Streptococcal impetigo is found everywhere in people with delicate and sensitive skin. This infection is usually the result of poor hygiene, so it often occurs in children, especially during the warm season.
Definition
Streptococcal impetigo (ICD 10 L01) is a highly contagious skin disease caused by a bacterium of the streptococcal group. It is manifested by conflicts (small blistering rash) with swelling and redness. Settling in groups, the bubbles merge and increase, and after the rashes pass, pinkish spots still remain on the skin for some time.
Skin manifestations are updated every five to six days. The infection quickly spreads to he althy areas, and the process begins again. Improper treatment and prevention can cause damage to a large area of \u200b\u200bthe skin. Most common location: face, hands, shoulders and other exposed skin.
In dermatology, the following varieties of streptococcal impetigo are distinguished: bullous, annular, slit-like, as well as tourniole (disease of the nail folds), streptococcal diaper rash and posterosive syphilis.
Causes of impetigo
The main causative agents of infection are considered streptococcus and staphylococcus aureus. The transmission route is contact, through dirty hands, toys, clothes and other household items. The penetration of bacteria through the mucous membranes is possible only if they are damaged, such as cracks or scratches.
Streptococcal impetigo in children occurs against the background of atopic dermatitis, eczema, allergic contact dermatitis, since the immune system is already compromised. Maceration of the skin, hyperhidrosis (sweating), rhinitis or otitis media with copious discharge are also favorable conditions for the onset of the disease. Parents of young children call streptococcal impetigo "fireworm" because it spreads at an amazing rate in the children's community.
Symptoms of disease
It all starts with the appearance of small reddish spots on the skin. A few hours later, bubbles appear in their place, but hyperemia does not go anywhere - these are conflicts. At this stage, the bubbles are tense, the liquid that is in them is transparent. But over time, their dome settles, and the contents become cloudy and turn into pus. From this moment, two scenarios are possible: the pus dries up, and yellow or brown crusts remain on the skin, or the bubbles open spontaneously, liquid pus flows out, leaving wounds. After everything heals or the crusts peel off, lilac spots remain on the skin for some time.
Staphylococcal impetigo lasts without treatment (one cycle of conflict) for seven days. Rash,as a rule, it is located on open areas of the body: face, arms, abdomen and back. Conflicts are located in conglomerates and tend to merge. Since the child itches, he himself spreads the infection throughout his body. With adequate treatment, the disease disappears in a month and leaves no cosmetic consequences.
Diagnosis
A dermatologist can identify clinical signs of streptococcal impetigo. A photo of the skin (dermatoscopy) and a study of its acidity only confirm the diagnosis. To accurately determine the etiology of the disease, the contents of the vesicles are sown on nutrient media, and when the colony of bacteria grows, its microscopy is performed.
If the disease often recurs, it makes sense to be examined by an immunologist so as not to miss any serious violations. Skin bacterial diseases are the first bell indicating the scale of the problem.
The doctor, in the process of collecting information about the disease, needs to differentiate it from folliculitis, ostiofolliculitis, impetigo vulgaris, epidemic pemphigus, herpes simplex, Duering's dermatitis. Clinically, they all resemble streptococcal impetigo. A high magnification photo of damaged skin helps to distinguish diseases from each other.
Annular impetigo
This disease begins with the appearance of small flat blisters that are filled with a cloudy liquid. They grow rapidly in breadth, spreading tohe althy areas, but at the same time dry up in the center with the formation of a brown crust. Therefore, by the end of the disease, conflicts have the form of rings. In some cases, the pattern of rashes resembles a garland.
In all other respects, the disease usually resembles streptococcal impetigo. Specialists differentiate this form from herpes zoster, exudative erythema and Dühring's dermatitis.
Bullous impetigo
The causative agent is streptococcus, but in some cases staphylococcus is also sown in patients. Bacteria enter the body through macerated skin. Most often this happens in the summer. The literature describes entire epidemics of this disease in soldiers.
The signs that distinguish between bullous and streptococcal impetigo are primarily a type of rash. Bubbles of large size (up to two centimeters) have a hemispherical shape and are filled with a cloudy liquid mixed with blood. The favorite localization of these conflicts is the hands and shins. There is swelling and inflammation of the lymphatic vessels around the affected areas. Local symptoms are accompanied by a general reaction of the body: fever, headache, increased leukocytes and ESR (erythrocyte sedimentation rate) in the general blood test.
