Streptoderma is an infectious pathology that occurs with damage to the epidermis. The disease is easily transmitted and spreads rapidly. Most often, children of preschool and primary school age get sick. This is due to the fact that the child's immune system is not fully developed. Treatment of streptoderma should be started as early as possible, until the disease has affected the deep layers of the skin and has not passed into the chronic stage. In the early stages, this ailment heals quickly and leaves no marks on the skin.
Pathogen
The causative agent of streptoderma is streptococcus. This bacterium is normally present on the epidermis in many people. It lives on the surface of the skin, but does not penetrate into the inner layers, as it is quickly destroyed by immune cells. With the good work of the body's defense system, this microbe does not cause any infectious diseases. Therefore, streptococcus is consideredopportunistic bacteria. However, if a person's immunity drops and at the same time there are wounds on the skin, then microbes penetrate into the deep layers of the epidermis. There is a disease - streptoderma.
There are cases when streptococcus joins an already existing infectious pathology. With chickenpox, herpes or eczema, streptoderma exacerbates the symptoms of the underlying disease. These pathologies are often accompanied by itching. Streptococcus enters the skin through wounds from scratching. In this case, doctors talk about secondary streptoderma.
What can provoke the onset of the disease
The direct cause of streptoderma is the causative agent - streptococcus. However, in order for the development of the disease to begin, additional unfavorable conditions are necessary. These include all factors that contribute to a decrease in immunity:
- stress;
- avitaminosis;
- chronic diseases of the gastrointestinal tract and endocrine system;
- circulatory disorders;
- past acute infections.
In children, symptoms of streptoderma may occur after suffering a sore throat or scarlet fever. These diseases are caused by the same microorganism - streptococcus.
In addition, the causes of streptoderma may also be in violation of the integrity of the skin. After all, the infection enters the epidermis through wounds. Even small scratches, abrasions and bites can become a gateway for bacteria to enter.
Acidity (pH) of the skin also plays a big role. Its normal values arevalues from 5.2 to 5.7 units. If the pH rises to 6-7 units, then the microflora of the epidermis is disturbed. The result is a favorable environment for microbial growth.
Often people with hormonal disorders suffer from streptoderma. Improper functioning of the endocrine glands affects the condition of the epidermis. With a hormonal imbalance, the skin becomes oily and covered with blackheads. This epidermis is very susceptible to infection.
Transmission routes
Is streptoderma contagious? The infection quite easily passes from a sick person to a he althy one. The following transmission methods can be distinguished:
- Contact. The pathogen appears on the skin of a he althy person after a handshake or other contact with the patient's epidermis.
- Household. The infection is transmitted through objects used by a sick person.
- Airborne. This route of transmission is rarely noted. However, a sick person can shed the bacteria when they sneeze and cough. If they get on the skin of a he althy person, then a disease occurs.
- Dusty. Bacteria enter skin wounds through dust contaminated with streptococci.
Streptoderma in adults is much less common than in children. This disease is more typical for preschool and primary school age. It is enough for one child to get sick, as an outbreak of this infection begins in the children's team. Adults most often become infected through contact with sick children.
Streptoderma does not form immunity. Relapses are not uncommon.
Types, shapes anddisease stages
Infection can affect both the superficial layer of the skin and the deeper parts of the epidermis. In the first case, the disease is called impetigo, and in the second - ecthyma.
In medicine, the following stages of streptoderma are distinguished depending on the depth of the epidermis lesion:
- Bullous. Bacteria infect only the surface layer of the skin. Rashes appear in the form of small bubbles. Then they open, the wounds heal. No traces remain on the epidermis. Usually, the infection affects the skin of the face.
- Non-bullous. Large blisters and ulcers form on the skin. Characterized by damage to the deep layers of the epidermis. General he alth worsens. The process of treatment of this stage of the disease is very long. Often there is non-bullous streptoderma on the arms and legs.
- Chronic. It is observed with insufficient or incorrect treatment. The infection affects large areas of skin (up to 10 cm).
With timely treatment, the disease ends at the bullous stage. In this case, skin damage is limited to only its upper layers.
Also, streptoderma is classified depending on the nature of the rash. The following forms of the disease are distinguished:
- streptococcal impetigo;
- bullous impetigo;
- dry streptoderma;
- streptococcal congestion (slit-like impetigo);
- periungal panaritium (turniol);
- streptococcal diaper rash;
- vulgar ecthyma.
Symptoms of streptoderma will differ depending on the form of the disease. Clinical picture of different typespathology will be discussed further.
