Erysipelas on the face or erysipelas is a lesion of the skin and underlying tissues by streptococci, which is accompanied by acute inflammatory reactions of the body. This is an infectious disease, but its infectivity is low. Mostly manifestations are observed in the spring-summer period.
More often, women, the elderly, as well as those who have weakened immunity, are ill. Inflammation is provoked by streptococci, and repeated cases of the onset of the disease are associated with a genetic predisposition, that is, a certain immune response to the penetration of streptococci into the body.
Erysipelas of the face (ICD code 10 - A46) has a staged course, so a mild form of the disease that does not impair the quality of life can go into a severe stage. With a prolonged course of inflammation without the required treatment, the skin gradually dies. When the first signs of the disease occur, you need to visit a doctor and not self-medicate, as this can provoke the development of complications.
Features of the disease
Erysipelas of the face (ICD 10 - A 46) is an acute inflammatory lesion of the skin of an infectious nature. Often, the pathology recurs, but it does not differ in a high degree of infectivity. Inflammation is accompanied by intoxication, feverish signs and a specific focus of skin lesions.
Long-term relapses lead to dangerous pathologies. In elderly people and those suffering from severe concomitant diseases, erysipelas on the face provokes a variety of complications, in particular, such as pneumonia, sepsis, acute renal failure. In the presence of cardiovascular diseases, as well as skin lesions, inflammation significantly aggravates their course.
Classification
Erysipelas of the face (ICD 10 - A 46) has several different clinical forms. It is classified into species such as:
- by the presence of a focus of infection (primary or secondary);
- the nature of the inflammation (bullous, necrotic, erythematous, phlegmonous);
- the prevalence of the process (local, creeping, migratory, metastatic);
- type of course (primary, repeated, recurrent);
- the severity of symptoms (classic, worn, abortive, atypical).
The formation of inflammation of the eyelids is also possible. The most dangerous form is necrotic, as it is accompanied by the death of affected tissues.
Causes of occurrence
Among the main causes of erysipelas of the face, the effects of infection should be highlighted. The rapid multiplication of pathogens in the lymphatic system with the release of toxic substances into the circulatory system occurs under certain conditions. Erysipelas of the skin of the face can occur for reasons such as:
- fungal skin lesions;
- the presence of dystrophic processes, traumatic violation of the integrity;
- chronic diseases with impaired blood flow;
- diabetes;
- constant exposure to the skin of harmful chemicals, dust.
The mechanism of development of erysipelas on the face can be triggered by a rapid weakening of immunity, as well as being in a state of constant stress. According to studies, a weakened body does not respond normally to the penetration of streptococci into the body, and there is also a violation of the balance of immunity cells.
Damage to the immune system contributes to the active development of dangerous microorganisms, which is complicated by dangerous purulent processes, which greatly complicates the treatment.
At the age of 20-30 years, a similar disease mainly affects men who work in harmful conditions that contribute to skin contamination. In old age, women are much more likely to get sick. Among the provoking factors that can lead to erysipelas on the face, stressful conditions and constant overstrain, both physical and emotional, take an important place. Among other factors, it is necessary to highlight such as:
- sudden changes in temperature;
- excessive tanning;
- skin damage.
The causative agent of the disease comes into contact with the carrier of infection. Often, erysipelas on the face develops in people with weakened immune systems, pregnant women, in the presence of chronic skin diseases or diabetes.
Main symptoms
Symptoms of erysipelas on the face largely depend on the form and severity of the pathology. The multiplicity of the development of the disease is also important, since some relapses and secondary infections can be much more difficult to tolerate. The localization of the area of inflammation is only partially a determining factor, however, the overall prevalence of erysipelas leads to an increase in the intensity of symptoms.
Often, the disease begins with a feeling of slight chills, which intensifies quickly enough, and subsequently severe weakness and drowsiness appear. In some cases, in the first few hours, there is a strong throbbing pain, muscle spasms and nausea. In addition, the heartbeat can greatly increase and the temperature rises sharply.
Sometimes the symptoms can be more unpleasant, and at the slightest suspicion of having a severe form of the disease, you should immediately visit a doctor to conduct the required diagnosis and prescribe subsequent treatment. The first signs of a severe form of erysipelatous inflammation are the appearance of periodic convulsions and impaired speech, as well as delusional conditions. If appropriate measures are not taken in time, then the lining of the brain may suffer.
