Erythematous erysipelas. Erysipelas: symptoms, treatment. Complementary Therapies

Erysipelas disease is an acute infectious disease caused by the bacteria Streptococcus pyogenes. It is characterized by symptoms of general intoxication and manifestations of the inflammatory process on the skin. If you have this disease once, there is a chance of a relapse.

Localization and prevalence

The disease affects people of all ages and social groups. Most often, erysipelas is observed in men aged 25-40, engaged in physical labor (loaders, builders, workers), since their skin is daily exposed to adverse mechanical effects. In the category of older people, women are more likely to get sick. The disease is equally common in all climatic zones.

Erysipelas disease causes

Erysipelas can occur both with direct contact of streptococcus with the damaged area, and as a result of the transfer of the pathogen along the lymphatic tract from the focus of chronic infection. Not every person who has had contact with streptococcus develops erysipelas. For the appearance of a detailed clinical picture, several predisposing factors are necessary:

1. The presence of an active infectious focus (chronic tonsillitis, caries).
2. Reduced tolerance to streptococcal flora (considered a genetic factor).
3. Decreased overall body resistance.
4. The presence of severe comorbidity.
5. Postoperative complications.
6. Long-term treatment with glucocorticosteroids.

Erysipelas is transmitted both from a sick person and from a bacteriocarrier, who may not have symptoms of the disease at all.

Erysipelas symptoms and forms

Usually the disease begins acutely, so that patients can accurately indicate the day and hour of its occurrence. At the first stage, the leading symptoms of the disease are manifestations of the syndrome of general intoxication:

• rapid increase in body temperature to febrile (38-39C);
• chills;
• pain in muscles and joints;
• nausea, sometimes vomiting.

After some time, local redness appears on the skin, accompanied by a feeling of pain and burning. Depending on the shape of the erysipelas, the affected area may appear:

1. Only redness and swelling erythematous form.
2. Spotted red rash hemorrhagic form.
3. Bubbles filled with clear liquid bullous form.

The same patient may have mixed forms - erythematous-bullous, bullous-hemorrhagic or erythematous-hemorrhagic. Regional lymph nodes enlarge and become painful to the touch. With a moderate course, the resolution of the disease occurs in a week. Bullous blisters leave behind crusts that can go off for a long time, turning into trophic ulcers and erosion. With a successful outcome of the pathological process, the site of the lesion is cleared of crusts, begins to peel off and eventually heals without a trace.

Erysipelas disease on the face appears with a primary lesion, and on the trunk and limbs it usually recurs.

Diagnosis of erysipelas

The diagnosis is made on the basis of the patient's complaints, the history of the disease and the results of laboratory tests. In the blood of patients, a typical manifestation of the inflammatory process caused by a bacterial infection is observed: an increase in leukocytes, neutrophilia, an increase in ESR. It is important to correctly differentiate erysipelas from other diseases: phlegmon, anthrax, toxicoderma, scleroderma, systemic lupus erythematosus.

Erysipelas treatment

Therapy consists in the use of antibacterial agents both internally and externally. The drugs of choice for the development of streptococcal infection are:

• penicillin;
• erythromycin;
• clindamycin.

The doctor chooses one of these antibiotics based on the individual characteristics of the patient. The course of treatment is at least a week. Effective is the appointment of antibiotics in combination with nitrofuran derivatives. Locally (for example, when an erysipelas disease appears on a leg or arm), various ointments and powders with an antimicrobial effect are applied to the affected skin. Therapy is supplemented with the use of antipyretic drugs, vitamins, painkillers and antihistamines. During the period of illness, the patient must comply with strict bed rest and diet. Plentiful drinking is shown.

Treatment of erysipelas with folk remedies

It is possible to treat erysipelas with folk remedies:

1. Crumble ordinary white chalk, sift out large particles through a sieve and sprinkle the affected skin area with the resulting powder.
2. Lubricate reddened skin with pork fat or propolis.
3. Apply chopped bark of bird cherry or lilac to the affected areas.
4. Mix 1 tablespoon of chamomile flowers with 1 tablespoon of coltsfoot leaves and 1 tablespoon of honey. Lubricate the skin in the affected areas with the resulting mixture.
5. 1 tablespoon of yarrow leaves pour a glass of water. Cook over low heat for 10 minutes. Strain, cool, apply to the affected areas.