ICD classification
According to the International Classification of Diseases of the Tenth Revision, streptoderma refers to infections of the skin and subcutaneous tissue. Such diseases are designated by codes L01 - L08. The ICD-10 streptoderma code will depend on the form of the disease.
Most often this disease occurs in the form of impetigo (damage to the upper layers of the skin). In this case, it is designated in the ICD-10 code L01.
Deep skin lesions (ecthyma) with streptoderma are coded under the code L08.8, which means - "Other specified local infections of the skin and subcutaneous tissue".
General symptoms
How does streptoderma start? The incubation period after infection is about 7 days. Then the first signs of the disease appear. They depend on the form of pathology. However, it is possible to distinguish the general symptoms of streptoderma, characteristic of all types of this disease:
- Red spots on the epidermis. They are most often localized on the face, limbs, armpits and groin, as well as in skin folds. The spots are round. In the area of redness, peeling of the skin is noted.
- Bubble rash. The size of the rash can range from a few millimeters to 1-2 centimeters.
- Severe itching in affected areas.
- Pain and swelling of the skin at the site of the rash.
- Swollen lymph nodes.
In addition, many patients feel worse. There is weakness, malaise, headache. The temperature can rise up to +38 degrees. That's how he reactsbody for infection. Next, we will consider in more detail the symptoms of different types of streptoderma.
Symptoms of streptococcal impetigo
Most often the disease occurs in the form of streptococcal impetigo. This is the mildest form of pathology. A slight redness appears on the skin, and then vesicles (conflicts). Inside them is purulent content. Conflicts can grow up to 1–2 cm. Such a rash occurs mainly on the face. Then their walls are torn and pus comes out. At the site of the rash, crusts form, which subsequently fall off. When the skin heals, a stain remains, which then turns pale. There are no traces in the places of rashes. The disease lasts up to 2-4 weeks.
Clinical picture of bullous impetigo
Bullous impetigo is more severe. This disease is more common in infants. Bubbles with this form of the disease usually appear on the arms or legs. They reach sizes of 1–2 cm. Over time, they break through. In their place, ulcers appear that heal for a long time. Itching worries the patient after the opening of the bubbles. This form of the disease is always accompanied by a significant deterioration in well-being: weakness, fever, swollen lymph nodes. Skin healing can take up to 2 months.
Dry streptoderma
Dry streptoderma is usually easily tolerated. Only the uppermost layers of the dermis are affected. Rashes are formed in the form of white or pinkish spots covered with scales. Bubbles are not observed. The manifestations of the disease practically do not bother the patient, there is no deterioration in the general condition. However, this form of pathology is insidious in that the patient remains contagious with normal he alth. Very often, children with dry streptoderma transmit the infection to others.
Streptococcal congestion
This form of streptoderma in adults and children is noted quite often. Rashes are localized most often in the corners of the mouth, less often in the area of the wings of the nose and eyes.
Redness appears on the affected area. Then a small amount of bubbles form. Usually single rashes are noted. Over time, they open up on their own, crusts and cracks form in their place, and then the skin heals.
Usually, eating does not make you feel worse, and the disease responds well to treatment. However, it is this type of streptoderma that often becomes chronic, especially in people suffering from dental diseases.
Paraungual felon
In this case, streptococci infect the skin in the area of the nail bed on the fingers or toes. Painful swelling and redness appear around the nails. Then bubbles form. After opening them, the affected area is covered with a brown crust, from under which pus is released.
Streptococcal panaritium usually occurs in people after damage to the skin around the nails during manicure procedures or hangnails. This disease must be treated as early as possible. If left untreated, nail rejection may occur.
Streptococcal diaper rash
Of all types of superficial streptoderma (impetigo), this form of the disease is characterized by the most severe course. Pathology often occurs in infants, the elderly or bedridden patients. Streptococci affect the skin folds in the armpits, in the groin and gluteal region, and in women - under the mammary glands. The disease affects overweight children and adults who have a lot of fat folds on the body.
Inflammation of the skin occurs with severe itching, pain and redness. Then bubbles form, which merge with each other. Often, streptococcal lesions develop against the background of diaper dermatitis or common diaper rash, which makes the course of the disease even more severe. In addition, the skin folds are constantly moisturized by the secretions of the sweat glands, which increases the irritation of the epidermis. This form of the disease is characterized by a long course and slow healing of the skin.
Ecthyma vulgaris symptoms
When vulgar ecthyma occurs, the deep layers of the skin are affected. This is the most severe form of streptoderma. It develops with a strong decrease in immunity: in patients with diabetes, tumors, viral infections.
Lesions are marked on the legs and buttocks. Large blisters with thick walls are formed, filled with pus. After their breakthrough, painful ulcers appear, which heal very slowly. Rough scars remain on the skin. The disease is always accompanied by symptoms of general intoxication: high fever, weakness, swollen lymph nodes, headache.
