Superficial piodermiya – group of the contagious dermatosis of mainly kokkovy genesis affecting epidermis and the top layers terms. It is clinically shown by polymorphic rashes , small knots, bulls, . The form of primary element depends on a kind of a superficial piodermiya. Bubbles are quickly opened, form erosion, become covered by crusts and regress without trace. Diagnose a superficial piodermiya on the basis of clinical manifestations, Dermoscopy, the crops separated bulls on Wednesdays of blood test on sugar, immunogramma. In treatment apply antibiotics, immunomodulators, vitamins. Outwardly use aniline paints and antiseptics.
Superficial piodermiya – the purulent defeat of blankets of an integument of a bacterial origin which is often found in dermatology. Not less than a quarter of all diseases of skin and more than a half of all piodermiya falls to its share. The superficial piodermiya arises against the background of non-compliance with rules of personal hygiene and accommodation in insanitary conditions. Piodermichesky process is professional for workers of spheres of production and agriculture whose work is connected with insanitary conditions. Children are ill to a superficial piodermiy thicket of adults, the incidence reaches 30-60% of total of a children's dermatosis. Ways of infection – airborne and contact.
The probability of development of a disease depends on quantity and structure of flora, and also on the level of resistance of an organism. The main activators of a superficial piodermiya are representatives of kokkovy flora, each of which has the features. Streptococci cause pathological process, endemic for regions with tropical and subtropical climate. The peak of seasonal activity of microbes falls on summer months therefore in June-August growth of incidence of a superficial piodermiya is noted. Feature of this infection is the manifestnost of clinical manifestations and inability to a latent carriage. Stafilokokki, on the contrary, are not endemic, perhaps latent carriage that demands preventive treatment of all contacting to the patient with a superficial piodermiya. Relevance is defined by prevalence and contageousness of pathology.
Reasons of a superficial piodermiya
Causative agents of pathology are cocci, widespread in the environment and having high invasive activity that allows them to overcome barrier properties of skin, to be fixed in blankets of epidermis and terms, and then to breed. Exogenous and endogenous factors provoke a superficial piodermiya. Injuries, differences of temperatures, influence of chemicals concern to the first. To the second – overfatigue, intoxications, the centers of a perifokalny infection, hypovitaminosis, somatic diseases. The probability of emergence of a superficial piodermiya increases at violation of the rules of personal hygiene, existence of insanitary working conditions and life.
Development of inflammatory process on skin depends on quantity of pathogenic flora, reactivity and resistance of an organism. Kokkovy flora, damaging cells of skin, stimulates production of biologically active agents, activates T-lymphocytes with development of an inflammation. Prevalence of an ekssudation promotes formation of the cavities filled with liquid in epidermis, that is, to emergence of bulls on skin. Proliferation leads to emergence of small knots. The inflammation is followed by allocation of a histamine, there is an itch, there are raschyosa, secondary piokokkovy flora joins, the superficial piodermiya develops.
Classification and symptoms of a superficial piodermiya
Now dermatologists subdivide superficial piodermiya on an etiologichesky sign on streptococcal, staphylococcal and mixed, on sharpness of process – on sharp and chronic. Clinically all kinds of a superficial piodermiya are united by primary element – a fliktena of the different sizes and localization.
Sharp streptococcal superficial piodermiya include:
- The streptococcal intertrigo () which is characterized by maceration and puffiness of skin folds. On this background there are fliktena which are quickly opened with formation of the erosion tending to merge. Because of continuous friction the drain center of irregular shape on the periphery is surrounded with an epidermis frill – the tire remains . Process is followed by an itch, burning, ekskoriation and accession of a secondary infection.
- Streptococcal impetigo – a contagious dermatosis which is shown by small bullous rash against the background of hyperaemia. Rash is localized on a face, extremities and a trunk. Bulls erozirutsya, become covered by the crusts which are not leaving behind a trace. High contageousness of a dermatosis demands isolation of the patient before absolute clinical recovery.