Erysipelas prognosis and complications

With timely diagnosis and the appointment of adequate therapy, the prognosis is favorable. The disease may recur. The appearance of erysipelas on the arms or legs most often indicates a re-infection.

Prevention of erysipelas

Specific prophylaxis has not been developed. Follow the rules of personal hygiene, immediately treat any wounds, abrasions, cuts and other skin lesions, preventing contamination.

erysipelas photo

Bullous-hemorrhagic form of erysipelas

In recent years, doctors have noted an increase in erysipelas, which manifests itself on the skin in the form of red areas with raised edges or separated from the dermis layer. More often, the disease is diagnosed in women after 50 years of age or in infants when the infection enters the umbilical region.

Erysipelas on the arm is dangerous with complications, if not treated, then can lead to sepsis, blood poisoning and death. This is a rather rare occurrence in civilized countries, but today there is a tendency towards a constant increase in the number of cases. When the first symptoms appear, you should not hesitate to contact the doctors.

What kind of disease is erysipelas on the arm?

erysipelas- this is a manifestation of an infectious focus on the skin caused by streptococcal infection, in the form of reddening of the area, accompanied by fever and signs of intoxication. Streptococcus is a bacterium that can quickly penetrate through the pores of the skin through cuts, abrasions, insect bites.

At the same time, erysipelas is contagious. Streptococcal infections can spread quickly from one person to another. In order to avoid infection upon contact with the patient, it is necessary to use gloves, use antibacterial soap to wash hands, and immediately treat cuts with antiseptics to prevent streptococcus from entering under the skin after contact with sick people.

Causes of the disease

Streptococcus lives in the body of almost every person, and many people are its carriers. But the development of erysipelas, another streptococcal disease does not occur if there are no provocative factors.

The occurrence of pathology is possible as a result of:

• damage to the dermis of a purulent, viral infection;
• circulatory disorders against the background of post-traumatic scars after the operation;
• decrease in immunity;
• taking a number of drugs - cytostatics, steroids;
• the presence of pathology in metabolic processes;
• diseases of the immune system;
• AIDS;
• having bad habits.

Transmitted erysipelas by airborne droplets or by direct contact with patients. It quickly begins to develop against the background of diabetes mellitus, sudden changes in temperature, malnutrition, viral infectious diseases, chronic ailments in the body.

Provoking factors

Inflammation in the hand can be triggered by:

• surgery to remove the mammary glands in women;
• excessive insolation;
• overheating or hypothermia;
• infection of abrasions, scratches, bruises, cuts with sharp objects.

In addition, the risk group includes people with pathologies such as:

• diabetes;
• alcoholism;
• obesity;
• varicose veins;
• lymphostasis;
• tonsillitis;
• caries;
• periodontitis;
• fungal infection of the feet;
• thrombophlebitis.

The cream is a uniquely effective remedy for combating all types of fungal infections both on the skin and on the nails.

It not only eliminates pathogenic dermatophytes, pathogens of epidermycosis and trichomycosis, but also restores the protective functions of the skin. Effectively eliminates itching, peeling and irritation from the first application.

Typical symptoms of erysipelas on the arm

Microorganisms, penetrating into the pores of the skin on the hand, first for some time remain in the stage of the incubation period until 2-3 days. Infection may not occur if the site is immediately treated with an antiseptic in case of an unexpected cut or with a fairly stable immune system.

Otherwise, the primary and characteristic signs of the development of erysipelas are as follows:

• a sharp increase in body temperature;
• nausea;
• dizziness;
• increased fatigue;
• body aches;
• chills;
• loss of appetite;
• redness appears on the arm in the form of a pink-red spot with tongues of flame or a roller with uneven edges;
• further - peeling, burning sensation, bursting at the site of the lesion;
• in some cases, hemorrhages or vesicles with serous or bloody fluid appear within the lesion.

