Streptoderma: symptoms, treatment
- Microbiological characteristics
- Features of streptoderma
- Symptoms of streptoderma
- Impetigo streptococcal
- Treatment of streptoderma
Streptodermia is a vast group of skin infections caused by various variants of streptococcus. There is a predominant lesion of the skin proper, without involving the sebaceous glands and hair follicles in the process (in contrast to staphylococcal infection).
The most common variant is the classification of streptococci in accordance with their antigenic structure. About 20 groups of streptococci are named in the letters of the Latin alphabet. Danger to humans are streptococci in groups A, B and D.
All streptococci in the field of view of a light microscope have the form of a tape (necklace) of red (gram-negative strains) or blue (gram-positive strains). All streptococci do not form a dispute, but some strains have a capsule, which creates significant difficulties for antibiotic therapy.
Most streptococci have significant biochemical activity, and also synthesize a large number of aggression factors, which ultimately causes a variety of clinical manifestations of the disease (from skin lesions to severe septic conditions).
Still the most informative in the diagnosis of streptococcal infection is bacterioscopic (microscopic) and bacteriological methods. As a biological material for microbiological studies, detachable from the elements of the rash with streptoderma (sometimes a smear-imprint) is used.
Almost all kinds of streptococcus are not exacting to the conditions of cultivation, therefore classical nutrient media (basic) can be used. Only some representatives of Group B Streptococcus require strict adherence to the temperature regime and the presence of certain biochemical constituents of the nutrient medium. According to the results of the bacteriological method (cultural, tinctorial and biochemical properties), a conclusion can be drawn about a specific strain of streptococcus that caused the disease, and also sensitivity to certain antibacterial drugs was established.
Features of streptoderma
It should be understood that streptococci surround man almost everywhere. They are present on their own mucous membranes, in air and soils, on surfaces of household items and clothing. Completely destroy this group of microorganisms is impossible, in addition, there is no need.
Streptodermia is more susceptible to small children (tender skin, insufficient level of immunological reactivity); women (especially during the period of hormonal changes), people of elderly and senile age (weakened by chronic diseases, with insufficient trophism of the skin).
Streptococcal infection develops only in the presence of predisposing factors, namely:
- Severe somatic pathology (diabetes mellitus, stomach diseases (hypo- or anacid gastritis ) .Correlation was found between lowering of acidity and the appearance of pyoderma).
- Pathology of the nervous system (neuroses, depression).
- The imbalance in nutrition (starvation, lack of proteins and trace elements, the predominance of all types of carbohydrates).
- The presence of local foci of infection, which leads to sensitization of the human body ( dental caries , chronic rhinitis and tonsillitis ). There is an intoxication of an organism with bacterial toxins and products of autolysis of tissues from the foci into the general bloodstream.
- Diseases of the endocrine system.
- Change in the immune status - decrease in specific and nonspecific immunobiological reactivity of the organism, violation of the T-system of lymphocytes (decrease in their number and inhibition of functional activity).
Often such a contingent of people has a contact with the so-called carrier of streptococcus. This is a person on the mucosa of which there is an aggressive strain of streptococcus, which does not harm the host and does not cause clinical manifestations of the disease. But such a person is a danger (as a source of infection) for others, especially if he is an employee of a children's school or preschool institution, a food company, a medical worker. The following variants of infection are also most typical:
- minor injuries (cuts and scratches);
- prolonged mechanical impact (shoes not in size, tight clothes);
- prolonged exposure to low or high temperatures;
- lack of proper hygienic skin care;
- various itching dermatoses ( eczema , scabies , neurodermatitis ), since itching facilitates the introduction of streptococci into the skin.
Symptoms of streptoderma
The most common variant of streptococcal infection is streptodermia (superficial lesion of the skin), often more deeper skin lesions (abscess, phlegmon, carbuncle), the most severe and worst variant is the general infection of the blood with streptococcus (sepsis).
There are the following variants of streptoderma:
1. Impetigo streptococcal:
- impetigo bullous;
- impetigo slit;
- streptococcal cheilitis;
- simple lichen ;
- surface panaritium (tournamentol);
- diaper rash; streptococcal;
- postoperative syphiloid;
2. Ecthima vulgaris.
Impetigo got its name from the Latin notation - a rapidly evolving process. Impetigo streptococcal (it is Fox or contact). The most typical localization is the limbs, face, and also the lateral surfaces of the trunk. On the surface of the skin a reddish shade forms, which quickly enough transforms into a bubble (flikenu). At the beginning of the conflict, it is strained, then becomes flabby, filled with a transparent serous (rarely hemorrhagic) content. Usually, several conflict are formed, delimited one from another, rarely they merge. Within a few weeks, the phlyctenum undergoes reverse development, collapses and forms a crust. A scar may form on the crust site.