Signs of erysipelas of the face and nose can intensify during the day, and after about 24 hours, symptoms of local inflammation begin to appear. These include:
- the presence of pain;
- burning and itching;
- swelling;
- a feeling of tension in the affected area.
Soreness in the scalp may be present. Often there is an erythematous and bullous form of the course of the disease. When the first form occurs, the affected area acquires a deep red skin tone, any touch of which is quite painful. The edges of the affected area have notches, and the affected area is usually quite swollen, and may also slightly rise above the surface of the skin. Subsequently, its upper layer may begin to peel off.
Diagnostics
If the first signs of erysipelas occur, you must visit a dermatologist to conduct a comprehensive diagnosis and prescribe the required treatment. In order not to make a mistake with the diagnosis, you may need to consult an infectious disease specialist, surgeon, immunologist. Differential diagnosis is very important. The diagnosis of erysipelas of the face can be made only after the exclusion of other diseases with similar symptoms.
During the diagnosis, it is necessary to take a blood test, as it will help to detect the presence of inflammation. In addition to a general blood test, a bacteriological study is often prescribed . This analysis helps to identify the causative agent of the disease and determine its sensitivity to antibacterial agents. If problems arise with the diagnosis, then tissue analysis of the affected area is required. After conducting a comprehensive diagnosis, you can choose the desired treatment.
Treatment features
When the first symptoms of erysipelas on the face occur, treatment must be started immediately, and it must be comprehensive. With a mild and moderate course of the disease, you can do without hospitalization. The person is under the supervision of a therapist. If there are blisters, additional consultation with the surgeon will be required to open them and eliminate the contents. After that, local remedies are applied. Among the indications for hospitalization, it is necessary to highlight such as:
- elderly age;
- inflammation in a child;
- severe course of the disease;
- recurrent course of the disease.
In the presence of any form of the disease, the use of penicillin antibiotics is required, since streptococci have remained highly sensitive to these drugs. In severe cases of the disease, antistreptococcal serum and gamma globulin can be additionally prescribed.
Anti-inflammatory drugs, as well as antihistamines, are used as additional funds. Local therapy is also indicated, which helps to significantly improve the overall well-being of the patient and slightly reduce the severity of the course of inflammation. Alternative therapies are not used as the main method of therapy, as they are not able to replace traditional medications.
Physiotherapy is widely used, in particular, electrophoresis, magnetotherapy, ultraviolet radiation, infrared laser therapy, lymphopressotherapy.
Drug therapy
How to treat erysipelas of the face and ear, only a doctor can determine after a diagnosis. The treatment methods are selected depending on the characteristics and severity of the course of the disease, characteristic lesions and the presence of possible complications. With a bullous or hemorrhagic form of erysipelas, hospitalization of the patient in the surgical department is indicated.
Treatment of erysipelas of the face with antibiotics is the basis of therapy, since the disease is infectious. With an erimatous form of erysipelas and a mild course of the disease, a course of antibacterial drugs in tablets is prescribed, in particular, such as Erythromycin, Doxycycline, Cytoprofloxacin. The course of taking medications should be 5-7 days. If you are allergic to these drugs, they are replaced with Delagil or Furazolidone. Their reception is indicated for 10 days.
With erysipelas of the face, antibiotics can be prescribed in the form of injections. In particular, penicillins (Amoxiclav) and sulfonamides (Sulfalen) are used. The course of taking medications lasts for 10-14 days. Multiplicity and daily dosage are selected individually.
Anti-inflammatory non-hormonal drugs are used for pain relief in erysipelas. Often, the doctor prescribes Meloxicam or Nise, since these drugs have a minimum of side effects.
Any form of this skin disease implies local therapy. Ointments from erysipelas on the face help to eliminate the pain that occurs in the affected area, suppress pathogens and reduce itching. The medicine must be applied to the area of inflammation up to 3 times a day in the absence of allergy to the constituent components.
Physiotherapeutic Techniques
Treatment of erysipelas of the skin of the face is also carried out using physiotherapeutic techniques. They help enhance metabolic processes in the connective tissue. To eliminate inflammation, procedures such as:
- UHF and microwave therapy;
- ultraviolet radiation;
- electrophoresis.