Sometimes the first symptoms are similar to ordinary dermatitis. That is why when the first dangerous signs appear, you should not postpone going to the doctor. If similar symptoms suddenly appear, you should not hesitate to call an ambulance or go to the nearest clinic. By the way, the disease is observed in older people during gardening, so you need to be vigilant.

initial stage

The appearance of a pink spot when streptococcus penetrates under the skin occurs within a few hours. The place begins to burn, burn, blush, resembling flames. The skin becomes edematous, hot to the touch. The infection spreads quickly.

The inflammation begins with:

• soreness, aches in the joints and muscles;
• fever, fever;
• deterioration in general well-being;
• the appearance of nausea and vomiting;
• headache, dizziness;
• palpitations.

At first, erysipelas has an acute course and the symptoms are not specific. Through 1-2 days there is a strong intoxication of the body, some even have hallucinations and delusions. Toxic damage to the kidneys, heart can occur. The patient is nauseated, shivering, sleepy. At the initial stage, erysipelas is similar to the flu.

Features of erysipelas on the arm

Feature of erysipelas on the hand in the fact that when it gets under the skin, the microorganism quickly penetrates into the deep layers of the dermis, leads to a sharp increase in temperature, chills up to loss of consciousness. This unpleasant disease, which can greatly impair the quality of life, interferes with normal household chores.

If the disease is not treated, then the outcome of such a disease is extremely unfavorable. A slight lesion on the skin can lead to disruption of tissue trophism, gangrene.

In children, the disease is usually mild, but in older people it is more difficult to tolerate. A feverish state can last about 2 months, all chronic diseases in the body often become aggravated. Erysipelas tend to recur and are poorly treated. Those who are ill with suspected illness should not delay contacting a dermatologist, immunologist or infectious disease specialist.

Features of erysipelas on the leg

It has the following properties:

• Freely penetrates under the nail and interungual spaces
• Has an antibacterial effect. Relieves itching and inflammation in 1 application
• Removes cracks and itching between the fingers thanks to propolis
• Kills spores with alkaloids
• Golden mustache restores healthy nails

Complications

With proper treatment, erysipelas on the arm, after 2-3 weeks, can go away on its own. Redness and swelling will subside and will soon disappear altogether. But pigmentation may remain. Relapses are possible.

New erysipelas can subsequently lead to:

• stagnation of the lymph;
• insufficiency of lymphatic circulation;
• thromboembolism of the pulmonary artery;
• sepsis;
• necrosis of the skin;
• thrombophlebitis.

All this indicates untimely treatment and progression of the disease.

Complications, as a rule, are caused by untimely access to doctors, self-medication, and the addition of a secondary infection. The risk group includes people with diabetes mellitus, HIV-infected people who have had meningitis, pneumonia.

Erysipelas with complications can lead to the formation of trophic ulcers on the arm, lymphostasis, abscess, suppuration and thickening of the skin, which will greatly complicate the treatment, and even may endanger the life of the patient.

Treatment

When visiting the clinic, the doctor will first of all examine the integument of the skin, identify the nature, location, degree of damage and the shape of the erysipelas. Most likely, the patient with clearly expressed clinical signs will be referred for hospitalization in the infectious diseases department.

For the treatment of erysipelas appoint:

• antiallergic drugs(Suprastin, Diazolin, Tavegil);
• sulfonamides(Biseptol, Streptocid);
• nitrofurans(Furadonin, Furazolidone) to kill bacteria;
• corticosteroids(Prednisolone) to eliminate the infection;
• biostimulants(Pentoxyl, Methyluracil) to stimulate the formation of new healthy immune cells and skin regeneration;
• vitamins(ascorbic acid, Ascorutin) to strengthen vascular walls damaged by bacteria, increase proteolytic enzymes (trypsin, lidase, taktivin).

Left untreated, it can lead to serious complications and death. Self-medication with erysipelas is excluded. Only a qualified specialist will be able to direct the treatment in the right direction.

