Streptoderma (lat. streptodermia strepto- + (pyo) dermia, also pyoderma streptococcal) - pyoderma caused by streptococci, characterized by the occurrence of conflict.
Streptoderma is divided into superficial and deep. The superficial include: Streptococcal impetigo, dry streptoderma, zade, felon. To deep streptoderma include: cellulite, ecthyma ordinary and chronic ulcerative-vegetative pyoderma (mixed strepto-staphylococcal pyoderma). source not specified 786 days
Infection with streptoderma occurs in close contact with a sick person. The incubation period of the disease lasts about 7 days. Chronic form may occur near wounds and ulcers that do not heal over a long period of time. In addition, the factors provoking the development of the disease in a chronic form are the following: varicose veins, long-term cooling of the extremities, leading to increased skin sensitization to streptococcal and staphylococcal infections.
The spots formed during this skin disease can be of various sizes, gradually their diameter reaches 3-4 cm, as a rule, they have a slightly pink color, rounded shape. Spots covered with fine-scaled scales. They are localized especially often on the face (then the disease is called “simple face versicolor”), less often - on the back, buttocks, limbs, and are usually found in boys of 7-10 years old. After the spots leave a temporary depigmentation. Sometimes microvesicles filled with serous or serous-purulent contents are formed on the skin.
Subjective sensations in a patient are usually not observed, but sometimes he may be disturbed by a slight skin itch, dry skin, an increase in body temperature, and an increase in lymph nodes.
Streptoderma in a chronic form is characterized by a relapsing course and the development of large-sized (5–10 cm in diameter) lesions of the skin. Foci are clearly limited spots with uneven, scalloped edges and flaking corneous epidermis at the edges, most often they are localized on the legs. Bubbles appear on the skin, after opening, which form large crusts of yellowish-brown color. After removal, a bright pink erosion is detected at the site of the peel, from the surface of which serous-purulent exudate is abundantly separated. Between relapses, the formation of new bubbles ceases, instead of crusts, peeling centers with grayish-yellow scales are formed.
The long existence of an infectious focus, as well as the resulting increased sensitivity of the skin to microbes, can lead to the transition of the disease from chronic streptoderma to microbial eczema. The characteristic features of this process are the appearance of eczematous wells, a change in the boundaries of the lesions (with eczema, they become uneven, vague)
What is streptoderma
On the skin of an adult there is a mass of various bacteria that, under normal conditions, do not manifest themselves. However, there are cases that microbes begin to actively proliferate, thereby affecting the epidermis and causing a lot of unpleasant symptoms. Streptoderma is one of the many skin diseases that are caused by streptococcus or staphylococcus bacteria. More often, children suffer from the infection due to a thin outer layer of skin, but there are cases of infection in adults.
How streptoderma is transmitted
The disease is infectious, which means that there can be a lot of ways to spread it. Basically, streptoderma is transmitted from a carrier to healthy people, but there are cases of domestic infection through the surrounding area: bedding, towels, slippers, and common clothes. Even taking a ride on public transport, an absolutely healthy person gets increasing risks of becoming a carrier of dangerous streptococci.
How to distinguish herpes from streptoderma
With self-diagnostics, it is very important to understand what streptoderma looks like: this knowledge and skills will help you consult a doctor in time and begin treatment. The main difficulty of the disease is that it is extremely similar in symptoms to other common and less dangerous infections, for example, herpes simplex or catarrhal rashes.
It is possible to distinguish herpes from streptoderma by the characteristic features:
- Just as with herpes, on the skin of an adult appear bubbles filled with unclear liquid. However, with streptoderma, when dropsy breaks, cracks remain on the skin. Herpes blister such defects does not give even after unauthorized opening.
- The first sign of an upcoming herpes is severe itching at the site of the lesion. Streptoderma is accompanied by a slight redness at first, and itching occurs much later and is quite insignificant.
Symptoms of streptoderma
As mentioned above, the first symptoms of streptoderma are pinkish specks, slight itching and desquamation. Then in the lesions begin to form bubbles of small diameter with a cloudy-yellow liquid. If the disease does not begin to heal in time, then the bubbles can merge, touching over large areas of the skin. After eczema dries, scales appear on the surface, resembling lichen.
