Streptoderma is an infectious pathology that occurs with a defeat of the epidermis. The disease is easily transmitted and spreads rapidly. Most often, children of preschool and primary school age fall ill. This is due to the fact that the child’s immune system is not fully formed. Treatment of streptoderma should be started as early as possible, until the disease has affected the deeper layers of the skin and has gone into the chronic stage. In the early stages, this ailment is quickly cured and leaves no residue 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 protective system of the body working well, this microbe does not cause any infectious ailments. Therefore, streptococcus is considered an opportunistic bacterium. However, if a person's immunity drops and there are wounds on the skin, then the 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 trigger the onset of the disease
The direct cause of streptoderma is the pathogen - streptococcus. However, in order for the development of the disease to begin, additional adverse 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;
- acute infections.
In children, streptoderma symptoms can occur after a sore throat or scarlet fever. These diseases are caused by the same microorganism - streptococcus.
In addition, the causes of streptoderma can also be a violation of the integrity of the skin. After all, the infection enters the epidermis through the wounds. Even small scratches, abrasions, and bites can become gates for bacteria to enter.
A major role is played by the acidity (pH) of the skin. Its normal indicators are considered values from 5.2 to 5.7 units. If the pH rises to 6–7 units, the microflora of the epidermis is disturbed. The result is a favorable environment for the reproduction of microbes.
Often, streptoderma affects people with hormonal disorders. Improper functioning of the endocrine glands affects the state of the epidermis. With hormonal imbalance, the skin becomes oily and becomes covered with acne. Such an epidermis is very susceptible to infection.
Transmission ways
Is streptoderma contagious? The infection moves quite easily from a sick person to a healthy one. The following transmission methods can be distinguished:
- Contact. The causative agent appears on the skin of a healthy person after a handshake or other contact with the epidermis of the patient.
- Domestic. Infection is transmitted through objects used by a sick person.
- Airborne. This transmission path is rare. However, the patient can secrete bacteria when sneezing and coughing. If they get on the skin of a healthy person, then a disease occurs.
- Dusty. Bacteria penetrate wounds on the skin through dust infected with streptococci.
Streptoderma in adults is much less common than in children. This disease is more characteristic of preschool and primary school age. It is enough to get one child sick, as an outbreak of this infection begins in the children's team. Adults most often become infected by contact with sick children.
Streptoderma does not form immunity. Often there are cases of repeated illness.
Types, forms and stages of the disease
Infection can affect both the surface 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 epidermal lesion:
- Bullous. Bacteria affect only the surface layer of the skin. Rashes appear in the form of small bubbles. Then they open, the wounds heal. There are no traces on the epidermis. The infection usually affects the skin of the face.
- Not bullous. Large blisters and ulcers form on the skin. The defeat of the deep layers of the epidermis is characteristic. The general health worsens. The treatment process for this stage of the disease is very long. Often there is nebulous streptoderma on the arms and legs.
- Chronic It is observed with insufficient or improper treatment. Infection affects large areas of the skin (up to 10 cm).
With timely treatment, the disease ends at the bullous stage. In this case, the skin lesion is limited only by its upper layers.
Also, streptoderma is classified depending on the nature of the rashes. The following forms of the disease are distinguished:
- streptococcal impetigo;
- bullous impetigo;
- dry streptoderma;
- streptococcal seizure (slit-like impetigo);
- periungual felon (tournaments);
- streptococcal diaper rash;
- vulgar ecthyma.
Symptoms of streptoderma will vary depending on the form of the disease. The clinical picture of different types of pathology will be discussed below.
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 indicated 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 (lesions of the upper layers of the skin). In this case, it is indicated in ICD-10 by code L01.
Deep skin lesions (ectima) in streptoderma are encoded under the code L08.8, which means "Other specified local infections of the skin and subcutaneous tissue."
General symptoms
How does streptoderma begin? 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, we can distinguish common symptoms of streptoderma, characteristic of all types of this disease:
- Red spots on the epidermis. They are most often localized on the face, limbs, armpit and groin area, as well as in skin folds. The spots are round in shape. In the area of redness, peeling of the skin is noted.
- Bubble rash. The size of the rashes can be from a few millimeters to 1-2 centimeters.
- Severe itching in the affected area.
- Pain and swelling of the skin at the site of the rash.
- Enlarged lymph nodes.
In addition, many patients feel worse. Weakness, malaise, and headache are noted. The temperature can rise to +38 degrees. This is how the body reacts to infection. Next, we will consider in more detail the symptoms of different types of streptoderma.
Symptoms of streptococcal impetigo
Most often, the disease proceeds in the form of streptococcal impetigo. This is the easiest form of pathology. A slight redness appears on the skin, and then - vesicles (conflicts). Inside them is purulent contents. Conflicts can grow up to 1-2 cm. Such a rash is noted mainly on the face. Then their walls are torn and pus comes out. In place of the rash, crusts form, which subsequently disappear. When the skin heals, a spot remains, which then turns pale. There are no traces in the rashes. The disease lasts up to 2–4 weeks.