In addition, treatment is carried out in a hospital with the appointment of:

• benzylpenicillin, as the main antibiotic for streptococcal infection;
• cephalosporins to suppress pathogenic flora in the event of an abscess, phlegmon. The course of treatment is up to 10 days.

Treatment also includes the following:

• Conducted detoxification therapy in severe cases of the disease by intravenous injection of hemodez or saline with glucose.
• It is possible to prescribe cardiovascular, antipyretic, diuretic drugs, also treating the lesion site by applying applications from a solution of dimexide, enteroseptol powders to kill bacteria at the lesion sites, preventing the attachment of another infection.
• Patients are advised to independently wash the wounds with furacilin., other solutions with antimicrobial action to kill bacteria. An oxycyclosol aerosol will help, bandaging with synthomycin ointment, Vishnevsky liniment, to relieve inflammation and heal wounds.

Can't warm up the place- will only accelerate the movement of streptococci through the blood and the spread of bacteria throughout the body. The main treatment is antibiotics, and in no case should you resort to home formulations and prescriptions without the knowledge of a doctor.

Be sure to sick need to strengthen the immune system, take vitamins, multivitamins, antiallergic drugs. Electrophoresis, laser therapy, ultraviolet irradiation, high-frequency magnetotherapy, physiotherapy are shown on hand for the complete suppression of pathogenic microflora.

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Prevention

There is no specific specificity and prevention for erysipelas.

Development can be prevented if:

• do not neglect the rules of personal hygiene, wearing loose clothing and shoes made from natural fabrics;
• use soap when showering with lactic acid to create a protective layer on the skin;
• treat immediately any damage, abrasions on the skin with antiseptics;
• avoid exposure to ultraviolet radiation, chapping, frostbite of the extremities.

Erysipelas is a common ailment, and it is treated fairly quickly with timely medication. A neglected disease will eventually lead to a chronic relapsing course, scarring on the arm, swelling, and lymph stagnation.

Symptoms will recur from time to time, up to the appearance of stiffness in the joints, constant pain, limited mobility and disability. You can not ignore the appearance of a red, itchy and flaky spot on the arm. Perhaps a streptococcal infection occurred. The sooner the better to seek advice from a dermatologist.

The relevance of the problem of the occurrence of erysipelas remains to this day.

This is facilitated by:

• stable incidence rate, which is quite high. This is the most common streptococcal infection;
• the disease is prone to chronic and recurrent course;
• the clinical course of erysipelas is often variable and is aimed at aggravating the pathological process. Often there is hemorrhagic erysipelas.

Epidemiological characteristics of erysipelas

It is caused by group A beta-hemolytic streptococcus (GABHS). The source of the infectious disease is both sick children and streptococcus bacteria carriers.

The transmission mechanism is most often contact. The microbe enters the human body through damage to the skin. In addition to the contact path, there is also an airborne one. At the same time, at the very beginning of the disease, the nasopharynx is affected, and after the streptococcus is introduced onto the skin by means of the hands, or it spreads further by the lymphogenous and hematogenous route. It should be noted that not everyone can get erysipelas. There is some acquired or congenital predisposition to this infectious disease. The contagiousness of patients with erysipelas is negligible.

Basically, erysipelas occurs in the summer-autumn period, however, cases of the onset of the disease in winter are not uncommon.

Who is sick?

Most often, women suffer from erysipelas - almost 2 times more than men. The disease develops mainly at the age of 40 years. The primary form of erysipelas and recurrent are recorded at the age of 35-45 years, as well as during menopause. Men are affected by this disease at the age of 50 years.

Register erysipelas symptoms to a greater extent among cleaners, cooks, sometimes among drivers, among persons engaged in physical labor. All these representatives of professions often have microtraumatization of the skin. It is also worth noting the high incidence of erysipelas in housewives and pensioners.

With the development of primary and recurrent erysipelas, patients have concomitant chronic diseases. For example, erysipelas in the chest area can develop after mastectomy, that is, removal of the mammary gland, after mastectomy lymphedema.

