Streptoderma in children. Local and systemic therapy in the treatment of streptoderma in children Streptoderma in children mkb 10

Treatment of streptoderma in children is not a long process. Despite this, it should be complex, even if the disease is mild. The disease involves the skin and is characterized by a variety of symptoms.

According to the International Classification of Diseases 10th revision (ICD-10), streptoderma is assigned a code - L08. This section includes pyoderma code L08.1 and specified infectious lesions L08.8.

The cause of streptoderma in children is the entry into the body and the conduct of life in this environment of a pathogenic microorganism - streptococcus.

Such may gain a foothold on the skin, getting there from the following sources:

household items: from toys, towels, dishes, etc.;
from a sick person or from a healthy person who is a carrier of the infection;
from a sick person with such pathologies as: tonsillitis, pharyngitis, scarlet fever,.

The disease is epidemic. Children attending kindergartens, schools, sections can get sick by picking up an infection from another child. The duration of the incubation period is from 2 to 10 days.

Based on the source of transmission of infection, the ways of transmission of the disease are distinguished:

contact: during direct contact of the skin of a sick person with the epidermis of a healthy person (during games, kissing, etc.);
contact-household: during the transfer of any object from a sick person to a healthy person - toys, towels, dishes, etc .;
airborne: during sneezing or coughing, when infected saliva gets on the damaged skin of a healthy person.

Causes of relapse

In the normal state of the immune system (both local and general), in the absence of a violation of the integrity of the epidermis, a streptococcal infection has no chance of surviving in the body, it is simply suppressed by it.

Relapses, as well as a progressive course of the disease, occur in the following cases:

in violation of immunological reactivity, which is observed in premature babies, in children with anemia, malnutrition;
with the concomitant development of another infectious pathology;
with the concomitant development of a chronic skin disease (scabies, pediculosis, etc.);
with allergic symptoms,;
with the concomitant development of otitis, rhinitis (due to the release of exudate from the nose, which irritates the skin).

External factors also influence the development of the disease: high or low temperature (burn, frostbite of the skin, through which streptococci can enter the body).

If personal hygiene for caring for a child is not observed, this also increases the risk of pathology.

What forms can the disease take?

What streptoderma looks like can be said based on the form of the disease. In medicine, there is a division of pathology into the following varieties.

Streptococcal impetigo

It is definitely difficult to say how streptoderma of this form begins. In some children, the initial stage of the development of the pathology is a slight reddening of the skin, while in others, characteristic bubbles immediately appear.

At the beginning, a transparent exudate is localized in the vesicles, which eventually turns into pus with blood impurities. Bubbles can merge into one large spot. To the question Is streptoderma contagious in children, you can say with accuracy - yes. The content of the elements that burst has a large amount of streptococci, which, when they enter the skin of a healthy person, cause streptoderma in him. After the bubbles have dried up, crusts remain in their place, and after the latter dry out, blue spots appear.

Bullous and slit-like impetigo

Streptoderma in children looks like large blisters that are larger than the elements with streptococcal impetigo. After the bubbles burst, a crust forms in their place, and after it dries out, erosion with progressive development.

Slit-like on the face of a child - in the form of jamming that occurs in the corners of the mouth. An oblong-shaped element quickly bursts, and a crack appears in its place.

lichen simplex

Dry streptoderma in children is characterized by the appearance on the skin of rounded elements that have a pinkish or whitish tint. The rashes may itch slightly.

Impetigo nails

An inflammatory process occurs around the nails, and the nail plate can completely exfoliate. The disease develops after injury to the finger or with chronic hangnails. The general condition may worsen.

Intertrigo

Symptoms of streptoderma in children occur in skin folds. The rash quickly merges into one large spot, forming a bright red weeping erosion. With a long course of the disease, a fungal or staphylococcal infection may join with the occurrence of other characteristic symptoms.

Ecthyma vulgaris

At the initial stage, the pathology has the same symptoms as in the classical form of streptoderma, but with blisters that have a high density. After their opening, ulcers appear, containing rough edges and a dirty coating. After the ulcer heals, a scar and pigmentation appear.

Diagnosis of the disease and features of therapy

A dermatologist is engaged in the diagnosis and treatment of streptoderma on the hands, streptoderma on the legs and in other areas of the body. He will be able to determine the form of the disease and its stage by the appearance of the rash.

To confirm the diagnosis, prescribe additional diagnostic measures:

microscopy of scrapings of the epidermis (for fungus);
bacteriological seeding of the excreted exudate;
examination of the skin under the Wood's lamp;
RPR test and tuberculin test (to rule out syphilitic ulcers and skin tuberculosis).

Differential analysis of streptoderma on the head of a child and in other areas of the body is carried out with skin pathologies such as herpes simplex, chickenpox, pyoderma, pemphigus, candidiasis, eczema.

How to cure streptoderma, a specialist decides after examining the patient. Streptoderma in children should be treated as early as possible - this will avoid negative consequences. The treatment is complex.

Hygiene

Using the right ointment is the first step in the treatment of streptoderma

First of all, personal hygiene must be observed. Even if the mother adheres to all other prescriptions of the attending physician, uses the prescribed drugs, but does not observe hygiene, the chances of a quick recovery are reduced.

With streptoderma, it is important to follow the following recommendations:

in the first 3-4 days after the onset of the appearance of bubbles it is forbidden to carry out water procedures(water is a conductor of infection);
those areas of the skin where there are no pathological elements are wiped with a cotton swab dipped in warm water or in a decoction of medicinal herbs (chamomile, string);
blisters should not be scratched;
the child should have individual household items: a towel, dishes, which are carefully processed after use;
plastic toys are washed every day, and soft toys are put on the far shelf;
bedding is changed daily or ironed.

In the presence of any, even minor damage to the skin, it is treated with an antiseptic solution three times a day.

Local therapy

How to treat streptoderma in children, what drugs are prescribed and manipulations are performed? Treatment can be carried out at home, but only in accordance with the prescriptions of the attending physician.

The bubbles are carefully opened with an injection needle pre-treated with an antiseptic.. Next, the surface is treated with a solution of aniline dyes, a dry antiseptic dressing is applied.

To remove crusts, use salicylic vaseline, which is pre-lubricated with crusts, leaving for 2-3 hours. Also in the treatment of streptoderma in children at home, the following ointments can be used.