Treatment of streptoderma insuch a severe form should be started immediately. Vulgar ecthyma is often complicated by sepsis. In addition, staphylococci often join streptococcal infections, resulting in even more severe skin lesions.
Diagnosis
Diagnosis and treatment of streptoderma is done by a dermatologist or therapist. Usually, the disease is determined already during the examination according to the patient's complaints and the appearance of the rash. Laboratory methods are rarely used. Sometimes a complete blood count is done. An increase in the number of leukocytes and ESR indicates the presence of inflammation.
In some cases, an analysis of the bacteriophage of the contents of the vesicles is required. It is needed to choose the right method of therapy. During the study, the sensitivity of streptococci to different types of antibacterial drugs is determined.
External remedies
How to smear the affected areas of the skin with streptoderma? This question often worries patients. Before applying ointments, rashes must be treated with the following antiseptic solutions:
- brilliant green;
- fucorcin;
- iodine solution;
- boric acid"
- hydrogen peroxide;
- "Miramistin";
- "Chlorhexidine";
- alcohol and water solution of methylene blue;
- potassium permanganate.
Alcohol solutions with dyes (brilliant green, fukortsin, methylene blue) most effectively affect the pathogen. However, they can not be used for rashes on the face, as well as fortreatment of streptoderma in infants and the elderly. These drugs can cause skin irritation. Children under 3 years of age are not recommended antiseptics with iodine, chlorhexidine and Miramistin.
Rashes are treated with antiseptics 3-4 times a day. You can apply spotting local remedies to the affected areas only 30 minutes after applying the solutions.
For streptoderma, ointments with antiseptics and antibiotics are prescribed:
- "Tsindol";
- zinc ointment;
- salicylic ointment;
- "Baneocin";
- "Levomekol";
- "Synthomycin";
- "Streptocide";
- "Fusiderm".
These topical products penetrate into the deep layers of the epidermis and prevent the growth of bacteria. They are applied to the skin or used as compresses.
It is important to note that Acyclovir ointment should not be used for streptoderma. It is an antiviral agent that does not affect streptococci.
Sometimes dermatologists recommend hormonal ointments with corticosteroids to relieve itching. In no case should such funds be used independently. The question of their appointment can only be decided by the attending physician. They are not shown to all patients. They are usually prescribed for streptococcal ecthyma, the chronic course of the disease, as well as the combination of streptoderma with dermatitis. Apply corticosteroid ointments "Pimafucort","Akriderm", "Triderm".
During treatment, it is not recommended to take hygienic water procedures. Streptococcus thrives in humid environments, and washing rashes can spread to he althy areas of the skin.
Oral antibiotics
Oral antibiotics for streptoderma are not indicated in all cases. The question of the need to prescribe antibacterial drugs is decided by the attending physician. Antibiotics must be prescribed for ecthyma, extensive skin lesions, signs of incipient complications, as well as high fever and other symptoms of general intoxication of the body.
The choice of an antibacterial drug is determined by an analysis of the contents of the rashes for bacteriological culture. For streptococcal infections, penicillin drugs are most effective:
- "Amoxicillin";
- "Flemoxin Solutab";
- "Amoxiclav";
- "Augmentin".
However, penicillins often cause allergic reactions. Therefore, if the patient has undesirable effects, then these drugs should be replaced with macrolide antibiotics, cephalosporins or fluoroquinolones:
- "Clarithromycin";
- "Azithromycin";
- "Sumamed";
- "Rovamycin";
- "Cefuroxime";
- "Ciprofloxacin";
- "Levofloxacin".
Antibacterial drugsappointed for a period of 5 to 14 days. Most often, antibiotics are taken orally, intramuscular or intravenous administration is indicated only in severe cases.
Prevention
It is important to remember that streptoderma can cause serious complications. Bacteria can affect not only the skin, but also the kidneys, the lining of the heart, and the throat. A complication of streptoderma can be streptococcal nephritis, rheumatism, tonsillitis. The most dangerous consequence of the disease is blood poisoning. Therefore, you need to take measures to prevent infection with streptococcus.
Any scratches and small wounds on the skin should be treated with antiseptics and dressings should be applied to damage. It is also necessary to strengthen your immunity: try to eat foods rich in vitamins, avoid stress. Streptococcal diseases (tonsillitis, scarlet fever) must be treated on time and undergo therapy until complete recovery.
It is very important to avoid contact with people with streptoderma. Even with small skin rashes, you should immediately visit a dermatologist or therapist. These measures will help reduce the risk of infection.