To normalize metabolic processes in the connective tissue, techniques such as:
- laser therapy;
- magnetotherapy;
- paraffin therapy.
To improve lymph outflow, vibration therapy is indicated, as well as therapeutic massage sessions. To eliminate toxic substances, an abundant consumption of alkaline mineral water is indicated.
Folk remedies
Folk remedies are recommended as adjuvant therapy. First you need to consult your doctor so as not to provoke even more inflammation and swelling. To eliminate puffiness, you can use an ointment prepared on the basis of coltsfoot and chamomile. For this, the plants need to be carefully ground, add honey, and then the mixture is applied to the affected area.
With erythematic erysipelas, the inflamed areas need to be lubricated with pork fat. In the case of blistering, you need to use a mixture of burdock, plantain and Kalanchoe, which are taken in equal proportions. To do this, fresh leaves need to be ground into gruel and applied to the affected areas. Keep such a mask for 1 hour.
For washing and as prophylaxis, decoctions of chamomile, string, coltsfoot are used. These plants have pronounced antibacterial qualities and prevent the attachment of a secondary infection.
Dieting
To accelerate the treatment process, it is necessary to follow the basic rules of a healthy diet. When the first signs of infection appear, the patient must adhere to a strict diet. Only the consumption of water, lemon and orange juice is allowed. Follow a similar diet for 1-2 days.
After that, you can gradually add fresh fruits to the menu, as they help eliminate toxic substances, and also promote wound healing. Fresh milk is very useful, as it has a bactericidal property.
Beekeeping products have antibacterial qualities, therefore, they are recommended for use in treating patients with erysipelas. In addition, honey contains carbohydrates and vitamins. It is imperative to consume foods with calcium and potassium, as they help reduce puffiness and remove excess fluid.
It is unacceptable to eat salty, fatty, spicy foods. Strong tea and coffee, sour-milk products, fresh bread and cabbage are not recommended. Alcohol and tobacco are strictly prohibited.
Surgical intervention
If medications do not produce the desired result, surgery may be prescribed. With a developing disease, a good effect is exerted by:
- quartzing;
- cryodestruction;
- laser therapy.
Indication for the operation is the formation of ulcers, necrotization of the skin. The operation takes no more than 30-40 minutes and is performed under local anesthesia.
During the intervention, the surgeon performs an autopsy of the abscess cavity and then cleans its contents. Often, the wound remains open and drainage is established in it to drain the fluid. In the presence of necrotic tissues, they are completely removed, and then conservative therapy is performed.
In the event of a bullous form of the disease, the doctor initially opens the blisters, and then treats their surface with an antiseptic and puts a bandage soaked in Chlorhexidine.
Complications and prognosis
Erysipelas on the face can have a long course and provoke various kinds of complications. Often, the disease entails superficial damage to the skin in the form of phlegmon, necrosis, ulcers, thrombophlebitis, abscess. A consequence of the disease can also be a violation of the outflow of lymph, which entails the occurrence of lymphostasis. Sometimes pathology provokes the development of pneumonia or sepsis.
With untimely access to a doctor or improper treatment, erysipelas can even lead to the death of the patient. If therapy was carried out on time and in full, then complications arise rather rarely. At risk are the elderly and those with weakened immune systems. Complications include:
- renal failure;
- blood clots;
- circulatory disturbance;
- blood poisoning;
- inflammation of the bronchi;
- the formation of necrosis, abscesses, ulcers;
- lymph congestion.
With timely treatment, the prognosis is favorable and normalization of health occurs on the 7-10th day from the onset of the onset of the disease, however, it is worth remembering that relapse can occur within 2 years.
Preventive measures
Since the disease is quite difficult to treat and complications can arise, you must know how to avoid erysipelas of the skin on the face. Preventive measures should include such as:
- timely treatment of existing chronic infections;
- strengthening immunity;
- dieting;
- strict observance of hygiene rules;
- dieting;
- limitation of contacts with patients with erysipelas.
In addition, it is important to avoid hypothermia and sudden changes in temperature, regularly take vitamin complexes. To prevent relapse, an antibacterial treatment course is required annually. The dosage and course of taking the medicine is selected individually.
Erysipelas can be very dangerous, so if you have the first signs of the disease, you should immediately visit a dermatologist.