	Dosage, method of application	Contraindications	Side effects	Average price, rub.
Streptocid, ointment	Apply a thin layer, securing with a bandage on top. The frequency of use is determined by the doctor	Hypersensitivity, acute porphyria, acute renal pathology, infants, pregnancy, lactation	allergic reactions	60-80
TETRACYCLINE, ointment	Apply a thin layer under the bandage 2 times a day	Hypersensitivity, children under 11 years of age	allergic reactions	20-30
GENTAXAN, ointment	Apply a thin layer to problem areas 2 times a day, fixing with a tight bandage on top	Hypersensitivity	Itching syndrome, dermatitis, urticaria	1300
BANEOTSIN, ointment	Apply baneocin with streptoderma in children twice a day, fixing it with a bandage on top	Hypersensitivity, severe skin lesions	Urticaria, increased dryness of the skin	300
BACTROBAN, ointment	Apply with a cotton swab 2-3 times a day, spreading over problematic skin, fix with a bandage on top	Hypersensitivity	Urticaria, erythema, hyperemia	400

Streptocid ointment has a pronounced antimicrobial effect, helps to suppress infection. The only one lack of the drug - the addiction of pathogenic microorganisms to the substances that make up, which becomes the reason for the inefficiency of the ointment.
Tetracycline ointment has an antiseptic effect, contributing to the rapid elimination of pathogens. As part of the drug - an antibacterial substance from the tetracycline group - tetracycline hydrochloride.
Gentaxan ointment has a powerful antimicrobial effect due to the gentamicin sulfate that is part of the substance. Despite the high efficacy of the drug, ointment often causes side effects as a skin allergic reaction.
Baneocin ointment also refers to antibacterial drugs used in the treatment of gram-positive pathogenic microorganisms. The drug is prescribed for both children and adults.
Bactroban ointment includes the antibacterial component mupirocin. The drug helps to stop the growth and vital activity of pathogenic microorganisms and has a bactericidal effect. The drug is used both in monotherapy and in the complex treatment of streptoderma..
Ointments for streptoderma are prescribed by the attending physician, based on the form of the disease. If local therapy does not help get rid of the pathology, drugs are used in the form of tablets.

Antiseptics

It is possible to disinfect the surface of the skin, where the rashes are localized, using any antiseptic solution.

Name of the drug, release form	Dosage, method of application	Contraindications	Side effects	Average price, rub.
BRILLIANT GREEN, liquid	Treat the affected areas 2-3 times a day	Hypersensitivity, weeping wounds on the skin, bleeding		36
HYDROGEN PEROXIDE, liquid	Treat the affected areas several times a day with a swab	Hypersensitivity	Allergic reaction on the skin	6
BORIC ALCOHOL, liquid	Treat the affected areas 2 times a day	Hypersensitivity	Allergic reaction on the skin	16

Brilliant green solution has an antiseptic effect and is used not only for streptoderma, but also for many other skin diseases. Adverse symptoms are rare and allows the use of the drug in the treatment of pathology in young children.
Hydrogen peroxide is a tool that is used to disinfect damaged areas of the skin (which is necessary for streptoderma), as well as to stop minor bleeding and in dental practice. Due to the natural composition of the drug, there are practically no side effects.
Boric alcohol has an antiseptic effect and rarely causes irritation. skin cover. It is used not only for streptoderma, but also for other skin pathologies in children (for example, with diaper rash).

Systemic antibiotic therapy

In severe cases, antibiotics are prescribed. These can be penicillins - drugs that are most effective in treating. Macrolides are considered no less effective.

The dosage, duration of therapy, type of antibiotic is determined by the attending physician. It is forbidden to self-medicate with antibiotics, they often cause side effects.

Name of the drug, release form	Dosage, method of application	Contraindications	Side effects	Average price, rub.
AMOXILAV, tablets	Children under 2 years - 2.5 mg, after 2 years - 5 mg as a single dose	Diseases of the heart, blood, respiratory system, liver, kidneys, periods of pregnancy and lactation, hypersensitivity to components	Nausea-vomiting syndrome, flatulence, allergic reactions, dyspepsia, convulsions	300-400
erythromycin tablets	20-40 mg per 1 kg of weight, 3 times a day	Similar	Similar	18-102
FLEMOKSIN, tablets	30-60 mg per 1 kg of weight, 2-3 times a day	Similar	Similar	250

Amoxiclav belongs to the group of penicillins and rarely causes side symptoms due to good tolerance by the body. If tablets with this name are prescribed for adults, then for children, it is advisable to use a suspension.
Erythromycin belongs to the group of macrolides and is better tolerated by the body than penicillins. The action of the drug is identical to penicillins. Prolonged use of erythromycin may cause pathogen resistance to its substances.
Flemoxin belongs to the group of semi-synthetic ampicillins. The advantage of the drug is fairly rapid absorption. The drug belongs to combined agents and is used not only for skin diseases, but also for the gastrointestinal tract, respiratory system (including in children).

Folk remedies

Tinctures, decoctions or compresses from medicinal plants are effective helpers in the treatment of the disease.

How to quickly cure streptoderma at home, are there folk remedies that are approved for use by both adults and children?

Chamomile, oak bark (an infusion of these has a drying effect): pour 1 tbsp. l. raw materials 200 ml of boiling water, insist for an hour, strain, make a compress on the affected area 2 times a day;
elderberry bark (a decoction of the bark helps soften the crusts): 1 tbsp. l. raw materials pour 200 ml of milk, boil for 15 minutes, cool, make lotions on the affected area three times a day;
grated garlic, ground pepper (to eliminate weeping plaques): mix the ingredients in equal volumes, apply on a piece of gauze, then on the affected area, hold for 15 minutes (make a compress twice a day).

You can increase the protective function of the body, thereby accelerating recovery, by taking an infusion from the bark and leaves of hazel: 1 tbsp. l. raw materials pour 200 ml of boiling water, insist for an hour, strain, take orally before meals 1-2 tbsp. l.

How to brew a series for bathing a newborn - read. What should be the temperature of the water for swimming -.

Differential analysis and duration of treatment

For example, a herpetic rash is present along with a pain syndrome, while it is absent with streptoderma. Chickenpox is characterized by the simultaneous presence of both fresh pimples and already dried blisters.

Streptoderma does not occur with catarrhal symptoms: cough and runny nose are absent. At the initial stage of the formation of vesicles, they have a transparent content, while in other skin diseases it can immediately be cloudy.

Streptococcal seizures differ from herpes in that they quickly open, forming cracks. After opening the herpes element, cracks do not remain.

It is possible to accurately determine the ongoing disease based on the results of the diagnostic measures taken.

The following factors influence the duration of treatment for streptoderma in children on the face and other areas of the body:

the age of the sick person (children recover faster due to a strong immune system than adults);
the severity of the disease;
the presence of comorbidities.

If you start therapy for streptoderma at the initial stage of development, you can recover in 7-10 days. With advanced pathology, therapy lasts for months.

Features of treatment in infants

In the treatment of newborns, it is important to follow all the doctor's instructions. There is no need to interrupt therapy, even if positive changes in the general condition are visible.

In the presence of fever, the baby is prescribed bed rest, taking appropriate drugs (antipyretics: Nurofen or others). Water procedures are contraindicated for this period.

It is necessary to keep the baby's hands clean, and cut the nails (find out in a separate article). This is necessary because even if the child touches the rash, the risk of secondary infection will be minimized.