Bullous impetigo is characterized by large dimensions of the skin defect and preferential localization on the limbs. Integrity in this case is not long, a fairly extensive erosion is formed, which heals long enough. Around the erosion there are sometimes remnants of covering the fiction.
The slit impetigo differs in its characteristic localization. These are the corners of the mouth (the so-called zaeda), the edges of the eye slit and the wings of the nose. Actually, the conflict quickly loses its integrity, a crack or erosion is formed. Covering the skin defect, the crust does not last long, as permanent maceration takes place. Zaeda can exist for any length of time, there is a tendency to infect others through common utensils and other household items.
Simple lichen is distinguished by the fact that dry elements are formed, and not wet flies. Papular foci appearing on the face, trunk, less often on the limbs, are quite dense, covered with scales. After the reverse development of the elements of the rash, a lighter coloration of the skin in these areas is noted, which gave the name to this type of streptococcal infection.
Tournole (okolonogtevaya fliktena) is formed only around the nail plate as a result of chronic trauma (production or living conditions), with the presence of burrs, broken trophic in the metabolic syndrome, diabetes mellitus. Flickety surround the nail plate. The amazed finger swells, becomes sharply painful, acquires a bluish-purple hue. Tournament is prone to peripheral growth, can provoke purulent melting and rejection of the nail plate.
Streptococcal diaper is formed in natural skin folds in people with obesity (under the stomach, on the buttocks), in women - under the mammary glands. The resulting numerous flickens merge with the formation of extensive erosion erosion. Typically, children are noted skin rash. Erosion does not heal for a long time, deep cracks form which cause a lot of inconveniences and painful sensations to a person.
Ecthima vulgaris (fulgary) is a fairly extensive and profound skin defect. Observed in weakened people. A very large flabby fliken with a quenching-purulent or purulent content is formed. Fliktena is easily opened spontaneously, transforming into an ulcer. The ulcer is filled with purulent secret, poorly healed - usually by secondary tension. A rough scar is formed. Peripheral growth is possible.
Treatment of streptoderma
Streptodermia therapy includes local effects, directly on the lesions, and the general, providing stimulation of immune defense and general reactivity of the human body.
Complex impact on the entire human body includes:
- normalization of the regime of work and rest;
- balanced full-fledged nutrition enriched with proteins, trace elements and vitamins;
- observance of all items of personal hygiene (regular shower at room temperature, change of underwear and clothes, frequent change with pre-ironing of bed linen, use of only individual dishes and hygiene items);
- treatment of somatic accompanying diseases in order to stabilize the period of remission;
- if necessary - taking sedatives on a herbal basis (motherwort, valerian).
The effect on the microbial agent involves the administration of antibiotics. It should be remembered that an independent choice of an antibacterial agent may not have the necessary effect. Amongst some Streptococcus strains resistance to penicillin and cephalosporin group drugs is quite widespread. Therefore, the drugs of choice should be fluoroquinolones, penicillins (protected), macrolides and aminoglycosides. It is necessary to observe the average duration of the course of antibiotic therapy - at least 10 days - to prevent recurrence of the disease.
Local treatment is aimed at the sanation of skin elements of the rash, prevention of spreading to healthy areas of the skin, as well as healing by primary or secondary tension. For this, various ointments and gels containing an antibacterial component, decongestants and cell division stimulating components can be used. Often, drying agents are used to quickly convert the frichene into the crust, for example, brilliant green solution, fucarcin, methylene blue, potassium permanganate solution. It is strictly forbidden to sprinkle chalk or talcum, applying lotions and moist compresses.
Strengthening of immune defense can be achieved with the help of immunomodulators:
- plant adaptogens (aloe, echinacea, eleutherococcus);
- preparations based on the thymus gland (thymogen, thymalin, thymohexin);
- cytokine preparations - substances normalizing the process of inflammation (leukomax, leukinterferon, Roncoleukin);
- chemical agents, one of the side effects of which is immunostimulation (levamisole).
When treating any variant of streptoderma, any physiotherapeutic procedures are categorically contraindicated - this will promote the spread of infection and worsen the condition of the sick person.
It should be understood that only an integrated approach to treatment and strict implementation of all medical recommendations will help quickly and effectively cope with the manifestations of streptoderma.
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