procedures. With complications affecting the internal organs, everything is much more complicated: you need a comprehensive examination, with an individual course of treatment in each case.