The living quarters where the newborn is constantly located are ventilated daily and carry out wet cleaning. If the child is breastfed, the nursing mother should follow a healthy diet. Artificers are transferred to hypoallergenic mixtures. How to choose the right mixture, by what criteria to do this is described.

Features of the disease in adults and during pregnancy

The course of streptococcal infection in adults is easier than in children. Complications rarely occur.

If you ignore the therapy prescribed by your doctor, the rash can spread to large areas of the body.

Treatment of the disease in adults is no different from that carried out in relation to children. The exception is the period of pregnancy, in which many drugs are prohibited for use. Systemic therapy is rare. More often, local preparations are used that are not harmful to the fetus.

Complications

Streptoderma can be accompanied by complications, especially with untimely and inadequate treatment. Among those:

chronization of the inflammatory process;
rough scars that require cosmetic procedures;
development of microbial eczema;
fungal infections requiring other specific therapy;
dermal atrophy.

Preventive measures

Observe the rules of personal hygiene yourself and teach children from a very young age. It is better to prevent the onset of the disease than to end up stubbornly treating

How to treat streptoderma in a child on the face or in another area, found out.

It is necessary to take care of the prevention of the disease, how to deal with it and its negative consequences.

Preventive measures include:

timely treatment of wounds on the skin with the help of appropriate drugs;
preventing scratching of the skin during the development of a skin disease, an insect bite, and other injuries;
personal hygiene (very important);
maintaining a healthy lifestyle;
adherence to proper nutrition;
avoid contact with sick people.

findings

Streptoderma is not a dangerous disease, but the first symptoms should not be missed. Get the treatment you need right away. If therapy is started in a timely manner and carried out correctly, one can hope for a complete recovery and the absence of relapses.

Streptoderma is a dermatological bacterial disease caused by streptococci. It is characterized by the fact that pinkish scaly rounded spots form on the skin.

It is more correct to call this disease streptoderma, since together with staphyloderma, they form an extensive group of pustular skin diseases (pyoderma). The development of these diseases is based on a purulent inflammatory process that affects the skin and subcutaneous fat. All pyoderma are divided into clinical forms depending on the pathogen, the prevalence and depth of the inflammatory process.

Pyoderma code (staphyloderma and streptoderma) ICD 10 - L08.0. Streptococcal impetigo is classified as L01. Erysipelas (caused by group A beta-hemolytic streptococci) is classified as A46.

For reference. Streptoderma is pyoderma caused by streptococci (mainly group A beta-hemolytic streptococci).

Symptoms of the disease are quite diverse and largely depend on:

the depth of the inflammatory process (superficial or deep streptoderma);
localization of the inflammatory process;
the age of the patient, the state of his immunity, the presence of concomitant diseases, etc.

Streptoderma - classification

Depending on the depth of the inflammatory process, streptoderma is usually divided into superficial and deep.

Superficial forms of streptoderma are presented:

streptococcal impetigo;
crevice impetigo;
papulo-erosive streptoderma;
intertriginous streptoderma;
erysipelas;
streptococcal toxic shock syndrome;
acute diffuse streptoderma.

Deep forms of streptoderma include cellulitis (phlegmon of subcutaneous fat) and ecthyma vulgaris.

For reference. In some cases, the inflammatory process can be caused by a mixed flora (staphylostreptoderma), in which case superficial impetigo vulgaris most often develops.

Causes of streptoderma

Normally, human skin is colonized by a large number of opportunistic pathogens. They make up its natural microflora and do not cause an inflammatory process.

Also, they help maintain the natural defense mechanisms of the skin.

With a sufficient level of immunity, intact skin has nonspecific resistance (relative innate resistance to certain 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 (destructive) on group A beta-hemolytic streptococci.

Attention. In the presence of risk factors (decreased immunity, skin trauma, etc.), the level of nonspecific resistance is markedly reduced. Against this background, the inflammatory process can be caused by both pathogenic microorganisms and conditionally pathogenic microorganisms that are constantly present on the skin.

Risk factors contributing to the development of inflammatory processes in the skin and subcutaneous fat are:

immunodeficiency states;
stress, chronic lack of sleep, overwork;
constant hypothermia;
work in hot, stuffy rooms;
living in regions with a humid climate;
work in conditions of high humidity (greenhouses, etc.);
violations of the integrity of the skin;
deficiency of vitamins A, B, C, E, as well as zinc, magnesium or sulfur;
unbalanced diet;
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 the rules of personal hygiene;
improperly selected skin care (overdrying of the skin, the use of too aggressive cleansers, etc.);
the use of low-quality cosmetics;
obesity;
the presence of foci of chronic infection (streptococcal tonsillitis).

Attention. Due to the lack of barrier functions of the skin, young children are more prone to staphylo- and streptoderma than adults.

What can cause streptoderma

The most pathogenic streptococci for humans, often causing streptoderma, are hemolytic, viridescent and non-hemolytic streptococci.

Group A beta-hemolytic streptococci are the main cause of all streptoderma. Green and non-hemolytic streptococci affect the skin less often and, as a rule, cause streptoderma in children or debilitated patients.

For reference. The prevalence of streptoderma is due to the fact that about 45% of schoolchildren (in older patients this percentage is higher) are chronic carriers of group A beta-hemolytic streptococci in the nasopharynx.

Streptococci are transmitted by airborne droplets, when coughing, talking or sneezing.

In the presence of streptococcal inflammatory processes on the skin (erysipelas, impetigo, etc.), the infection can be transmitted by contact (personal items, sheets).

For reference. The main difference between streptoderma and staphyloderma is the lesion of smooth skin.

With streptoderma, the skin around the mouth, the skin of the legs, armpits, above the mammary glands, in the inguinal and gluteal folds, etc. are affected. There is also a peripheral spread of the focus of the inflammatory process (from the center to the periphery).

Streptoderma is an infectious skin disease caused by the activity of bacteria of the genus Streptococcus. In most cases, it affects children under 12 years of age. It is rare in adults.

The disease is transmitted in 2 ways:

Direct or indirect contact with the patient: hugs, touches, use of common items (dishes, towels, toys).
Airborne, that is, through the general air.

Streptoderma in the international classification of diseases (ICD-10) is indicated by the code L01.1.

The main cause of the disease is the activity of various strains of streptococcus. This bacterium can be found anywhere on human skin, including the mucous membranes of the eyes, nose, digestive system, and reproductive organs. In a healthy person, it is suppressed by local immunity. But under certain circumstances, it gets the opportunity to penetrate the body and begin its harmful activity:

Skin damage: scratches, abrasions, wounds, ulcers, burns, abrasions.
Weak immunity due to age, poor nutrition, in which light carbohydrates (sweets) predominate and vitamins are missing in the right amount, prolonged psychological overload.
Poor hygiene or lack of it.

The main role in the appearance of streptoderma is played only by the first 2 reasons. The third is an additional source of infection and aggravates the treatment of the disease.

