Streptoderma is a type of pyoderma, purulent lesion of the skin, which is caused by streptococci and is characterized by rashes in the form of bubbles and bubbles ranging in size from a few millimeters to several tens of centimeters.
Most often, children with streptoderma are ill, which is associated with high contagiousness (contagion) of the disease and close communication between children (schools, kindergartens). In adults, mass outbreaks of the disease are observed in closed collectives (military unit, prison). The infection is transmitted by contact through tactile contact with the patient, through bed linen and personal belongings.
From the point of view of the course of the disease, acute and chronic streptoderma is distinguished.
According to the depth of the skin lesion, there is a surface (impetigo streptococcal), ulcerative or deep, and also dry streptoderma ( ectima vulgaris).
A separate item is the intertriginous form: the rash appears in skin folds or rollers.
The etiological factor of streptoderma is beta-hemolytic streptococcus group A, which affects the damaged surface of the skin.
Predisposing conditions for the appearance of the disease are:
- violation of the integrity of the skin (abrasions, cracks, jammed in the corners of the mouth, insect bites);
- personal hygiene (combing bites or abrasions with dirty hands);
- weakened immunity;
- stressful situations;
- endocrine diseases (diabetes);
- chronic skin diseases (psoriasis, dermatitis, pediculosis);
- lack of vitamins;
frequent or rare water procedures (with frequent – a protective film is washed off from the skin, and with rare ones – dead cells of the epidermis and opportunistic microorganisms are not removed);
- circulatory disorders (varicose veins);
- burns and frostbite.
- Symptoms of streptoderma in children and adults
- Often, an adult infection occurs from a sick child. However, in children, the disease is more severe.
- Streptoderma in children is often accompanied by:
- temperature rise to 38-39 ° C;
- general intoxication of the body;
- increase in regional lymph nodes.
- The incubation period of the disease is 7-10 days.
After a given period of time, red round spots appear on the skin (especially in places where it is thin and tender, often on the face).
After 2-3 days, the spots are converted into bubbles (conflict), the contents of which have a cloudy color.
Flitstena very quickly increase in diameter (up to 1.5-2 cm), after which they burst with the formation of a dry honey-colored crust. In this case, the patient feels unbearable itching in the affected areas, combing crusts, which contributes to the further spread of the process.
After the discharge of the crusts, the skin heals, there are no cosmetic defects (scars) – this is the surface form of streptoderma (impetigo).
Dry form of streptoderma
The dry form of streptoderma ( ecthyma ) is more common in boys. It is characterized by the formation of white or pink oval spots up to 5 cm in size. The spots are covered with scabs and are initially located on the face (nose, mouth, cheeks, chin) and ears, spreading rapidly throughout the skin (usually along the hands and feet).
The dry form refers to deep streptoderma , as the germ layer of the skin ulcerates, and after healing, scars remain. The affected areas after recovery remain non-pigmented and do not tan under the action of sunlight. After a while this phenomenon disappears.
Streptococcal zade ( angular stomatitis, slit impetigo)
The corners of the mouth are often affected, as a rule, this is due to the lack of vitamins of group B. Because of the dryness of the skin, microcracks form where the streptococci penetrate.
First, there is redness, then – purulent rollers, which later become covered with honey-colored crusts. The patient complains of soreness when opening the mouth, intense itching and drooling.
Perhaps the appearance of slit-like impetigo in the wings of the nose (constant nasal congestion and pain when blowing your nose) and in the outer corners of the eyes.
Superficial felon ( streptoderma skin rollers)
It develops in people who have the habit of biting their nails. The tournament characterizes the appearance of conflicts around the nail ridges. Subsequently, they are opened, and a horseshoe-shaped erosion is formed.
Streptococcal diaper rash ( papulo- erosive streptoderma )
Often this form of the disease occurs in infants. Skin folds are affected: small bubbles appear in them, merging with each other. After opening them in the skin folds formed moist surfaces pink.
If streptoderma treatment is inadequate or the patient’s immunity is reduced, the disease becomes chronic, which is more difficult to treat.
Conduct a differential diagnosis of streptoderma . This disease is important to distinguish from allergic reactions (urticaria), pityriasis versicolor, staphylococcal pyoderma, eczema and atopic dermatitis.
The diagnosis of ” streptoderma ” is established on the basis of anamnestic data (contact with a sick person, an outbreak of the disease in the team) and a visual examination (characteristic bubbles and yellowish-honey crusts after opening them).
From laboratory methods use:
smear microscopy of the affected skin area;
bacteriological analysis (sowing crusts on nutrient media).
Microscopy and bacperic need to be carried out before the start of antibiotic treatment and if there is no self-treatment
The dermatologist deals with the treatment of streptoderma .
First of all, especially for children, a hypoallergenic diet with a restriction of sweet, spicy and fat is prescribed.
For the period of treatment prohibited water procedures (bath, shower) to prevent the spread of the disease. Healthy skin is recommended to wipe with chamomile decoction.
It is important to eliminate the wearing of synthetic and wool clothing, as this causes sweating and contributes to the increase and spread of lesions. Patients are strongly advised to give preference to natural tissues.
After opening the bubbles with a sterile needle and emptying them, the infected skin areas are treated with aniline dyes (methylene blue or brilliant green) twice a day.
In order to stop the growth of foci, the healthy skin around them is smeared with boric or salicylic alcohol. To make wet surfaces dry, they are coated with silver nitrate (lapis) or resorcinol. Treatment of flare and facial streptoderma on the face is also carried out with silver nitrate (lapis).
On crusts bandages with antibacterial ointments:
- physical dermis
After 7, a maximum of 14 days after appropriate local treatment, the symptoms of streptoderma disappear.
In difficult cases, antibiotics are prescribed systemically ( amoxiclav, tetracycline, levomycetin ) for a period of 5-7 days.
Desensitizing drugs are prescribed to relieve itching (claritin, telfast , suprastin). At the same time, immunostimulating therapy ( immunal , pyrogenal , autohemotherapy), prescription of vitamins A, C, P, group B are performed.
At high temperatures, antipyretics (paracetamol) are indicated.
During treatment of streptoderma, the use of herbal medicine is allowed (dressings with infusions of onion, garlic, burdock, milfoil).
Symptoms of streptoderma with adequate treatment disappear after a week, but in some cases (with a weakened immunity or the presence of chronic diseases) complications are possible:
- transition to the chronic form;
- guttate psoriasis;
- microbial eczema;
- scarlet fever;
- septicemia – blood poisoning, in which a huge amount of streptococci circulates;
- boils and phlegmon.
The prognosis for this disease is favorable, but after suffering a deep form of streptoderma cosmetic defects remain.