Streptococcal impetigo: causes and treatment

Streptococcal impetigo is found everywhere in people with tender and sensitive skin. This infection is usually a consequence of poor hygiene, so it often happens in children, especially in the warm season.

Definition

Streptococcal impetigo (ICD 10 L01) is a highly contagious skin disease caused by a bacterium of the streptococcus group. It manifests itself as flictenes (small-bubble rash) with swelling and redness. Located in groups, the vesicles merge and increase, and after the rash has passed, there are still some pinkish spots on the skin.

Skin manifestations are updated every five to six days. Infection quickly spreads to healthy areas, and the process begins again. Incorrect treatment and prevention can cause a large area of the skin to be affected. The most frequent localization: the face, hands, shoulders and other open areas of the skin.

In dermatology, the following varieties of streptococcal impetigo are distinguished: bullous, ring-shaped, slit, and tournamentol (nail roller disease), streptococcal intertrigo and post-erosive syphilis.

Reasons for impetigo

The main pathogens of infection are streptococcus and staphylococcus aureus. The transmission path is contact, through dirty hands, toys, clothes and other household items. The penetration of bacteria through the mucous membranes is only possible if they are damaged, for example, cracks or combs.

Streptococcal impetigo in children occurs against atopic dermatitis, eczema, allergic contact dermatitis, since immunity has already been compromised. Maceration of the skin, hyperhidrosis (sweating), rhinitis or otitis with an abundant discharge are also favorable conditions for the onset of the disease. Parents of small children called streptococcal impetigo "fire", because in the children's team it spreads with surprising speed.

Symptoms of the disease

It all starts with the appearance on the skin of small reddish spots. A few hours later, bubbles appear in their place, but the hyperemia does not go anywhere - these are fiction. At this stage, the bubbles are strained, the liquid that is in them is transparent. But over time, their dome settles, and the contents become turbid and turns into pus. From this moment, two variants of the development of events are possible: pus dries, and yellow or brown crusts remain on the skin, or bubbles open spontaneously, liquid pus flows, leaving the wound. After all heals or the crusts peel off, lilac spots remain on the skin for a while.

Staphylococcal impetigo lasts without treatment (one cycle is fliken) seven days. The rash, as a rule, is located on the open parts of the trunk: the face, hands, stomach and back. Flicks are conglomerates and tend to merge. As the baby itches, he himself carries the infection through his body. In the presence of adequate treatment, the disease passes in a month and does not leave behind cosmetic consequences.

Diagnostics

A dermatologist can determine the streptococcal impetigo by clinical signs. The photo of the skin (dermatoscopy) and the study of its acidity only confirm the diagnosis. To accurately know the etiology of the disease, the contents of the vesicles are sown to nutrient media, and when the colony of bacteria grows - its microscopy is carried out.

In case the disease often recurs, it makes sense to be examined by an immunologist in order not to miss any serious violations. Skin bacterial diseases - this is the first bell, indicating the scale of the problem.

The doctor in the process of collecting information about the disease should differentiate it with folliculitis, ostiophalliculitis, vulgar impetigo, epidemic pemphigus, herpes simplex, Durance dermatitis. Clinically, they all resemble streptococcal impetigo. A photo of damaged skin with a large increase helps distinguish diseases from each other.

Ring-shaped impetigo

This disease begins with the appearance of small flat bubbles, which are filled with a turbid liquid. They quickly grow in breadth, extending to healthy areas, but they dry up in the center with the formation of a brown crust. Therefore, by the end of the disease, the flicks have the appearance of rings. In some cases, the pattern of the eruption resembles a garland.

In all other respects, the disease resembles a streptococcal impetigo. Specialists differentiate this form with herpes zoster, exudative erythema and Dühring dermatitis.

Bullous impetigo

The causative agent is streptococcus, but in some cases, patients are sown and staphylococcus. Bacteria enter the body through macerated skin. Most often this happens in the summer. The literature describes the whole epidemic of this disease in soldiers.

The symptoms that distinguish bullous and streptococcal impetigo, it is primarily the type of rash. Large bubbles (up to two centimeters) are hemispherical and filled with a turbid liquid with an admixture of blood. The favorite localization of these flies is the brush and shin. Around the affected areas there is swelling and inflammation of the lymphatic vessels. Local symptoms are accompanied by a general reaction of the body: fever, headache, increase in leukocytes and ESR (erythrocyte sedimentation rate) in a general blood test.