Varieties of the disease and symptoms

Medical literature offers the following classification of streptoderma:

streptococcal impetigo;
bullous or bubble impetigo;
slit-like impetigo;
superficial felon;
streptococcal ecthyma;
dry streptoderma.

Streptococcal impetigo is more common than other types of streptoderma and is considered its classic form. Its characteristic symptom is rounded redness, later turning into vesicles, appearing on the head, back, arms and legs. It is the mildest form of the disease.

Bubble impetigo is characterized by deep skin lesions and, as a result, long-term treatment. Rashes in this form of the disease look like large blisters filled with purulent or serous fluid. Most often they are located on the limbs. In their place, after spontaneous or deliberate opening, weeping wounds appear.

Slit-like impetigo or "jam" is one or more pustules that occur in the corners of the mouth, eyes, or under the nose. This type of disease is not dangerous and is easily treated. Sometimes it becomes chronic in metabolic disorders.

Superficial panaritium is a disease associated with streptococcal streptoderma. It occurs due to the transfer under the skin around the nail of the causative agent of the underlying disease. This is due to the scratching of the rash. It is manifested by edema and inflammation of the skin at the site of penetration of streptococcus, as well as the appearance of a similar rash or erosion. Treatment not started on time can deprive the patient of the nail plate.

Streptococcal eczema is a type of disease that is difficult to treat and affects the limbs and buttocks. Accompanied by a rash that turns into deep and painful ulcers.

The latter type differs from the rest in the absence of a blistering rash. Dry streptoderma is accompanied by the appearance of red spots, on the surface of which there is a large amount of dead skin. Her presence causes intense itching.

Each form of streptoderma, in addition to specific manifestations, has common symptoms:

temperature rise to 37.5 - 38 ° C;
intoxication of the body;
weakness and general malaise.
enlarged lymph nodes;
nausea, vomiting;
muscle pain and joint pain.

Course of the disease

Like any other disease, streptoderma develops along a path characteristic only of it. It includes 4 stages:

incubation period.
Bullous or bubble period.
Opening of the rash and the formation of ulcers.
Recovery.

The first period lasts from 3 to 10 days. At this time, rounded spots of dark pink color appear on the body. Appears itching and subfebrile temperature (37-37.3 ° C).

In the second stage, the spots are filled with a cloudy liquid or pus. After a few days, they open up or the patient himself destroys their shell with the help of nails due to unbearable itching. But it is better to use sterile needles from syringes for this purpose.

This event marks the transition to the third stage of the disease. After opening, the lesion site is covered with crusts of a dirty yellow color. They should also be removed, and then the resulting wound should be disinfected.

After the removal of the crusts, the stage of healing and recovery begins. It lasts about a week. On average, it takes 10-15 days from infection to complete recovery.

Diagnosis and treatment

The following specialists are involved in the diagnosis and treatment of streptoderma:

pediatrician if the child is sick;
therapist, if an adult is sick;
dermatologist.

The purpose of diagnostics is to exclude similar skin diseases from the preliminary diagnosis: various forms of herpes, atopic dermatitis, pyoderma, urticaria and others.

To do this, the doctor conducts an examination, prescribes a general blood test. In most cases, these data are sufficient, since the manifestations of streptoderma are very specific.

But sometimes a culture of a scraping or the contents of the rash may be required. It allows you to determine the type of pathogen. If the patient began to use antiseptic ointments on his own, then this diagnostic method gives a false negative result.

After the diagnosis is made, the doctor prescribes medication. The following groups of drugs are usually used for it:

Antibiotics in the form of tablets or injections: Ceftriaxone, Amoxicillin, Flemoclav, Cefixime, Clarithromycin.
Ointments or creams with antibacterial and healing effects: Tetracycline, Levomekol, Erythromycin, Synthomycin, Baneocin.
Antiseptic solutions: Miramistin, Chlorhexidine, boric alcohol, a solution of brilliant green ("brilliant green").
Antihistamines to reduce itching and redness: Zodak, Zirtek, Suprastin.
Prebiotics to restore the balance of microflora in the gastrointestinal tract: Hilak Forte, Linex, Lactobacterin;
Immunostimulants: Viferon, Polyoxidonium;
Multivitamins: Vitrum, Alphabet, Supradin.

If the child is allergic to antibiotics, the doctor may prescribe ultraviolet irradiation. It has a similar effect and does not cause allergies.

In addition to taking drugs orally (through the mouth), treatment involves the treatment of wounds after opening the blisters of the rash. To do this, the skin around them is lubricated with brilliant green or boric alcohol, and then the damage is lubricated with antibacterial ointment. This procedure is repeated once every 12 hours until complete healing.

In addition to following the doctor's recommendations, it is necessary to keep the body clean, while avoiding water on the affected skin. You should also protect the latter from re-combing with bandages or the use of antiallergic agents.

Complications

Incorrect or not started treatment on time can cause serious diseases:

transition to a generalized form (scarlet fever);
septicemia (getting streptococci into the blood);
rheumatism;
post-streptococcal glomerulonephritis (inflammation of the kidneys);
guttate psoriasis;
myocarditis.

These diseases are rare, but cause serious health problems. Therefore, the recommendations of the doctor should not be neglected.

Prevention

To reduce the likelihood of contracting streptoderma from a family member or in a public place, a number of simple rules must be observed:

The patient should not take a shower or bath for 4 days after the end of the incubation period. Drops of water left after this procedure on the walls of the bathroom or shower can infect the rest of the household.
The patient must be isolated from other family members. He must also use his own dishes, bedding, hygiene items.
Things used by patients need to be subjected to serious antiseptic treatment, since streptococcus can withstand up to 15 minutes of boiling and 30 minutes at 50 ° C.
Remove “dust collectors” from the patient’s room: soft toys, clothes, towels, etc.
Improving immunity through a varied diet, physical activity, hardening.
If scratches or wounds appear, disinfect them and seal them with a plaster with an antiseptic pad. Saniplast, for example.

Streptoderma is a highly contagious disease transmitted through contact with another person. Its main cause is a symbiotic bacterium of the genus Streptococcus. Therapy of the disease rests on three pillars: the regular intake of drugs, the treatment of sores and the observance of special hygiene rules by family members.

Definition

streptoderma is a skin lesion caused by streptococci. The disease is caused by various strains of streptococci (most often group D).

Causes

The cause of streptoderma is streptococcus. Streptococci penetrate the skin in the area of microtraumas of the epidermis and cause an inflammatory process of a predominantly superficial nature, however, in the presence of predisposing factors, deep streptoderma may develop.

Other causes of streptoderma may include:

decreased appetite;
hypo-, beriberi, dysproteinemia;
metabolic disorders;
acute and chronic diseases;
physical fatigue;
neuropsychic overwork, vegetative neurosis;
changes in the reactivity of the body;
hypothermia and overheating of the body;
local circulatory disorders and innervation of the skin;
skin pH changes;
microtrauma;
excessive contamination of the skin;
the presence of skin diseases.

