Chronic diffusion streptodermiya
Chronic diffusion streptodermiya – a recidivous scattered inflammation of skin of a kokkovy etiology. Primary elements are the flat bulls appearing against the background of an edematous eritema, merging, forming the deckle-edged large centers. Serous and purulent bubbles erozirutsya, become covered by crusts, a row new appear. Skin diffuzno infiltrirutsya. Diagnose a disease on the basis of clinic, microscopy of scrapes and bacteriology of dabs from the defeat center. Treatment assumes improvement traffic, sanitation of the centers of an infection. Bulls open, impose the damp drying antiseptic bandages, apply the vitamin therapy and means improving peripheral blood circulation.
Chronic diffusion streptodermiya
Chronic diffusion streptodermiya – a chronic superficial kokkovy infection of integuments with diffusion infiltration of skin. Feature of pathology is its favourite localization around not healing ulcers or in places of a constant travmatization of skin. The disease has no age, gender and seasonal framework, not endemically. Exact data on structure of incidence of a chronic diffusion streptodermiya are absent as this pathology in some cases is regarded as eczema or a consequence of trophic violations.
In domestic dermatology the outstanding representative of the St. Petersburg school of skin diseases professor S. T. Pavlov was engaged in an ekzemopodobny dermatosis. It the first described the post-traumatic chronic diffusion streptodermiya which is transformed to eczema against the background of not healing ulcer. He proved that it is long the existing center of a kokkovy infection in the form of a chronic diffusion streptodermiya almost in 90% of cases leads to a sensitization terms and transformations in microbic eczema. Relevance of a problem at the present stage is connected with need of timely and exact diagnostics of a chronic diffusion streptodermiya at vascular diseases of the lower extremities which are followed by the expressed trophic violations.
Reasons of a chronic diffusion streptodermiya
Streptococcal or strepto-staphylococcal intervention of skin is a cause of illness. Provocative factors of a chronic diffusion streptodermiya consider varicosity, thrombophlebitis, the irrational irritating therapy. The mechanism of emergence of a chronic diffusion streptodermiya is caused by trophic violations. At the first option of development the main role is played by long violation of local blood circulation. Because of formation of the erosive and ulcer site of the infected skin there is an ischemia terms caused by an angiospasm as a result of pathogenic action of microbes on their wall and development of an inflammation. The injured arteries trombirutsya that creates additional obstacles to a local blood-groove. The inflamed fabrics around the center of a chronic diffusion streptodermiya kompressionno squeeze nearby vessels, and the formed kollateral promote blood redistribution that aggravates ischemia of an affected area, breaks to a skin traffic.
The second option of development of a chronic diffusion streptodermiya is connected with a hypoxia of fabrics terms. Oxygen starvation – the investigation of ischemia, but not only. The hypoxia terms develops as a result of infectious damage of enzymes of intracellular mitochondrions. As a result of a cage lose ability to acquire oxygen. The third option of emergence of a chronic diffusion streptodermiya – emergence of exchange violations. In this case the inflammation in a term develops because of activation of T-lymphocytes of immune system that leads to strengthening of cellular proliferation for the purpose of restoration of integrity of integuments.
For this purpose, first of all, protein – the main construction material terms is required. Therefore delivery in skin of the proteins, fats and carbohydrates providing normal cellular metabolism changes the proportions in favor of a proteinaceous component. The exchange balance is broken, and after it and a traffic of fabrics. Overcooling of skin is capable to slow down metabolism. Besides, a traffic terms at a chronic diffusion streptodermiya changes as a result of violation of an innervation of skin. Most often it occurs at infringement of the numerous nervous terminations located in skin the hems which are formed on the place of ulcers.
Symptoms of a chronic diffusion streptodermiya
The disease begins with a rash of serous and purulent bulls of the small sizes against the background of edematous and hyperemic skin in response to action of streptococcal and strepto-staphylococcal flora. At the same time protective and barrier functions of skin are broken that allows microbes to be fixed on the surface of epidermis or to get deep into terms. Force of response of an organism depends on a condition of immune system of the patient, virulence of cocci, their quantity. The formed bulls are opened, bare the erosive surface which is becoming covered by serous or serous and purulent crusts, begin to be shelled. At a chronic diffusion streptodermiya primary elements possess a tendency to merge therefore in places of typical localization of pathological process (on the lower extremities) quickly enough there are large centers with indistinct contours surrounded on perimeter with the exfoliating epidermis.
Rashes are followed prodromy and not intensive itch. A cycle of existence of primary elements – 10-12 days. Near involyutsioniruyushchy educations there are fresh, joins moknuty. The current of a chronic diffusion streptodermiya gains recidivous character, skin diffuzno infiltrirutsya. Hair follicles and the ferruterous device terms are involved in process, ostiofollikulita develop. Eventually the centers grow on the periphery, regionarny lymph nodes increase. On one sites of an integument process subsiding begins, the krupnoplastinchaty peeling appears, in the next centers there are melkotochechny erosion with serous filling against the background of a bright eritema that testifies to a sensitization of skin and the beginning of transformation of a chronic diffusion streptodermiya in eczema.
Diagnostics and treatment of a chronic diffusion streptodermiya
Diagnosis of pathology is performed by the dermatologist on the basis of the anamnesis and clinical symptomatology. For specification of the diagnosis and performing differential diagnostics carry out scrape microscopy from the defeat center, bacteriological crops of the inflammation separated from epicenter for definition of sensitivity to antibiotics. Patogistologiya states the lack of a horn and granular layer of epidermis alternating with the phenomena of a parakeratoz, lymphocytic infiltrate. The chronic diffusion streptodermiya is differentiated with eczema, atopic dermatitis, piodermiya.
Treatment consists in opening of bulls and their disinfection. Perform bandagings. Locally apply rassasyvayushchy sulfuric ointments, at their inefficiency sometimes use X-ray therapy. It is shown to Ural federal district. Inside appoint the vitamins, vasodilating means, medicines improving to a traffic. Consultation of the vascular surgeon is recommended. Prevention consists in observance of rules of personal hygiene and regular care of skin. Forecast of a chronic diffusion streptodermiya rather favorable.