Streptoderma may occur on the face, chest, back, abdomen, limbs and extremely rarely on the genitals of an adult. However, regardless of the location, the symptoms and signs always remain the same. It should be noted that in childhood streptoderma can often begin with other manifestations, for example:
- signs of general intoxication of the body: nausea, weakness, dizziness,
- increased low-grade body temperature, as a rule, to 38-39 degrees,
- swollen lymph nodes where redness appears.
This form of the disease is considered the most severe and occurs more often in adult men or boys of preschool age. Dry streptoderma is characterized by the appearance of white spots, usually oval or rounded, the size of which does not exceed 5 centimeters. The lesions of the skin are quickly covered with scabs and initially localized only on visible parts of the body, further covering the rest of the epidermis. After recovery, these areas of the body remain unpigmented for a long time.
Causes of streptoderma
Open wounds, scratches, burns, insect bites, or other skin lesions are the main causes of streptoderma, in other cases, an adult protects the immune system. If in an adult the protective functions of the body are reduced, the likelihood of inflammation increases, especially if you have:
- diabetes mellitus
- prickly heat,
- violation of the pH balance of the skin,
- varicose veins
- regular physical fatigue or stress.
Treatment of Streptoderma in Adults
It is often important not only to know how the disease looks, what causes it, what signs distinguish it from banal herpes, but also how to treat streptoderma in adults. Simple folk remedies can only serve as an addition to high-quality therapy with medicines of different groups. As a rule, with a mild lesion, doctors prescribe antibacterial ointments. Treatment of streptoderma in adults in the advanced stage is carried out exclusively with antibiotics.
In addition, during treatment of streptoderma should take drugs that increase the protective functions of the body and complex vitamins. If a doctor prescribes an antibiotic for you, then along with this medicine in a pharmacy, it is useful to buy probiotics that will help preserve the natural intestinal microflora:
How much streptoderma is treated
The incubation period of the development of the disease in adults lasts about 5-7 days, after which the microbes begin to multiply actively. If this process is seen in the early stages, then streptoderma is treated quickly, with local antiseptics: ointments, antifungal dressings, and so on. During the transition to the chronic stage, the appearance of wounds on the body, open ulcers and ulcers, the treatment may take more than one week, and the wounds themselves will be unhealed for a long time even after successful therapy.
Antibiotics for streptoderma
The reason for receiving antibiotics in adults is only the advanced stage of streptoderma or a wide range of skin lesions, in all other cases, the doctor will prescribe a superficial treatment. Among a wide range of antibiotics, streptococcal dermatitis is well treated with penicillin preparations, for example:
However, even penicillin antibiotics for streptoderma may not always be used. Contraindications for the treatment of adults are the pathology of the liver or kidneys, the presence of individual intolerance to penicillin or other auxiliary components. If as a result of laboratory tests, allergies or any other contraindications were identified, then cephalosporins are used for treatment:
Under other circumstances, the least toxic antibiotics, macrolides, may be prescribed for the treatment of adults. These drugs include:
- Azithromycin dihydrate,
If streptoderma in adults is extremely difficult, then drugs from different groups can be combined at the discretion of the doctor. For small lesions use light-acting agents: Retapamulin or Vibramitsin. With light streptoderma formations in adults, 5-7 days of active treatment will suffice, but sometimes the duration of medication can be from 10 to 14 days. Additional therapy may look like this: 3 days drink pills, 3 days break.
Streptoderma ointment in adults
As the main treatment for streptoderma are antibiotic ointments. They are considered the most effective in the early stages of the disease. An antibiotic ointment for streptococcal in adults relieves inflammation, helps tissues restore regenerating function faster. During treatment, the patient must exclude any water procedures. After the crust appears, the elements can be treated with an antiseptic solution of potassium permanganate, brilliant green, and fucorcin.
Which ointment is better to choose, the doctor decides, but more often than the rest the following drugs are used:
- Zinc ointment. Apply it to a thin layer on the affected area of the body from 4 to 5 times a day. No contraindications.
- Ointment with two antibiotics - Baneotsin. Used a couple of times a day, but is contraindicated for the treatment of pregnant women and nursing mothers.
- Tetracycline ointment. Apply to problem areas under the bandage twice a day.
- Bactroban. The ointment is squeezed out first on a cotton pad, which you subsequently need to treat the skin and apply a sterile bandage on top of it.