Symptoms

Among the main symptoms, one can single out the formation on the face, buttocks, on the back of light pink spots of various sizes (1-3 cm), which are covered with scales. Usually there is a slight itching and dryness of the skin, sometimes an increase in body temperature, an increase in lymph nodes, an itchy rash appears. Conflicts are also formed - superficial vesicles, the serous contents of which quickly become cloudy, and the conflicts themselves quickly open, forming erosion, or becoming covered with a crust.

Also, streptococcal diaper rash, characteristic cracks, and diaper dermatitis sometimes appear in the area of \u200b\u200bthe folds. After 2-3 days, purulent-bloody crusts form. After rejection of the crusts, a rounded ulcer with steep edges, a juicy, bleeding bottom, covered with a dirty gray coating, is found. Healing occurs slowly - up to 3 weeks and ends with the formation of a pigmented scar.

However, like any other infectious disease, streptoderma can give complications to internal organs, especially often damage to the heart muscle (myocarditis) and kidneys (glomerulonephritis).

Classification

Streptoderma classification

superficial
	lichen white (lichen simplex)
	superficial panaritium (tourniol)

	syphilitic papular impetigo in children
	acute and chronic diffuse superficial streptoderma
deep streptoderma	ecthyma: vulgar, penetrating
deep streptoderma	Prevention In order not to provoke the recurrence of the disease, avoid contact with water or moisture on the affected areas. Streptoderma must be eliminated by drying to form a crust. As a remedy, you can use alcohol tinctures, salicylic alcohol. After localization of the infection, the wound will heal and the crust disappears. If the disease is actively progressing, it must be treated with disinfectants. They remove harmful microorganisms, germs, eliminate unpleasant odors and prevent the spread of new ones. With a serious development of the disease, you should consult a specialist. It is necessary to treat streptoderma with medications. Hormonal ointments and antibiotics are used to relieve particularly painful and difficult cases. After an illness, relapses often occur. To prevent relapse, it is necessary to eliminate predisposing factors: skin cracks; injuries, scratches; suppurative processes, etc.

Streptoderma is caused by a conditionally pathogenic bacterium - streptococcus, which is a normal symbiont of the human body. Streptococci can live on the mucous membrane of the nose, oral cavity and pharynx, in the vagina, and also in the large intestine, but their main habitat is the surface of the skin.

Normally, human skin has a mass of barrier mechanisms that prevent various bacteria from harming the body, but under certain conditions, streptococci can penetrate into the thickness of the skin, causing purulent inflammation in it, which is called streptoderma.

Streptococci are quite stable in the external environment. In dust and on household items, they can persist for months, losing their pathogenicity. The bacteria can withstand heating up to 56 degrees for 30 minutes and boiling up to 15.

The bacteria that cause pyoderma are also the causative agents of such common diseases as tonsillitis, pneumonia, erysipelas, scarlet fever, and purulent meningitis.

The source of infection with streptoderma can only be a person, both as a bacteriocarrier and suffering from tonsillitis, erysipelas, scarlet fever, and even the common cold or acute bronchitis. Infection from animals is impossible, since streptococcus is a symbiont exclusively of humans.

The route of transmission of streptococci is mainly airborne, but in the vast majority of cases they get on the skin by contact.

Reasons for development

Streptococci can penetrate the thickness of the skin and cause inflammation there due to the following factors:

skin injury;
metabolic disorders;
skin pH changes;
decreased immune defense.

Skin injury. The skin is a reliable armor against any microorganisms, however, even minor damage, such as scratches, scratches, bites, cuts, abrasions, etc., can become the entrance gate for the penetration of infections. Having penetrated into small wounds, bacteria bypass the protective barriers of the skin, which is the cause of streptoderma.

Metabolic disorders. Hormonal disruptions, as well as metabolic diseases, such as diabetes, adversely affect the quality of the skin. Changes can be of the following nature:

dryness, redness, peeling;
chronic itching;
violation of the healing processes;
disruption in the production of sebum.

These problems greatly simplify the penetration of bacteria into the thickness of the skin, and create the basis for a streptococcal infection.

Skin pH changes. Normally, the acidity of the skin is in the range of 4–5.7. Such conditions are unfavorable for the life of most pathogenic microbes, including streptococci, however, when the skin pH shifts above 6, the latter begin to actively multiply on it, which can lead to the development of streptoderma.

The reasons for the pH shift are as follows.

Endocrine diseases - diabetes mellitus, thyroid pathology, etc.
Abuse of cosmetic products that have an alkaline reaction. Most often, this is ordinary soap, which has a pH around 11.
Noninfectious dermatitis.

Decreased immune defense. A decrease in the immune status of the skin can occur for the following reasons:

chronic diseases of the digestive system: gastritis, duodenitis, etc.;
chronic stress;
malnutrition: abuse of sweet, fatty foods, deficiency of vitamins and trace elements;
circulatory disorders in the skin - diabetes mellitus, heart failure;
coagulopathy (diseases of the blood coagulation system), cirrhosis of the liver, kidney failure, etc.

By origin, streptoderma can be classified as follows.

Primary - occurs on apparently healthy skin against the background of injuries.
Secondary - is a complication of a non-communicable disease, for example, atopic eczema.

Symptoms

As with any other infectious diseases, the symptoms of streptoderma can be divided into general and local.
General signs - non-specific symptoms of the presence of an infectious process in the body:

increase in body temperature;
weakness, weakness, lack of appetite, headache;
enlarged lymph nodes in the affected area.

The severity of general symptoms is different and depends on the type of disease, the age of the patient, individual characteristics of immunity.

Local signs - symptoms of the disease directly on the skin: vesicles of various sizes filled with transparent, cloudy or purulent contents, redness and swelling of the affected areas, peeling and yellowish crusts.

Classification by skin manifestations

According to the external symptoms of skin lesions, streptoderma can be divided into the following forms:

simple;
bullous;
slit-like;
erythema-squamous;
tourniole;
streptococcal diaper rash;
streptococcal ecthyma.

Simple form or streptococcal impetigo

The main group of patients are children under 12 years of age.

The disease goes through a certain staging.

At the beginning, against the background of a slight reddening, a conflict appears - a tense bubble 1-3 mm in diameter, filled with liquid.
Then the liquid becomes cloudy. The blisters open spontaneously or as a result of scratching, quickly becoming covered with yellowish scabs.
After the eschar has passed, the skin remains dark pink for some time.
The total duration of the development of one vesicle is 5-7 days.

Usually open areas of the skin are affected - the face and limbs. The first conflict, as a rule, bothers the patient a little, so it goes unnoticed. However, the fluid from conflict contains a huge amount of streptococci, which, through scratching, clothes, bed linen, etc., begin to infect new areas of the skin if treatment is not started on time. General symptoms appear infrequently, usually with streptoderma in children or with large areas of skin lesions.

bullous impetigo

A more severe form of streptoderma. The blisters are larger and are called bullae. Their content is purulent. Much more often the general condition of the body is disturbed. After the bullae are opened, erosions (similar to an ulcer) can form in their place.

