Piodermiya unite in themselves pyoinflammatory skin diseases which reason gnoyerodny microflora – piokokk, staphylococcus and streptococci is. About a third of all skin diseases make various piodermiya; primary piodermiya arise at damage of healthy skin, and secondary are a complication of diseases at which injuries of skin because of an itch are possible. Piodermiyami becomes complicated itch, eczema, and also diabetes and a chronic renal failure. If the piodermiya proceeds with involvement of deep layers of skin, then after it there are permanent cicatricial and pigmentary changes.
Piodermiya unite in themselves pyoinflammatory skin diseases which reason gnoyerodny microflora – piokokk, staphylococcus and streptococci is. About a third of all skin diseases make various piodermiya; primary piodermiya arise at damage of healthy skin, and secondary are a complication of diseases at which injuries of skin because of an itch are possible. Piodermiyami becomes complicated itch, eczema, and also diabetes and a chronic renal failure.
At uncomplicated piodermiya of damage of skin superficial and after recovery the integument is completely restored; if piodermiya accept a chronic or long current, deep layers of skin are involved in process, then there are hems and pigmentary spots.
Reasons of piodermiya
At skin of the person constantly there is a large number of microorganisms, some of them are normal microflora of skin, some saprofitny and tranzitorny microflora which at decrease in protective functions of skin is capable to cause piodermiya. As a result of activity microorganisms emit enzymes, endo-and ekzotoksina, as causes local reaction in the form of piodermiya.
In pathogenesis of piodermiya the important place is taken by working conditions and features of skin of the person, age and a condition of immune system; decrease in immunological reactivity of the person and non-compliance with personal hygiene increases probability of emergence of piodermiya. In most cases piodermiya are caused by saprofitny microflora, and therefore patients do not constitute danger to people around.
Microinjuries, stressful situations, overheating or overcoolings are factors which reduce protective functions of skin and increase probability of piodermiya; the people having diabetes, pathologies of a gastrointestinal tract, malfunction of blood formation and vitamin balance get into risk group, obesity and exhaustion also oppress local immunity.
The skin inclined to development of excessive amount of skin fat that happens at violations of TsNS, is most vulnerable for piokokk as change of the chemical composition of skin fat reduces sterilizing properties of skin. Change of a hormonal background or reception of kortkosteroid lead to the general diseases which are contributing to piodermiya.
Classification of piodermiya
Piodermiya classify depending on depth and weight of defeat, and also depending on the activator. Superficial piodermiya the shown ostiofollikulitam, sikozam of skin are most often stafilodermiya. Superficial streptodermiya and the mixed piodermiya clinically are shown in the form of impetigo vulgar.
Deep stafilodermiya are shown in the form of deep follikulit, gidradenit, a furunkulez and a karbunkulez. Deep inflammations of skin a streptococcal infection come to an end with the ulcer damages of skin proceeding as an ektima vulgar. Ulcer chronic forms of deep piodermiya most often are caused by the mixed microflora.
Treatment of a piodermiya
The dermatologist is engaged in treatment of a piodermiya. At piodermiya hair in the center of an infection and around it shear, but do not shave not to allow an obsemeneniye pathogenic microflora sites of healthy skin; if the piodermiya has generalized character, then water procedures including washing are forbidden. The contact with water is extremely not desirable, especially in a sharp phase of a disease.
Leather around an affected area is processed spirit solutions of aniline dyes and disinfectants, the good effect is rendered by salicylic acid and solution of permanganate of potassium. In spite of the fact that the contact with water is forbidden, it is daily necessary to wash carefully hands and to process nails of 2% iodine solution to prevent spread of an infection, and also to wipe healthy skin with a damp sponge.
Food during treatment has to be balanced, it is better to pass to a dairy and vegetable diet, to completely exclude extractive substances and alcohol from the menu, to limit the use of salt and simple carbohydrates. If the patient is weakened, has associated diseases or the piodermiya accepts long or chronic character of a current, at accession of symptoms of intoxication, it is expedient to carry out drug treatment of a piodermiya by antibacterial medicines. Before purpose of an antibiotic carry out separated or scrape, define the activator and its sensitivity to medicines. Antibiotics of a penicillinic row are practically not appointed because of their low efficiency, macroleads and tetratsiklina give good therapeutic effect, but erythromycin and it is undesirable to apply to treatment of children and pregnant women.
Treatment the combined antibacterial medicines and tsefalosporina (tsefotaksy and ) is appointed at infection with the mixed microflora as these medicines possess a broad spectrum of activity and steady against variability of bacteria. The course and a dosage of medicines are appointed individually, proceeding from weight of a current of piodermiya, usually reception of antibiotics should not be less than a week. Sulfanylamide medicines are less effective at piodermiya, but if the patient has an intolerance of antibiotics, then appoint + trimetopry, in the necessary dosages.
The active specific immunotherapy in combination with antibiotic treatment and local treatment yields good results, especially at chronic and slow processes. Two times a week carry out hypodermic introduction of anatoksin, specific anti-genes, stafiloprotektin in the conditions of policlinic or in a hospital if the patient is on hospital treatment.
For stimulation of nonspecific immunity resort to an autogemotransfuziya, transfusion of components of blood, ultra-violet radiation of blood (UFOK); such medicines as methyluracil, tincture of a magnolia vine and extract of an eleuterokokk stimulate immune system too. If there are immune violations, then it is expedient to carry out treatment of piodermiya with purpose of immunostimulators of group of medicines of a timus; medicines of gamma globulins and stimulators of production of interferon. Vitamin therapy is shown at all types of piodermiya.
Prevention of piodermiya
Prevention as for persons at whom is not present in the anamnesis of pustulous diseases and for persons with a recurrence of piodermiya in the anamnesis, consists in observance of rules of personal hygiene, in the organization of the warning measures in life and on production. Respect for sanitary and sanitary and hygienic norms on production significantly reduce incidence of piodermiya in separately taken establishment. Besides timely processing of injuries and microinjuries allows to exclude further infection of wounds and development of piodermiya.
Regular routine medical examinations for the purpose of detection of chronic diseases of a gastrointestinal tract, ENT organs allow to appoint treatment and not to allow development of secondary piodermiya. For patients with diabetes prevention of piodermiya consists in more careful care of skin, in its timely moistening not to allow maceration and formation of microinjuries as at diabetes even small scratch often becomes the reason of extensive and deep piodermiya.