The clinical picture of bullous impetigo
Bullous impetigo is more severe. This disease is more commonly seen in infants. Bubbles with this form of the disease usually appear on the arms or legs. They reach a size of 1-2 cm. Over time, they erupt. In their place, ulcers appear that heal for a long time. Itching disturbs the patient after opening the vesicles. This form of the disease is always accompanied by a significant deterioration in well-being: weakness, fever, swollen lymph nodes. Skin healing can last up to 2 months.
Dry streptoderma
Dry streptoderma is usually easily tolerated. Only the upper layers of the dermis are affected. Rashes form in the form of white or pinkish spots, covered with scales. No bubbles are observed. 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 health. Very often, children with dry streptoderma transmit the infection to others.
Streptococcal jam
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 number of bubbles form. Typically, single rashes are noted. Over time, they independently open, in their place, crusts and cracks form, and then the skin heals.
Usually, when you are seized, your well-being does not worsen, and the disease responds well to treatment. However, this type of streptoderma often turns into a chronic form, especially in people suffering from dental diseases.
Periungual felon
In this case, streptococci affect the skin in the area of the nail bed on the fingers or toes. Painful swelling and redness appear near the nails. Then bubbles form. After opening them, the affected area is covered with a brown crust, from which pus is secreted.
Streptococcal panaritium usually occurs in people after damage to the skin near the nails during manicure procedures or burrs. This disease must be treated as soon as possible. In the absence of therapy, 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 inguinal and gluteal region, and in women - under the mammary glands. The disease affects children and overweight adults who have many fat folds on their bodies.
Skin inflammation occurs with severe itching, pain, and redness. Then bubbles form, which merge with each other. Often a streptococcal lesion develops against the background of diaper dermatitis or usual diaper rash, which makes the course of the disease even more difficult. In addition, skin folds are constantly moisturized by secretions of 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.
Symptoms of vulgar ecthyma
With vulgar ecthyma, damage to the deep layers of the skin occurs. This is the most severe form of streptoderma. It develops with a strong decrease in immunity: in patients with diabetes mellitus, tumors, and viral infections.
Lesions are noted on the legs and buttocks. Large blisters with thick walls are formed, filled with pus. After their breakthrough, painful ulcers appear that heal very slowly. Gross scars remain on the skin. The disease is always accompanied by symptoms of general intoxication: fever, weakness, swollen lymph nodes, and headache.
Treatment of streptoderma in such a severe form should be started immediately. Vulgar ecthyma is often complicated by sepsis. In addition, staphylococci often join streptococcal infection, which leads to even more severe skin damage.
Diagnostics
A dermatologist or therapist is involved in the diagnosis and treatment of streptoderma. Usually, the disease is determined already during the examination according to the patient's complaints and the appearance of the rashes. Laboratory methods are rarely used. Sometimes a general blood test is performed. An increase in the number of white blood cells and ESR indicates the presence of inflammation.
In some cases, analysis of the contents of the vesicles for bacterial seeding is required. He is needed to choose the right method of therapy. During the study, the sensitivity of streptococci to different types of antibacterial drugs is determined.
Outdoor facilities
How to smear affected areas of 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 aqueous methylene blue;
- potassium permanganate.
Alcohol solutions with dyes (brilliant green, fucorcin, methylene blue) most effectively affect the causative agent of the disease. However, they can not be used for rashes on the face, as well as in the treatment of streptoderma in infants and in the elderly. These drugs can cause skin irritation. Children under 3 years old are not recommended antiseptics with iodine, chlorhexidine and Miramistin.
Rashes are treated with antiseptics 3-4 times a day. Apply spotting local funds to the affected areas only after 30 minutes after applying the solutions.
With streptoderma, ointments with antiseptics and antibiotics are prescribed:
- Tsindol;
- zinc ointment;
- salicylic ointment;
- Baneocin;
- Levomekol;
- Synthomycin;
- "Streptocide";
- "Fusiderm".
These local remedies penetrate the deeper layers of the epidermis and inhibit the growth of bacteria. They are applied to the skin or used as compresses.
It is important to note that the ointment "Acyclovir" should not be used for streptoderma. This 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 with a combination of streptoderma with dermatitis. Apply corticosteroid ointments "Pimafukort", "Akriderm", "Triderm".
During treatment, it is not recommended to take hygienic water procedures. Streptococcus multiplies intensely in a humid environment, and rashes after washing can begin to spread to healthy areas of the skin.
Antibiotics for oral administration
Oral administration of antibiotics for streptoderma is not indicated in all cases. The question of the need for the appointment of antibacterial drugs is decided by the attending physician. Antibiotics must be prescribed for ecthyma, extensive skin damage, signs of complications beginning, as well as for high temperature 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 bacterial inoculation. With streptococcal infection, the most effective penicillin preparations are:
- 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 antibiotics of the macrolide, cephalosporins or fluoroquinolones group:
- Clarithromycin;
- "Azithromycin";
- Sumamed
- "Rovamycin";
- Cefuroxime;
- Ciprofloxacin;
- Levofloxacin.
Antibacterial drugs are prescribed for a period of 5 to 14 days. Most often, antibiotics are administered 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, measures must be taken to prevent infection with streptococcus.
Any scratches and small wounds on the skin should be treated with antiseptics and applied to dressings damaged. 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 treatment 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.