Slit-like impetigo or streptococcal congestion

Occurs in the corners of the mouth, less often in the area of the wings of the nose or the folds of the corners of the eyes. It manifests itself as single conflicts without a tendency to spread and usually passes quickly without consequences.

Erythematous squamous streptoderma or dry impetigo

With this form of the disease, bubbles do not appear. Red, itchy patches covered with white scales form on the skin. It spreads more slowly and lasts longer than the above forms.

Turniol or superficial panaritium

Usually accompanies simple impetigo. Occurs as a result of the contents of the conflict entering the skin around the nail bed due to scratching. The skin around the nail becomes reddened, swollen, sharply painful, conflicts appear later.

Streptococcal diaper rash

It occurs not only in children, but also in the elderly, as well as sedentary obese people with poor-quality care. The essence of the problem is the infection of ordinary diaper rash with streptococcus. Large folds of skin are affected. Conflicts leave behind cracks that do not heal for a long time. It is difficult and long to be treated, especially in adults.

Streptococcal (vulgar) ecthyma

A severe form of streptococcal pyoderma affecting the entire thickness of the skin and subcutaneous fatty tissue. It is a purulent long non-healing ulcer. It usually affects the legs, but can also occur on the trunk or arms. It usually accompanies diabetes mellitus, heart failure and other problems that reduce the body's immunoreactivity.

Diagnostics

The diagnosis of streptoderma is based on the following groups of diagnostic criteria:

Characteristic changes in the skin.
General infectious laboratory signs - an increase in leukocytes in the blood, an increase in ESR, the appearance of a small amount of protein in the urine.
Detection of streptococci in the secret of conflict or bull - light microscopy of the secret is used or the pathogen is determined by seeding.

Treatment

Therapy for streptoderma consists of general and local treatment.

General or systemic treatment of streptoderma is the appointment of antibiotics. In mild and moderate cases, antibacterial agents are administered orally. In severe cases, intramuscularly or intravenously.

The main groups of antibiotics are as follows:

Penicillins: augmentin, amoxiclav.
Cephalosporins: cephalexin, cefuroxime, cefazolin.
Macrolides: clarithromycin, azithromycin, erythromycin.

Local treatment of streptoderma is the treatment of affected skin areas with a 2% alcohol solution of brilliant green 2-3 times a day.

In mild cases, in the presence of single rashes and the absence of general infectious symptoms, only local treatment of streptoderma is possible. For this purpose, antibacterial ointments and creams based on erythromycin, tetracycline, bacitracin, mupirocin, neomycin, etc. are used.

With streptoderma, bandages are usually not used, however, with unbearable itching, it is possible to cover the foci on the affected skin with gauze bandages to prevent the spread of the disease. Also, with itching, it is possible to use antihistamines inside: loratadine, cetrizine, etc.

Streptoderma is a contagious disease. The patient is isolated at home or in an infectious disease hospital for the entire duration of treatment. Quarantine is imposed on preschool institutions.

Prevention

You can avoid infection with streptoderma by following a few simple rules.

Observe the rules of personal hygiene, wash your hands often with soap.
Children's toys also need to be washed periodically.
Any, even the most minor, wounds and abrasions should be treated properly.
At the first symptoms of streptoderma, contact a specialist immediately.

What is streptococcal infection

If the child's local immunity is developed, the skin is not broken, the immune system functions normally, the reproduction of streptococcus is suppressed by the body. A more severe and persistent course of streptoderma, relapses of the disease occur in children with the following predisposing factors:

When a child's immunological reactivity is impaired: premature babies, with hypotrophy in children, anemia, with helminthiasis (see worms in children, worms in humans), with general infections.
In children with chronic skin diseases: scabies (symptoms), pediculosis (lice in children), allergic manifestations, atopic dermatitis
And also with otitis, rhinitis, when discharge from the auricles and nose irritates the skin
When exposed to external factors - high and low temperatures - burns and frostbite
Poor personal hygiene, poor child care
Prolonged or constant contact of damaged skin with water, lack of treatment.

Causes of streptoderma

The causative agents of the disease, microorganisms of the streptococcus family, are typical representatives of the conditionally pathogenic microbial flora of the body - with sufficiently intense local immunity, the integrity of the skin and mucous membranes, the normal functioning of the body's immune system as a whole, the active development and spread of this microorganism is limited, and the disease does not develop.

Classification

Streptococcal pyoderma is classified downstream into 2 forms:

The latter is associated with the constant presence of skin injuries, varicose veins, diabetes mellitus and other reasons for the weakening of local immunity and the general condition of the body. The skin on the site of the former conflicts is dry and flaky.

As mentioned above, such a disease is considered a collective term - this means that it includes a whole group of pathological conditions. Thus, streptoderma in children exists in the following forms:

Streptococcal impetigo - is the most common type of pathology and is characterized by the fact that it affects only the top layer of the skin. In such situations, rashes are often localized in the nasal cavity and mouth, on the upper and lower extremities, on the face and other open areas of the skin;
bullous impetigo - is characterized by a severe course than the previous form, in particular, large vesicles or bullae filled with liquid are formed. This type of disease requires careful and long-term treatment;
slit-like impetigo - is expressed in the fact that it is localized in the places where cracks form, for example, in the corners of the oral cavity, on the wings of the nose and in the eye area;
superficial panaritium - is formed against the background of the lack of treatment of streptococcal impetigo;
streptococcal diaper rash - lesions of the skin are located in the areas of natural folds and in the behind-the-ear zone;
erythematosquamous streptoderma - characterized by slow spread and much less discomfort compared to other forms;
ecthyma vulgaris is the most severe type of disease, since the negative effect of streptococcus extends to the deep layers of the skin.

During the diagnosis, clinicians also rely on the nature of the rash, which is why there is:

dry streptoderma - the basis of the symptoms is the appearance of spots and peeling of the skin;
exudative streptoderma - is such if the formation of bubbles of various sizes filled with liquid occurs. When they are opened, weeping, swelling and redness of the surrounding skin are observed.

According to the method of flow, such a pathology is divided into:

acute - has pronounced symptoms, is quite easy to treat and leads to a quick recovery of the patient;
chronic - proceeds sluggishly, diagnosis is possible only in the phase of exacerbation of clinical signs and requires long-term treatment. Often leads to complications. Sometimes a child may suffer from an illness throughout his life.

Depending on the depth of the skin lesion, streptoderma occurs:

However, depending on the location of the rashes, there are several clinical forms of this disease:

Depending on the pathogen, the following clinical forms of the disease are distinguished:

streptococcal impetigo (streptoderma);
staphylococcal impetigo;
impetigo vulgaris - caused by a mixed flora, that is, streptococci and staphylococci at the same time.