Against the background of other skin diseases, bullous impetigo is even more severe.
Streptogenic congestion
This is a streptococcal impetigo that develops in the corners of the mouth with the formation of small flat blisters, filled firstserous fluid and then pus. Due to constant traumatization (during eating, talking), conflicts open up, and cracks appear in their place. If the disease is neglected, then these cracks are quite deep and painful. In childhood, seizures often recur. This is due to poor hygiene and lack of B vitamins, as well as the presence of diseases such as diabetes.
Differentiate seizures with hard chancre, early congenital syphilis, Plummer-Vinson syndrome. The first two diseases are characterized by positive serological reactions for syphilis and the presence of other symptoms, and Plummer-Vinson syndrome is accompanied by hypochromic anemia, dysphagia, glossitis and stomatitis, which are not present in streptococcal seizures.
Surface panaritium (tourniol)
This disease is a type of bullous impetigo and occurs in the periungual folds. Its occurrence is provoked by injuries, burrs and scratches, which become infected with streptococcus and suppurate. Bubbles are located in the form of a horseshoe, surrounding the nail plates on the hands and feet. It can be either an isolated lesion of one finger, or a widespread one, covering the entire hand.
Bubbles increase in breadth and are filled with serous or purulent contents. If the lid of the vial is damaged, erosion remains, which eventually becomes covered with crusts. If the disease proceeds favorably, then all sores heal, but in rare cases, the infection penetrates deeper under the nail, up to its rejection. The bacteria then spread through the lymphatics and blood vessels.
Superficial felon should be distinguished from chancre-felon, candidiasis of the nail folds and Allopo dermatitis. Chancre is a manifestation of primary syphilis, therefore, characteristic symptoms are inherent in it: a dense red-bluish elevation with an ulcer in the center. In addition, the patient has other signs of syphilis. Candidiasis of the nail folds is a manifestation of a systemic decrease in immunity. In this case, there is no swelling of the finger tissues, the nails are dirty-brown in color, and fungi are found in the discharge from erosion.
Posterosive syphiloid
Or else Sevestre-Jacquet disease. It is most common in overweight infants. Due to the presence of a large number of folds, parents do not always manage to take good care of them, so areas of maceration and irritation appear on the skin.
The main symptom of the disease is the appearance of a rash on the buttocks, which, after opening, leaves erosions surrounded by a halo of desquamated skin cells. In advanced cases, conflicts can be located on the back and inner thighs, merge, forming bizarre arched shapes.
After some time, the erosion sites are infiltrated, and papules appear in their place. After the resolution of the rash, that is, the healing of ulcers, age spots often remain. Due to such an abundance of morphological elements, it is not always possible to diagnose the disease in time.
Differential diagnosis is carried out with papular syphilis and microbial eczema. In the first case, there isa positive Wasserman reaction, and in the second - there is no redness under the polymorphic elements of the rash. In addition, papules and vesicles in microbial eczema do not merge with each other.
Treatment
There are general principles for the treatment of streptoderma, which will help eliminate streptococcal impetigo. The treatment is carried out with antibacterial drugs and local disinfectants. If the elements of the rash are single, then they can be treated with aniline dyes: brilliant green or fucorcin. Also effective is the use of ointments with antibiotics ("Oxycort", "Dermazolone", "Neomycin" and others). When conflicts spread to large areas of the skin, streptococcal impetigo can be treated with resorcinol lotions.
Tableted antibiotic therapy is advisable in especially severe cases and with frequent relapses of the disease. In addition, general strengthening drugs are prescribed additionally. Streptococcal impetigo in children is not fundamentally different. The treatment remains the same, but before applying the ointment, you must wait for the spontaneous opening of the bubbles, and also make sure that the child does not scratch the skin.
Recommendations and prevention
As a preventive measure, a culture of hygiene should be instilled. Children and adults are advised not to wet the affected areas during the entire treatment process. All of the following must be observed:
- avoid contact with other children;
- use separate bath accessories and change bed and underwear regularly;- highlightsick set of dishes.
If you follow these rules, then neither within the family nor within the children's team the disease will not spread. In order to prevent infection, do not neglect personal hygiene, always carefully treat abrasions and scratches and try not to scratch the skin during rashes. Recurrent streptococcal impetigo is a complication that develops due to a decrease in the body's resistance. Don't forget about it and watch your he alth.