Against the background of other skin diseases bullous impetigo is even more difficult.

Streptogenic jaeda

This streptococcal impetigo, which develops in the corners of the mouth with the formation of small flat bubbles, filled first with serous fluid, and then with pus. Due to constant traumatization (during eating, talking), the crypts are opened and cracks appear in their place. If the disease is neglected, then these cracks are quite deep and painful. In childhood, seizures often recur. This is due to the low level of hygiene and the lack of B vitamins, as well as the presence of diseases such as diabetes mellitus.

Differentiate seizures with hard chancre, early congenital syphilis, Plummer-Vinson syndrome. The first two diseases are characterized by positive serological reactions to syphilis and the presence of other symptoms, and Plummer-Vinson syndrome is accompanied by hypochromic anemia, dysphagia, glossitis and stomatitis, which are not present in streptococcal galloping.

Surface frenzy (tournamentol)

This disease is a type of bullous impetigo and occurs in the peri-oral grooves. Its occurrence provokes trauma, burrs and scratches, which are infected with streptococcus and nagnaivayutsya. Vesicles are arranged in the form of a horseshoe, surrounding the nail plates on the arms and legs. This can be either an isolated lesion of one finger or a common one, covering the whole brush.

Bubbles increase in breadth and are filled with serous or purulent contents. If the bubble cover is damaged, there is erosion, which eventually becomes crusted. If the disease proceeds favorably, then all the sores heal, but in rare cases the infection penetrates deeper under the nail, until its rejection. After that, the bacteria spread through the lymphatic and blood vessels.

Superficial panaritium should be distinguished from chancra-panaritium, candidiasis of nail ridges and dermatitis Allopo. Shankr is a manifestation of primary syphilis, so it has characteristic symptoms: a dense red-cyanotic eminence with a ulcer in the center. In addition, the patient has other signs of syphilis. Candidiasis of the nail ridges is a manifestation of a systemic decrease in immunity. The swelling of the finger tissues is absent in this case, the nails are dirty-brown, and the mushrooms are found out of the erosion.

Posterosive syphiloid

Or else the illness of Sister-Jacquet. It is most common in infants with excessive body weight. Due to the presence of a large number of folds, parents do not always manage to take care of them qualitatively, so maceration and irritation develop on the skin.

The main symptom of the disease is the appearance on the buttocks of the rash, which after the opening leaves erosion, surrounded by a corolla of the left skin cells. In advanced cases, flickens can be located on the back and inner surface of the thighs, merge, forming bizarre arched shapes.

After a while, the places of erosion are infiltrated, and papules appear in their place. After resolving the rash, that is, healing ulcers, often there are pigmented spots. Because of this abundance of morphological elements, it is not always possible to diagnose the disease in time.

Differential diagnosis is carried out with papular syphilis and microbial eczema. In the first case, there is a positive Wasserman reaction, and in the second case there is no redness under the polymorphic elements of the rash. In addition, papules and vesicles with microbial eczema do not merge with each other.

Treatment

There are general principles for the therapy of streptoderma, which will help to eliminate streptococcal impetigo. Treatment is carried out with antibacterial drugs and topical disinfectants. If the elements of the rash are single, they can be treated with aniline dyes: green or fucorcin. Also effective use of ointments with antibiotics (Oxycorte, Dermazolon, Neomycin and others). When spreading flicten to large areas of the skin, streptococcal impetigo can be treated with resorcinic lotions.

Tablet antibiotic therapy is suitable in especially severe cases and with frequent relapses of the disease. In addition, additionally prescribed fortifying drugs. There is absolutely no difference in streptococcal impetigo in children. The treatment remains the same, but before applying the ointment it is necessary to wait for the spontaneous opening of the vesicles, and also to ensure that the child does not comb the skin.

Recommendations and prevention

As a preventive measure, a culture of hygiene must be inoculated. Children and adults are advised not to wet the affected areas during the entire treatment process. It is necessary to observe all the following activities:

- avoid contact with other children;
- use separate bath accessories and regularly change bed and underwear;
- to allocate the patient the complete set of ware.

If you comply with these rules, then neither within the family, nor within the children's collective disease will not spread. In order not to allow infection, do not neglect personal hygiene, always carefully handle abrasions and scratches and try not to comb the skin during rashes. Recurrent streptococcal impetigo is a complication that develops due to a decrease in the body's resistance. Do not forget about it and watch your health.