- Sulfuric ointment. Used to treat streptoderma for 5 days.
Prevention of streptoderma
In addition to the main stages of treatment, everyone should know the main rules that help prevent the occurrence of the disease. Prevention of streptoderma is:
- in need of washing hands thoroughly with soap after visiting public places, toilets, transportation,
- wean from the habit of constantly touching your face, combing, squeezing or scratching the skin,
- when traveling, always carry with you antiseptic solutions, antibacterial wipes, regularly treat them to open areas of the body, especially in children,
- always wash scratches, wounds or cracks with hydrogen peroxide solution, iodine or medical alcohol,
- follow your diet, eat foods rich in vitamins and minerals,
- follow the rules of personal hygiene,
- at the slightest deterioration of health, discomfort or other signs, immediately consult a doctor and begin treatment.
Video: how to cure streptoderma
Margarita, 31 years old I have always loved beautiful underwear. It lasted until an allergic reaction began under my armpits, as I had originally thought. A small spot of pink color over time began to increase, I had to go to the doctor. It turned out that I have streptoderma. Now I am undergoing treatment with antibacterial ointments.
Stas, 29 years old. I never would have thought that ordinary herpes can cause so much discomfort and even pain, I had to go to the clinic. After taking the samples, it turned out that I didn’t have herpes at all, but severe streptococcal dermatitis; by that time deep wounds had already formed. The doctor prescribed antibiotic treatment, forbade swimming, going to the beach.
Tatiana, 47 years old I read a lot about streptococcal virus, because I have three children and a husband who doesn’t like to wash hands often. I know almost everything about this disease and I hope that I can recognize the first symptoms if necessary. I want to advise everyone to adhere to the rules of personal hygiene and to touch the handrails in public transport as little as possible.
After a given period of time, red round spots appear on the skin (especially in places where it is thin and tender, often on the face).
After 2-3 days, the spots are converted into bubbles (conflict), the contents of which have a cloudy color.
Flitstena very quickly increase in diameter (up to 1.5-2 cm), after which they burst with the formation of a dry honey-colored crust. In this case, the patient feels unbearable itching in the affected areas, combing crusts, which contributes to the further spread of the process.
After the discharge of the crusts, the skin heals, there are no cosmetic defects (scars) - this is the surface form of streptoderma (impetigo).
Photo: Site of the Department of Dermatology and Venereology of the Tomsk Military Medical Institute
Dry form of streptoderma
The dry form of streptoderma (ecthyma) is more common in boys. It is characterized by the formation of white or pink oval spots up to 5 cm in size. The spots are covered with scabs and are initially located on the face (nose, mouth, cheeks, chin) and ears, quickly spreading to all skin integuments (usually hand and foot).
The dry form refers to deep streptoderma, as the germ layer of the skin ulcerates, and after healing, scars remain. The affected areas after recovery remain non-pigmented and do not tan under the action of sunlight. After a while this phenomenon disappears.
Photo: Site of the Department of Dermatology and Venereology of the Tomsk Military Medical Institute
Streptococcal zade (angular stomatitis, slit impetigo)
The corners of the mouth are often affected, as a rule, this is due to the lack of vitamins of group B. As a result of the dryness of the skin, microcracks form where the streptococci penetrate.
First, there is redness, then - purulent rollers, which later become covered with honey-colored crusts. The patient complains of soreness when opening the mouth, intense itching and drooling.
Perhaps the appearance of slit-like impetigo in the wings of the nose (constant nasal congestion and pain when blowing your nose) and in the outer corners of the eyes.
Photo: Site of the Department of Dermatology and Venereology of the Tomsk Military Medical Institute
Streptococcal diaper rash (papulo-erosive streptoderma)
Often this form of the disease occurs in infants.Skin folds are affected: small bubbles appear in them, merging with each other. After opening them in the skin folds formed moist surfaces pink.
If streptoderma treatment is inadequate or the patient's immunity is reduced, the disease becomes chronic, which is more difficult to treat.
* Find out the specific details of streptoderma occurrence in Federal recommendations 2013, in accordance with which this article is written.
Conduct a differential diagnosis of streptoderma. This disease is important to distinguish from allergic reactions (urticaria), pityriasis versicolor, staphylococcal pyoderma, eczema and atopic dermatitis.
