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  • Streptoderma - Causes, symptoms and treatment. MF.

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    Streptodermia or streptococcal pyoderma is an infectious disease of the skin that develops as a result of the introduction into it of pathogenic pathogens, streptococci. In this case, the greatest value is beta-hemolytic streptococcus group A. It is known that this microorganism is pathogenic not only for the skin. When it acts on the human body, heart and kidneys are often affected, various autoimmune diseases and allergic dermatitis develop.

    Causes of streptodermia

    The skin of a healthy person performs a good barrier function from the ingress of various pathogenic agents into the body. However, when the influence of various factors of the external and internal environment on the human body, this protective effect is significantly reduced. This includes contamination of the skin, and impaired local circulation( varicose veins), and local exposure to high and low temperatures. Various microtraumas of the skin also contribute to the penetration of pathogens into the skin. This and abrasions, and bites, and scrapes, and rubbing. Reducing the immune defense of the body as a result of chronic diseases and intoxications, fatigue, stress, starvation and hypovitaminosis are aggravating factors for the occurrence of streptoderma.

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    Symptoms of streptodermia

    The most common manifestation of streptodermia is impetigo .In this case, the thin and light-skinned skin of the face( near the nose and mouth) or the skin of other open areas of the body( brushes, feet, legs) is most often affected in children and women. Impetigo is characterized by a sudden onset. On the reddened background of the skin appears a bubble, the size of a pea filled with cloudy, yellowish contents. This bubble very quickly increases in size, up to 1-2 cm, then opens, exposing an erosive surface with scraps of epidermis around the periphery. Almost instantly, this element dries to honey-yellow crusts. Metamorphosis of these elements is accompanied by intolerable itching. Calculations contribute to the rapid infection of healthy skin areas and the spread of the process along the periphery, where such new elements of the rash are formed. Thus, extensive lesions are formed. One of the additional factors of the spread of infection are household items( towel, pillowcase, etc.).In this case, there are multiple infected skin areas that are not interconnected territorially. This is how the picture of classical impetigo develops.

    Photo impetigo

    Impetigo bullous

    Recently, increasingly began to appear features of the development of bubbles. When bubble form of impetigo, there are elements of rash-blisters with a denser tire. Such an element has no tendency to peripheral growth and dissection. At the same time on the skin of the body and hands there are numerous small bubbles with serous-purulent contents. Such bubbles with a dense cover often infect a peri-oral groove. Outwardly it looks like a horseshoe shaped bubble with the appropriate contents. This form of skin lesions streptococcus is called tournament .It is often possible to find bubbles, large sizes, drying in the center, and around the periphery surrounded by a roller containing serous-purulent contents.

    Most often, the impetigo of patients is concerned about the itching and dryness of the affected areas. Sometimes, in children, with extensive skin lesions and in the presence of concomitant diseases, there may be a rise in temperature and an increase in lymph nodes that are close to the lesions.

    When recovering on the place of impetigo, there are no cosmetic defects and scars, except for post-inflammatory hyperpigmentation.

    Streptococcus can affect deeper layers of the skin. This is the so-called streptococcal ectyme , in which there is an abscess with serous-purulent contents, not permeated with hair, tending to peripheral growth and rapidly increasing in size. Such an element soon shrinks into a crust of a greenish-yellow color, which, unlike impetigonous, sits tightly on the skin. When this peel is rejected, a painful ulcer is exposed, with uneven rounded margins and purulent discharge. Since the epidermis affects the growth layer of the skin, the healing of such an element occurs with the formation of a well-marked scar. Most often ectima is located on the lower limbs.

    In the picture streptococcal ecstema

    Diagnosis of streptodermia

    Due to the fact that streptoderma is an acute lesion of the skin and tends to spread rapidly, when symptoms such as a blister and itching appear, you should immediately consult a doctor. In this case, to confirm the diagnosis, microscopic and mycological examinations of skin scales will be prescribed. It is clear that self-treatment in this case is unacceptable, because with the use of antibacterial ointments diagnosis may not be confirmed.

    Treatment of streptodermia

    To exclude peripheral spreading, the skin around the focus is wiped with disinfectant solutions( boric or salicylic alcohol) with each dressing change, namely 2 times a day.

    At the initial stage of the pathological process, in the presence of bubbles and erosion on the background of reddened skin, it is necessary to carry out outdoor procedures. A quick and positive effect is provided by wet-drying dressings with various aqueous solutions( 1-2% resorcinol, 0, 25% silver nitrate).The therapeutic effect depends directly on the technique of performing such procedures. Sterile gauze cloth, from 6-8 layers, moistened in a room temperature therapeutic solution, is wrung out and superimposed on the damaged surface of the skin. After 15 minutes, the same cloth is re-wetted in the prepared solution, squeezed out and again covers the streptodermia site. Thus, within one and a half hours, manipulations with wet-drying bandages take place. During the first days of streptoderma treatment, wet-drying dressings conducted in this way should be repeated 2 to 3 times, with interruptions for 3 hours.

    Cracks in the corners of the mouth - seizures , it is necessary to lubricate 1-2% with silver nitrate from 2 to 3 times a day.

    Bubble covers should be opened in compliance with all asepsis rules. In the future, bandages with antibacterial ointments, such as tetracycline ointment or streptocidal ointment, are applied to the treated blisters 12 hours 2 times a day. On the crust as necessary to use ointments with disinfectants: 3% rivanol, etakridin-boron-naphthalan and erythromycin ointment.

