Shankriformny piodermiya – the atypical pyoinflammatory damage of skin which is characterized by similarity of clinical manifestations with a syphilitic firm shankr that found reflection in the name. A symptom of this disease is development of the single ulcer (more rare than multiple educations) most often localized in genitals or on a red border of lips, a chin, a neck. Diagnostics of a shankriformny piodermiya is made by serological and microbiological techniques, the supporting role is also played by all-clinical blood tests, dermatological survey. Treatment of this pathology is made antibiotics, antiseptics, antimicrobic means.
Shankriformny piodermiya – a rare dermatological disease of pyoinflammatory character which belongs to chronic ulcer streptostafilodermiya (the mixed piodermiya). For the first time this pathology was described in the 1934th year by Hoffmann who noted considerable similarity of its clinical manifestations with a firm shankr at syphilis. In some cases this circumstance led to the wrong diagnostics and, as a result, to incorrect treatment of a shankriformny piodermiya. This form of a streptostafilodermiya meets rather seldom, with an identical frequency strikes both men, and women. In clinical dermatology the shankriformny piodermiya belongs to atypical kinds of deep pyoinflammatory damages of skin as which also rank ulcer a piodermiya and a piogenny granuloma. The disease can develop at any age, an important role in its development is played by decrease of the activity of immunity and existence of other purulent damages of skin or other bodies.
Reasons of a shankriformny piodermiya
Activators of a shankriformny piodermiya are representatives of the mixed microflora – most often in ulcers golden staphylococcus and various representatives of streptococci is defined. They can get into fabrics through microinjuries of skin, a graze (including raschesa at the itch or other diseases which are followed by an itch), non-compliance with rules of personal hygiene facilitates infection. In rare instances the infection drift can become in the hematogenic way the reason of a shankriformny piodermiya. Serve as the contributing factors to development of this pathology decrease of the activity of immunity as a result of diabetes, improper feeding, wearisome diseases. At men the shankriformny piodermiya develops against the background of a fimoz more often.
After penetration into fabrics of a bacterium begin to breed violently, there is an inflammation, as leads finally to a characteristic clinical picture of a disease. Today the reasons of why pyoinflammatory process at a shankriformny piodermiya proceeds in such way – presumably are authentically unknown, it is connected with features of reactivity of an organism. The accurate interrelation between this disease and certain groups of microorganisms did not manage to reveal. For this reason the shankriformny piodermiya belongs to atypical pyoinflammatory damages of skin.
Symptoms of a shankriformny piodermiya
The Shankriformny piodermiya can arise both at men, and at women of different age. Most often inflammatory process is shown in genitals (on a head of a penis and extreme flesh at men, vulvar lips and a vagina at women), but also other localization is occasionally possible. Cases of development of a shankriformny piodermiya on lips, a chin, a neck, a mucous membrane of an oral cavity are described. Most often this pathology arises against the background of other dermatological or general diseases promoting decrease in immunity (for example, diabetes) or facilitating infection (other forms of a piodermiya, itch).
Originally at a shankriformny piodermiya on the surface of skin the bubble of 0,5-2 centimeters in size filled with serous contents is formed. Quickly enough (it is frequent – during the first hours after education) it collapses, baring an erosive bottom on which place then the ulcer with a diameter of 1-2 centimeters develops. Any subjective symptoms (an itch, morbidity, burning) has no this education at a shankriformny piodermiya that will come to it additional similarity with a firm shankr. The ulcer bottom pure bright pink or is covered with dark crusts, there is purulent or hemorrhagic separated. Around it the narrow inflammatory rim can be defined.
From other manifestations of a shankriformny piodermiya availability of the dense infiltrate in skin located under an ulcer, regionarny lymphadenitis is most often noted, there can sometimes be a temperature increase. Lymphadenitis is shown by increase in regionarny lymph nodes (inguinal, cervical), their morbidity at a palpation, but at the same time they are not soldered to surrounding fabrics and among themselves. Temperature increase at a shankriformny piodermiya is registered extremely seldom, fever can testify to a disease complication – accession of sepsis, metastatic transfer of the activator with development of abscesses in internals.
Diagnostics and treatment of a shankriformny piodermiya
Diagnostics of a shankriformny piodermiya generally comes down to definition of the causative agent of this disease and an exception of syphilis. Apply serological, microbiological and dermatological methods of a research to this purpose. Wasserman's reaction at a shankriformny piodermiya negative, at microbiological studying separated from ulcers in it there are no pale treponema, and also streptococci contain only staphylococcus. The dermatologist at survey reveals the ulcer localized most often in genitals, at inquiry it becomes clear that subjective symptoms are absent. The histologic research (at a shankriformny piodermiya it is made only at the erased and not clear symptomatology) reveals the expressed hypostasis terms, , the diffusion infiltration consisting, mainly, of neutrophils and lymphocytes.
Treatment of a shankriformny piodermiya it is admissible to start only after exact and reliable confirmation of the diagnosis and an exception of syphilis. Apply as local antiseptic and antibacterial means in the form of ointments and solutions, and system antibiotics. For the greatest efficiency of antimicrobic therapy at a shankriformny piodermiya it is necessary to carry out at a stage of diagnostics tests for sensitivity of activators to various antibiotics. Most often at this disease apply penicillin, macroleads, tetratsiklina, from other antimicrobic means – sulfanylamides. It is important to increase the immunity level therefore in treatment of patients use vitamins, immunostimulators, normalize a diet and the mode of a dream. Locally appoint solutions of aniline dyes, , for acceleration of healing and an epitelization appoint solutions and ointments on the basis of a gialorunat of zinc and biogenous stimulators. Also leads physiotherapeutic methods of treatment (ultra-violet radiation of the struck area, microwave warming up) to more bystry healing of ulcers at a shankriformny piodermiya.
Forecast and prevention of a shankriformny piodermiya
The forecast at a shankriformny piodermiya usually favorable – at correctly appointed treatment pyoinflammatory process fades, and the erosion heals. At the same time in case of its development on integuments there can be more or less noticeable hem whereas at localization on mucous membranes the ulcer heals completely. The forecast of a shankriformny piodermiya in the presence of an immunodeficiency, diabetes and other similar states worsens – in these cases treatment of pathology takes a lot of time, and also the risk of complications increases: new ulcers, other forms of a piodermiya, sepsis. For prevention of a shankriformny piodermiya it is necessary to follow the rules of personal hygiene, to support optimum level of immunity, to reveal and treat in due time the diseases promoting development of this state.