The diagnosis of "streptoderma" is established on the basis of anamnestic data (contact with a sick person, an outbreak of the disease in the team) and a visual examination (characteristic bubbles and yellowish-honey crusts after opening them).
From laboratory methods use:
- smear microscopy of the affected skin area,
- bacteriological analysis (sowing crusts on nutrient media).
Microscopy and bacperic need to be carried out before the start of antibiotic treatment and if there is no self-treatment.
Complications and prognosis
Symptoms of streptoderma with adequate treatment disappear after a week, but in some cases (with a weakened immunity or the presence of chronic diseases) complications are possible:
- transition to the chronic form
- guttate psoriasis,
- microbial eczema,
- scarlet fever,
- septicemia - blood poisoning, in which a huge amount of streptococci circulates,
- boils and phlegmon.
The prognosis for this disease is favorable, but after suffering a deep form of streptoderma cosmetic defects remain.
* This article is based on the Federal Clinical Recommendations adopted in 2013. on the management of patients with pyoderma.
Causes of Streptoderma
Normally, human skin is colonized by a large number of opportunistic microorganisms. They constitute its natural microflora and do not cause an inflammatory process.
They also help maintain the skin’s natural defense mechanisms.
With a sufficient level of immunity, intact skin has non-specific resistance (relative innate resistance to some pathogenic microorganisms). Nonspecific resistance is the first protective barrier that prevents the penetration of infectious agents into the body.
Fatty acids secreted by the skin, have a pronounced bactericidal effect (destroying) on beta-hemolytic streptococci of group A.
Risk factors contributing to the development of inflammatory processes in the skin and subcutaneous fat are:
- immunodeficiency states
- stress, chronic sleep deficit, overwork,
- constant hypothermia
- work in hot, stuffy rooms,
- living in regions with a humid climate,
- work in conditions of high humidity (greenhouses, etc.),
- violation of the integrity of the skin,
- deficiency of vitamins A, B, C, E, as well as zinc, magnesium or sulfur,
- unbalanced nutrition
- hormonal changes (youthful acne, etc.),
- endocrine diseases (diabetes mellitus, polycystic ovary syndrome, thyroid disease, etc.),
- concomitant diseases of the skin (dermatitis, psoriasis, etc.),
- non-compliance with personal hygiene,
- improper skin care (skin dryness, use of too aggressive cleansers, etc.),
- the use of poor-quality cosmetics,
- the presence of foci of chronic infection (streptococcal tonsillitis).
What can cause Streptoderma
Hemolytic, greening and non-hemolytic streptococci are the most pathogenic streptococci for humans that often cause streptoderma.
The main cause of all streptoderma is beta-hemolytic streptococci of group A. Greening and non-hemolytic streptococci affect the skin less frequently and, as a rule, cause streptoderma in children or debilitated patients.
Streptococci are transmitted by airborne droplets, coughing, talking or sneezing.
In the presence of streptococcal inflammation of the skin (erysipelas, impetigo, etc.), the infection can be transmitted by contact (personal belongings, sheets).
When streptoderma affects the skin around the mouth, the skin of the legs, axillary hollows, above the mammary glands, in the inguinal and gluteal folds, etc. There is also a peripheral spread of the source of the inflammatory process (from the center to the periphery).
When streptoderma in the inflammatory process is not involved hair follicles and sweat glands. Folliculitis and hydradenitis are characteristic of staphylodermia.
Papulo-erosive streptoderma: symptoms
Predisposing factors contributing to the development of this streptoderma are:
- improper child care,
- permanent use of diapers,
- the presence of a baby prickly heat,
- irritant effect on the skin of urine (with infrequent change of diapers and rare washing of the child),
- use of aggressive detergents when washing clothes, etc.
This streptoderma is located mainly on:
- gluteal folds
On the surface of the papular rash often conflicts are formed (purulent formations with an easily ruptured lining). After a gap flikten, the erosive surface is exposed. The skin around the erosions is inflamed, swollen and hyperemic.
Also characterized by the formation of crusts (dry or weeping).
Streptococcal impetigo Tilbury-Fox
For this type of streptoderma is characterized by the occurrence of a serous-purulent or serous (bubbles with a sluggish, flabby lid and transparent contents) flikten, surrounded by corolla hyperemia.