    With strong and unbearable itching, antihistamines such as Claritin, Telfast, are prescribed in standard therapeutic doses to rule out the active spread of infection. For the same purpose, children are daily lubricated with nails with an alcohol solution of iodine.

    In case of severe inflammation, on the periphery of the focus, hormonal external means may be used for a short period of time( Triderm, Lorinden A, C).It must be remembered that with the long-term use of these funds, irreversible changes occur on the skin in the form of its thinning. In this regard, hormonal external means should not be used without the supervision of a doctor.

    With the widespread nature of the process, with increasing temperature and increasing regional lymph nodes inside are prescribed antibiotics( semisynthetic penicillins or cephalosporins).

    With prolonged and sluggish process, the purpose of vitamin therapy( A, B1, B6, C, P) and immunostimulating therapy( autohemotherapy and appointment of pyrogenal courses) is justified.

    After removal of the acute inflammatory phenomena, a course of ultraviolet irradiation with suberythmic doses on the affected skin areas is prescribed.

    In the external treatment of streptodermia, the use of folk remedies has proved to be well established.

    Folk remedies for streptodermia

    To create a drying effect on the skin, it is recommended to use decoctions of various herbs in the form of wet-drying dressings. To exclude the possibility of additional skin allergization, the preference is given to the least allergenic herbs, such as oak bark or chamomile.

    For the entire period of streptoderma treatment, hygiene baths and showers are prohibited. Instead, a healthy skin is wiped with a napkin soaked with infusion of chamomile.

    The diet with the exception of acute, fatty and sweet reduces the allergic mood of the body, which leads to a decrease in exudation( wetting of the wound), thereby contributing to the drying out of the focus.

    Complications of streptoderma

    With the patient's allergic mood and with improperly and inappropriate treatment, streptococcal lesions can lead to increased sensitivity of the skin to microbes and cause a more complex disease to treat - microbial eczema .About joining to the basic process of an eczema it is possible to judge on occurrence on a reddened background of microerosions from which drops of a serous liquid are separated.

    Prevention of streptodermia

    In children's preschool institutions, children with streptoderma are isolated and quarantined for 10 days.

    A healthy lifestyle, a balanced diet and regular hygiene care are good conditions for the skin's immunity to streptococcal lesions.

    Consultation of a dermatologist on streptoderma:

    1. Is streptoderma and pyoderma the same?
    No, not really. Pyoderma is the defeat of the skin as a result of the introduction into it of any pathogenic pyococcus. Most often it is streptococcus and staphylococcus aureus. Depending on the type of microorganism, the diseases are called: streptoderma and staphyloderma, and pyoderma is the common name for pustular skin diseases.

    2. Can I do without any tests to determine which of the pathogens caused by skin lesions?
    It is impossible to determine without analysis, of course, but it can be assumed. For example, it is known that streptococci cause a superficial serous-exudative nature of the lesion that does not penetrate the appendages of the skin( hair follicles, sebaceous and sweat glands).Such a lesion is prone to peripheral growth, often located in the folds and is accompanied by severe itching.

    3. Why does quarantine apply to kindergartens when streptoderma is detected?
    Children have poorly formed immunity, so strokes of streptoderma in such groups occur very quickly. The reason for this is close contact of young children with each other, with the same toys.

    4. How many days should pass from the moment of infection to the appearance of the first elements?
    In medicine, this period is called incubation and with streptoderma it lasts about 10 days.

    5. Can an adult get infected from a child?
    Of course, such infection is possible with close contact with infected skin of children or through common with the child subjects.

    6. I've heard somewhere that cracks in the corners of the mouth are often caused by streptococcus. Is this also streptoderma?
    Such cracks are called zaeda and in fact it is erosion, surrounded by the collar of the stratum corneum, left after the opening of the blisters and surrounded by honey-yellow crusts. Most often, this skin damage is caused by streptococcus, and the constant licking of lips and increased salivation leads to the development of maceration( swelling of the skin as a result of impregnation with liquid), which helps to reduce the barrier properties of the skin and the reproduction in it of this pathogenic organism. In this case, an aggravating factor is Vitamin B2 hypovitaminosis, a deficiency in the body of riboflavin. As for increased salivation, this is most often a consequence of teething in children, wearing dentures in adults, and also a sign of helminthic invasions, for which an additional examination is necessary.

    7. Why are obese people prone to streptodermia of the skin folds?
    It is known that this process is most often localized in inguinal, interannual, axillary, behind-the-bows and under the mammary glands. This is promoted by increased flow and fat release, the release of sugar with sweat, which disrupts the integrity of the skin and promotes the development of streptococcus.

    8. At my daughter near a nose, after an excision of a crust of yellow color, there was a pigmented stain with a bluish shade. What now, this stain will always be on her face?
    Hyper-pigmented spots after a streptococcal skin lesion remain for a short time, and then discolored.

    9. What is white lichen?
    This is one of the forms of streptoderma, which is manifested by small-scaly exfoliation, against the background of a red-pink patch. It often occurs in children and in people who spend a long time in the open air and the sun. It contributes to the development of such a process of vitamin Vitamin A retinol vitamin.

    Doctor dermatologist Kuklin TP