Provoking factors

These factors are usually:

• Stress;
• Acute respiratory diseases;
• hypothermia;
• Psychic trauma.

Erysipelas classification

Currently, the following classification is used:

1. By the nature of local manifestations: erythematous, bullous, erythematous-bullous, erythematous-hemorrhagic;
2. According to the severity of the course: light, medium, heavy;
3. According to the frequency of occurrence: primary, repeated, recurrent. Repeated usually occurs two years later on another area of ​​the skin. If the infection recurs more than 3 times a year, we can talk about often recurrent erysipelas;
4. According to the prevalence of local symptoms: common localized, metastatic;
5. Complications of the disease: general and local.
6. Consequences of erysipelas: secondary elephantiasis, persistent lymphostasis (lymphedema, lymphatic edema).

The incubation (hidden) period ranges from hours to 5 days.

Clinical manifestations of erysipelas

The primary form of the disease begins with an acute increase in body temperature up to 39-40 C. Along with it appear:

• muscle pain;
• chills and headache;
• general weakness;
• sometimes nausea and vomiting occur.

A day after the onset of the disease, local symptoms manifest themselves:

• pain and burning of the affected area of ​​the skin;
• tension in the area of ​​penetration of the microorganism;
• hyperemia and edema. Hyperemia is often of a uniform nature and rises above the skin. Against the background of hyperemia, blisters with transparent or hemorrhagic contents can form, thus determining the form of the infection - erythematous-bullous or bullous-hemorrhagic.

In most cases, the process is localized on the legs. In a third of cases on the face and hands. On the torso erysipelas symptoms occur extremely rarely.

Erythematous bullous form of erysipelas

Its beginning is no different from erythematous. Only a few days later, blisters with serous contents appear in the area of ​​erythema. After the blisters open, brown crusts form, under which tender young skin is formed. When blisters are damaged and infected with other microorganisms, trophic ulcers occur, which heal for a very long time.

Erythematous-hemorrhagic form of erysipelas

Its symptoms are identical to the forms described above, however, hemorrhagic areas are formed in the area of ​​hyperemia.

Bullous-hemorrhagic form of erysipelas

The manifestations are similar, but differ from other forms in that the blisters are filled with hemorrhagic contents, and not serous.

In addition to all of the above, of the symptoms, it is worth noting an increase in regional lymph nodes and inflammatory changes in the lymphatic vessels in the form of lymphangitis.

If the treatment of erysipelas is started in a timely manner, many complications and consequences can be avoided. With uncomplicated erysipelas, elevated body temperature lasts about 5 days, and in some it lasts more than a week. The latter situation occurs with improper treatment, with a common pathological process.

In the general blood test in the acute period, there is neutrophilia with a stab shift of the formula to the left, there is an acceleration of ESR. Albuminuria may be observed in the urine. With erysipelas, severe kidney damage is almost never encountered.

In the recovery period, the temperature returns to normal, intoxication stops, as can be seen from the general blood and urine tests. Local symptoms disappear much later.

If the lymph nodes remain enlarged for a long time. The disease is classified as prognostically unfavorable. It is also worth mentioning the long-term presence of lymphostasis, as an unfavorable sign for recovery. After the bullous form of erysipelas, hyperpigmented areas of the skin may remain until the end of life, on which the blisters were localized.

During the recovery period, normalization of laboratory tests occurs.

Do they relapse erysipelas symptoms?

It may take from several days to 2 years before the first recurrence of the infection. If erysipelas occurs two years after the initial occurrence, they speak of repeated erysipelas, and it is localized in a new area, as mentioned earlier. If relapses of erysipelas occur quite often, fever and symptoms characterizing intoxication may be mild.

It also happens that relapses of erysipelas occur on the same areas of the skin. This indicates the allergization of the skin and its sensitization restructuring. The formation of immune complexes occurs in the skin.

Complications of erysipelas

Complications of erysipelas are similar to complications of other infections. Caused by streptococcus, however, there may be complications characteristic only for this pathology:

• abscesses and phlegmon;
• ulcers and necrosis of the affected areas of the skin;
• violation of the movement of lymph, which leads to the formation of elephantiasis.