Stages of the disease

There are 3 stages of the disease:

Bullous (blistering). The initial stage is characterized by a rash of vesicles with pus in the lesion. First, a red spot appears, and after a day a conflict (bubble) is formed. Over time, the number of bubbles increases. The size of the bubbles can be very different.
Non-bullous. The skin at this stage is deeply affected, the blisters do not heal well. Ulcers are formed - streptococcal ecthyma. They soon begin to dry out.
Chronic stage. It develops with neglected or improper treatment. It is characterized by episodic weeping rashes.

Symptoms and signs of streptoderma

The main manifestations of the disease are:

Most often, impetigo affects the face and hands. On slightly reddened skin, small, up to 1 mm bubbles appear - conflicts, collected in groups, inside the conflict there is a cloudy white or yellowish liquid.

After opening the bubbles, the leaked liquid dries up, forming yellowish crusts or scales on the skin. After the crusts fall off, redness of the skin persists for some time.

streptoderma

After recovery, hyperpigmentation may remain at the site of redness for several months.

Symptoms and forms of the disease

Common symptoms can appear with any common form of the disease and include:

an increase in body temperature up to 38 ° C and above
health disorder
intoxication
headache
muscle and joint pain
nausea, vomiting
inflammation of the lymph nodes in the area of \u200b\u200bthe foci of infection
changes in blood tests

The duration of the disease depends on the form and severity of the lesion and ranges from 3 to 14 days. Depending on the location and depth of the lesion in children, several of the most common forms of streptoderma are distinguished.

Streptococcal impetigo

The classic, most common and frequently encountered form. In this case, the child has single small rashes of a characteristic appearance on the skin of the face, hands, feet and other open areas of the body. Streptoderma in the nose usually also occurs in the form of classic impetigo.

The hidden period lasts about a week. After its completion, round or oval pink spots appear on the skin of an infected person, covered with small-plate scales, quickly degenerating into purulent-bubble elements.

The diameter of these spots can reach 5 cm, while the favorite places for their localization are the face, buttocks, limbs of the patient and his back.

Streptoderma code according to ICD 10: L01

Depending on the depth of the skin lesion, two forms of the disease are distinguished:

streptococcal impetigo (in this case, the blisters quickly open and heal, leaving no traces behind);
ordinary ecthyma (in this case, the growth layer of the skin is damaged and scars remain after the healing of the opened vesicles).

Subjective sensations with streptoderma are usually absent: in some cases, patients complain of dryness of the affected skin and slight itching. With extensive lesions of streptococcal infection, the patient may rise to subfebrile temperature and increase regional lymph nodes.

Initially, streptoderma is strictly localized, but in the absence of adequate and timely treatment, with frequent contact with water, as well as neglecting the rules of personal hygiene, it quickly becomes widespread.

In this case, the disease manifests itself in the form of large lesions with uneven edges and exfoliating epidermis along their periphery. After intentional or careless opening of purulent blisters, yellowish-brown crusts form on the surface of the patient's body.

When these crusts are removed, an erosive bright pink surface is exposed.

Diagnostics

Either a pediatrician or a pediatric dermatologist knows how to treat such a disease. The doctor can make the correct diagnosis already during the initial examination, however, other manipulations may be required to establish the form of the disease.

First of all, the clinician should:

to study the patient's medical history - to identify the underlying disease in secondary streptoderma;
collect and analyze a life history - to establish the route of infection;
carefully examine the affected areas of the skin;
to interview in detail the parents of a small patient - to determine the severity of the symptoms and the severity of the course of the disease.

Laboratory studies are limited to the implementation of:

bacterial culture, separated from the blisters;
microscopic examination of scrapings from damaged skin;
general clinical analysis and blood biochemistry;
tuberculin tests;
coprograms.

In cases where a doctor suspects a severe course of streptoderma with damage to internal organs, general instrumental procedures will be required, including ultrasound, radiography, CT and MRI.

It is necessary to differentiate such a disease from:

The diagnosis is made by an experienced pediatric dermatologist or pediatrician by the characteristic appearance of the elements, usually immediately. In doubtful and severe cases, microflora cultures are made from the elements, usually immediately with the determination of sensitivity to antibiotics, in order to start effective therapy as early as possible.

In severe cases, a complete blood count must be taken, in which an increase in ESR, the number of leukocytes and a change in their formula towards neutrophilia can be detected. Sometimes the doctor may prescribe additional studies to identify or exclude concomitant diseases:

The diagnosis of "impetigo" consists of the following criteria:

In the process of making a diagnosis, the disease is differentiated with diseases such as pityriasis versicolor, urticaria, atopic dermatitis, pyoderma and eczema. The main criteria for diagnosing the disease are:

stay in the lesion;
the presence of a characteristic clinical picture.

In addition, in the process of diagnosing, microscopic examination and bacteriological seeding of scraping spots are performed. At the same time, streptococci are found in the material taken during scraping from an infected person.

Treatment

A dermatologist should treat any streptoderma. Doing something on your own is unacceptable, especially with complex forms, such as SSTS or an acute diffuse form.

The table describes the methods of therapy used for streptococcal suppuration of the skin.

Type of treatmentMethods and preparations

Local drug treatment	with a small area of rashes, locally treat blisters and crusts, as well as the skin around them with alcohol solutions of aniline dyes (magenta, brilliant green) or a saturated solution of potassium permanganate; wipe the skin around the rashes with boric or salicylic alcohol; for opened crusts, use aqueous solutions of aniline dyes; when wet, make lotions and dressings with anti-inflammatory and disinfectants; after drying and with ecthyma - ointments with an antibiotic or disinfectant component; after removal of inflammatory foci with diaper rash - wiping with salicylic or boric alcohol and powder.
Systemic drugs	vitamin therapy; immunostimulating drugs; with large areas of damage - systemic antibiotics (cephalosporin, macrolide); antihistamines to relieve itching; intravenous administration of immunoglobulins in toxic shock syndrome.
Diet	exclude fatty, sweet, highly salted foods, as well as various seasonings from the diet; protein should predominate in the diet.
Skin care	the affected areas cannot be washed, only treated with disinfectant solutions or decoctions; wash clean skin with antibacterial soap.
Folk methods	can be used as an adjuvant therapy with the approval of the attending physician; powders from crushed oak bark and horsetail - for healing ulcers; compresses from St. John's wort; lotions from decoctions of oak bark; lotions of black pepper and garlic juice, taken in equal proportions; lotion from a decoction of chamomile.

Streptoderma in children photo how it starts

Sometimes the treatment of streptoderma is supplemented with homeopathy. It is also necessary to eliminate the indirect causes of the disease, for example, to achieve remission of atopic dermatitis, the treatment of which is described not only by dermatology and immunology, but also by psychosomatics.