As the disease progresses (3-4 days), the conflicts are shrinking, forming a friable, yellowish-green crust. After the crusts fall off, erosive surfaces may be exposed. After healing of erosions, temporary foci of hyperpigmentation and peeling remain.
The formation of deep atrophic scars for this streptoderma is not typical.
The disease is often complicated by the addition of lymphadenitis (inflammation of the lymph nodes) and lymphangitis.
Strep impetigo is located mainly on:
- facial skin
- around the lips (and on the red border of the lips),
- around the wings of the nose, etc.
How does streptoderma by type of bullous impetigo begin
Bullous streptoderma mainly affects the skin on the hands, legs and feet.
The disease is accompanied by the appearance of large blisters filled with serous-purulent or serous contents. The size of the bubbles can reach several centimeters. The bladder lid is tense, the formation is surrounded by an inflammatory corolla. The severity of the disease is determined by the thickness of the stratum corneum in areas of inflammation.
After opening the bubble, extensive erosive surfaces are exposed.
The inflammatory process affects the skin in the inguinal and gluteal folds, axillary region, behind the auricles, under the mammary glands.
This type of streptoderma is characteristic of patients with obesity, excessive sweating, severe cardiovascular pathologies or diabetes.
In severe streptoderma, ulceration of inflammations and the appearance of purulent and purulent hemorrhagic crusts are possible. The addition of lymphangitis and lymphadenitis is also possible.
Streptoderma on the face in the form of zaedov (fricative impetigo)
Impetigo slit located in the corners of the mouth. The disease can be both concomitant (combined with another type of staphylo-or streptoderma), and the only occurrence of streptococcal skin lesions.
Zayedy different highly specific clinical picture. The skin affected by streptococcus is swollen, inflamed. In the depths of the folds, rapidly opening conflict and erosion are formed with hanging white rims of detached epithelium. Next, a loose crust is formed that breaks easily when moving lips.
Paronychia is a streptoderma affecting the nail cushion. In children, this type of streptoderma is less common than in adults.
The disease begins with reddening of the skin of the nail roll, the appearance of edema and pain. With the progression of inflammation appears a bubble with serous contents, which quickly suppurate.
Tire purulent bladder tight, intense. The nail roller can swell significantly, surrounding the nail on the type of "horseshoe".
Erysipelas occurs predominantly in elderly patients or infants.
The inflammatory process is localized mainly on the skin of the legs (tibia), torso, face.
Concomitant factors contributing to the development of erysipelas of the skin are diabetes, thrombophlebitis of the lower extremities or venous insufficiency, the presence of eczema, fungal infections.
The disease is often complicated:
- subcutaneous abscesses,
The risk group for the development of subcutaneous fatty cellulose includes patients with severe endocrine pathologies (diabetes mellitus), cirrhotic liver damage, acute and chronic renal failure, immunodeficiency states, the presence of leukemia and malignant tumors.
Most often, cellulite occurs on the face and lower limbs.
The center of inflammation becomes bright red, edematous, the contours of inflammation are indistinct, and on palpation the center is sharply painful. On inflamed skin, abscesses, hemorrhagic rashes, pustules or vesicles may occur.
Also noted fever, weakness, a significant deterioration in the general condition of the patient.
Cellulite may be complicated by the development of:
- necrotizing fasciitis,
- septic arthritis
- lymphadenitis, etc.
Ecthyma (ulcerative streptoderma)
Ulcerative streptoderma occurs mainly in debilitated patients (people with severe chronic diseases, beriberi, immunodeficiency, wasting, alcoholism, etc.). The skin of the lower extremities is usually affected.
Symptoms of the disease is the appearance of purulent flichen, shrinking in the crust for several days. The inflammatory infiltrate deeply affects the tissues, therefore, after the crust falls off, residual purulent and purulent-hemorrhagic contents can be released, after which a deep ulcer is exposed. The edges of the ulcer rise above the skin, the bottom is covered with necrotic and purulent raids, with the slightest damage to the tissue bleed.
The raids can dry out, forming brownish crusts containing necrotic masses and blood.
Cicatrization of the ulcer is long and can last up to a month. After ulcer healing, a hypotrophic scar remains.