- Streptococcal I will come around – pustula in a mouth corner, not hazardous to health of the patient, but the causing pain. Usually zayedam (heylity) children or patients with endocrine violations suffer.
- The streptococcal dry streptodermiya which is characterized by emergence shelled with a tendency to merge and formation of the centers with scalloped edges to 10 cm in the diameter. More often children are ill. Pathology in nasolabial folds, behind ears, on cheeks is localized.
- Streptococcal felon – a pustulous inflammation on the palmar surface of fingers with hypostasis, hyperaemia and morbidity.
Among sharp staphylococcal superficial piodermiya distinguish:
- Ostiofollikulit – an inflammation of a hair follicle or a sebaceous gland with formation from which when pressing pus is emitted.
- Superficial follikulit – a pustulous inflammation of a hair sack, it is allowed without traces.
- Bullous impetigo at children – the most dangerous kind of a superficial piodermiya with is purulent - hemorrhagic bulls, erosion and multilayered crusts. Nails are surprised, somatic diseases become aggravated, the general health of patients is significantly broken.
- Pemfigoid of newborns – is characterized by emergence around a navel and pleated skin. Mucous can be involved in process.
- Eksfoliativny (listovidny) dermatitis of newborns of Ritter – reminds a puzyrchatka of newborns, rashes in the form of bulls are localized around a mouth, a navel and an anus, on genitals. The disease has three severity, is followed by violation of the general state, is capable to be transformed to an eritrodermiya. The child is more senior, the dermatitis proceeds more softly.
The mixed superficial piodermiya are presented by sharply current vulgar impetigo – an infectious skin disease with education around natural openings and involvement in process of appendages of skin.
Chronic forms of a superficial piodermiya include:
- Chronic diffusion streptodermiya with recurrent rashes on the lower extremities which are allowed with formation of erosion, crusts. Rashes are followed by not intensive itch.
- Staphylococcal vulgar with formation of follikulit in moustaches and a beard, possesses a recidivous current.
- The mixed chronic atypical abstsediruyushchy piodermiya with emergence any localization against the background of an immunodeficiency and inverse konglobatny eels – a kind of an abstsediruyushchy recidivous piodermiya with education in armpits, genitals and buttocks after the postponed acne disease.
Diagnostics and treatment of a superficial piodermiya
The clinical diagnosis is made on the basis of the anamnesis and typical symptomatology with use of Dermoscopy and crops of contents on nutrient mediums for the purpose of definition of a type of the activator and its sensitivity to antibiotics. Taking into account background pathology take blood on sugar, at a heavy current of a superficial piodermiya investigate the main characteristics of immune system by means of an immunogramma. Differentiate a superficial piodermiya with an eely sifilid, pink eels, a medicamentous toksikodermiya, an eozinofilny follikulit of HIV-positive people, gidradenity, flat it is deprived, dermatomikoza, a bullous epidermoliz, eczema, candidiasis, bromodermy.
Treatment is directed to sanitation of the center of defeat for the purpose of the prevention of distribution of a superficial piodermiya. At the localized forms local therapy is performed. Fliktena open, disinfect, appoint antiseptic solutions, aniline paints, pastes with antibiotics, the keratoplastichesky drying plasters. At resistance apply vitamins and antibiotics to external therapy orally. In hard cases hormones, immunomodulators, cytostatics, an autogemoterapiya are shown. At a staphylococcal superficial piodermiya use antistaphylococcal immunoglobulin, plasma, , a bacteriophage. Besides, at a superficial piodermiya UVCh, an electrophoresis with medicines, helium - the neon laser are effective Ural federal district. Furuncles treat surgically.
Prevention of a superficial piodermiya consists in observance of rules of personal hygiene and sanitary standards, sanitation of the centers of a chronic infection. It is forbidden to wash the defeat center, to squeeze out fliktena, to impose compresses. Processing of an affected area on perimeter spirit solutions is necessary. The forecast at respect for hygienic norms, timely diagnostics and treatment favorable, an outcome becomes an absolute recovery.