It is possible to treat streptoderma with the additional use of physiotherapy in the form of phototherapy. In difficult cases, surgery is required.

Preventive measures must be taken to prevent re-infection and the spread of infection.

Pathology can be cured using the following conservative methods:

oral medication;
the use of local medicines - ointments and antiseptics;
physiotherapy procedures;
dieting;
use of traditional medicine recipes.

Treatment of streptoderma in children with medications includes taking:

antibacterial substances;
antihistamines;
multivitamins;
immunomodulators.

For local use, the following antiseptics are indicated:

hydrogen peroxide;
fucorcin;
salicylic alcohol;
boric acid;
greenery.

A list of what streptoderma is treated in children with ointments:

"Mupirocin";
"Tetracycline ointment";
"Altargo";
"Levomekol";
"Baneocin";
"Levomitil";
"Ichthyol ointment";
"Gentamicin ointment";
"Lincomycin ointment".

The most effective physiotherapy procedures are:

UFOK;
UV and UHF;
laser therapy.

Treatment at home can be carried out only after the approval of the attending physician and is aimed at use as lotions:

Any form of streptoderma, even local, requires mandatory treatment, as it tends to spread, is contagious, and, in addition, streptococcus can provoke such serious autoimmune diseases as rheumatism, glomerulonephritis or endocarditis.

hygiene rules

In some cases, this is enough, in some, they are very surprised when it turns out that a child cannot recover from a seemingly small sore for several weeks, new rashes appear, and other family members become infected.

Mandatory hygiene moments in the treatment of streptoderma in children:

do not wash, at least 3-4 days, do not moisten the affected areas with water, as it is an excellent carrier of infection in this case;
gently wipe the unaffected areas of the skin with a damp towel or a cotton swab soaked in water or a decoction of a string / chamomile;
make sure that the child does not comb the affected areas; in addition to purely mechanical restrictions, antihistamines, which are prescribed by a doctor, also help to reduce itching of the skin;
the child should have an individual towel hanging separately from the towels of other family members;
individual dishes and cutlery, which must be carefully processed after a sick child has used them;
it is better to remove soft toys for the period of illness, and wash plastic ones regularly;
constantly change or iron the child's bedding with a hot iron, especially pillowcases;
in the presence of minor skin lesions - regularly treat them with an antiseptic.

Local treatment

What to do if your child has this disease? Regardless of the localization of foci of rashes on the skin and their number, if streptoderma is detected, it is necessary to prescribe the treatment of this disease.

Impetigo is a highly contagious bacterial infection and should be treated with antibiotics, especially in children.

The drugs of choice in this case are "protected" penicillins (augmentin, amoxiclav), as well as 1-2 generation cephalosporins (cephalexin, cefotaxime). In mild cases, drugs are prescribed orally, in severe cases - intramuscularly or intravenously.

Streptoderma during pregnancy

Topical treatment may complement antibiotic therapy. Conflicts are treated 2-3 times a day with an alcohol solution of brilliant green or methylene blue.

If the lesion is small and general infectious phenomena are not observed, antibiotics can not be taken orally and limited to the treatment of diseased skin with antibacterial ointments, creams or lotions, most often based on mupirocin or eryromycin.

Also, only topical treatment can be used in adults, especially if the impetigo is secondary.

During the entire period of treatment, the child should not attend kindergarten. It is necessary to follow the rules of personal hygiene, especially the cleanliness of the hands, so that the patient, combing the affected skin, does not spread bacteria to healthy areas.

In cases where the foci of streptoderma on the patient's skin are single and the general condition of the patient does not suffer, only local treatment of the disease is carried out.

In all other cases, in addition to local remedies, patients are prescribed restorative drugs, broad-spectrum antibiotic ointments, vitamin therapy, therapeutic ultraviolet irradiation on the affected skin, hemotherapy, and UV blood irradiation.

During the treatment period, patients are instructed to completely exclude any contact with water, and carefully wipe healthy areas of the skin with a cotton swab soaked in a decoction of chamomile flowers or other antiseptic medications.

Children with streptoderma are not allowed in children's groups. In addition, people who had close contact with them are also being isolated for 10 days.

Pustules and blisters in the lesions are carefully opened with a sterile needle at the base and treated twice a day with brilliant green, methylene blue or other aniline dyes.

After treatment, dry aseptic dressings with disinfectant solutions and ointments are applied to the lesions. The crusts formed during streptoderma are carefully lubricated with salicylic vaseline: this allows you to painlessly remove them after 20–25 hours.

The development of the disease is often accompanied by the appearance of non-healing seizures on the patient's face, which must be regularly and thoroughly wiped with 2% silver nitrate. With prolonged and sluggish streptoderma, patients are recommended to be treated with antibiotic therapy.

Complications and why the disease is dangerous

With improper and untimely treatment, microbial eczema will follow. A complication can be diagnosed by drops of serous fluid, which is released against a reddened background of microerosions.

In the vast majority of cases, impetigo resolves without sequelae. However, there are situations when this disease can cause irreparable harm to the body.

Streptococcal impetigo, like any other streptococcal infection (erysipelas, scarlet fever, tonsillitis, etc.) can cause a malfunction in the immune system due to which the kidneys (nephritis) or heart (myocarditis, rheumatism) can suffer.

Definition

Streptoderma is a skin lesion caused by streptococci. The disease is caused by various strains of streptococci (most often group D).

Causes

Other causes of streptoderma may include:

decreased appetite;
hypo-, beriberi, dysproteinemia;
metabolic disorders;
acute and chronic diseases;
physical fatigue;
neuropsychic overwork, vegetative neurosis;
changes in the reactivity of the body;
hypothermia and overheating of the body;
local circulatory disorders and innervation of the skin;
skin pH changes;
microtrauma;
excessive contamination of the skin;
the presence of skin diseases.

Symptoms

Among the main symptoms, one can single out the formation on the face, buttocks, on the back of light pink spots of various sizes (1-3 cm), which are covered with scales. Usually there is a slight itching and dryness of the skin, sometimes there may be an increase in body temperature, an increase in lymph nodes, an itchy rash appears. Conflicts are also formed - superficial vesicles, the serous contents of which quickly become cloudy, and the conflicts themselves quickly open, forming erosion, or becoming covered with a crust.

However, like any other infectious disease, streptoderma can give complications to internal organs, especially often damage to the heart muscle (myocarditis) and kidneys (glomerulonephritis).

Classification

Diagnostics

Diagnosis is made on the basis of anamnesis and clinical picture.

Bacteriological research methods (collection of material from the infectious focus with subsequent inoculation in order to isolate etiologically significant microorganisms and determine their sensitivity to antibacterial drugs).

It is necessary to do tests for the presence of fungi in the study of scrapings and conduct additional diagnostics to exclude eczema.

Sources

https://liqmed.ru/disease/streptodermiya/
http://badacne.ru/streptodermiya/streptodermiya-mkb-10.html
http://med36.com/ill/951