Diagnosis and differential diagnosis of erysipelas

If erysipelas is suspected, it is carried out:

• general analysis of blood and urine;
• determination of the level of glucose in the blood, prothrombin index;
• determination of antibodies to streptolysin-O;

The diagnosis is made according to the following criteria:

• Acute onset of the disease and pronounced clinical signs of intoxication;
• The local inflammatory process is localized in most cases on the lower extremities;
• Local manifestations have a typical appearance for erysipelas;
• Manifestations of regional lymphadenitis;
• There is no pronounced pain syndrome at the site of the inflammatory process.

This disease is differentiated from phlegmon, abscess, felon, thrombophlebitis, festering hematoma, eczema, dermatitis, herpes zoster, erythema nodosum, eryzepiloid.

How to treat erysipelas?

All therapeutic measures are carried out, starting from the form of the disease, its course, the nature of the manifestations and the patient's condition. Basically, antibiotic therapy is prescribed, the drugs of choice of which are drugs of the penicillin series, cephalosporins.

Among the drugs of pathogenetic therapy, the following can be distinguished:

1. Anti-inflammatory. They are prescribed if there is a pronounced swelling and tension of the focus of inflammation;
2. Vitamins of groups B, A, C, rutin for 1 month;
3. If the form of the disease is severe, detoxification measures are carried out by administering infusion solutions intravenously with glucocorticosteroid hormones;
4. In the hemorrhagic form with and without bulls, treatment with heparin and trental is carried out in the presence of hypercoagulation. If there is no hypercoagulability, contrycal and gordox are used;

Local therapy

Local treatment of the erythematous form is not carried out. In the presence of blisters that have not yet been opened, they are incised, exudate is released and then an aseptic dressing with furacillin is applied. Bandages are changed several times a day. Bandaging with erysipelas is prohibited.

- This is a fairly common disease, which is one of the most pressing problems of modern medicine. At the moment, in Russia, this pathology in the form of sporadic cases occurs everywhere, characterized by an increase in the proportion of severe erysipelas, accompanied by the development of hemorrhagic and infectious-toxic syndromes.

Clinical classification

In clinical practice, this pathology is classified according to the following features:

Multiplicity of flow;
The nature of local manifestations;
Severity;
The prevalence of the pathological process.

Disease classification according to the multiplicity of the flow. In the event that the disease occurs for the first time, it is diagnosed primary erysipelas. As a rule, most often with this form of pathology, the skin of the face is affected. Erysipelatous inflammation that developed two years after the first case of the disease (or earlier, but with a different localization) is repeated. If the inflammatory process periodically occurs in the same place, we are talking about recurrent erysipelas. The disease can occur in mild, moderate and severe forms.

Forms of erysipelas:

1. Erythematous.
2. Erythematous bullous.
3. Erythematous-hemorrhagic.
4. Bullous-hemorrhagic.

The prevalence of the inflammatory process:

Localized form(the focus of inflammation does not go beyond one area, that is, it appears only on the leg, or on the face, arm or trunk).
Common form(simultaneously uniting several areas).
Creeping (migratory) form.
Metastatic form(damage to areas remote from each other).
Erysipeloid (pigs face). This form of erysipelas is considered an occupational disease caused by swine erysipelas. As a rule, it occurs in rural areas, and also develops in workers in the meat and fish industry after bone injections and injuries with tin cans or various tools. Most often, inflammation is localized on the finger or on the hand.

Note: under natural conditions, swine face affects piglets 3-12 months old. In animals, the disease can occur in several forms: fulminant (white erysipelas), septic (acute form), cutaneous (subacute) and chronic. In order to prevent the imminent death of animals, they require a special aluminum hydroxide vaccine, which helps to form active immunity and causes unacceptability to infection.

Clinical signs of erysipelas

With the development erythematous form erysipelas after 5-10 hours from the onset of infection in a limited area of ​​​​the body, there is a burning sensation and fullness, as well as itching and pain, aggravated by touch. Then the affected area swells, thickens, turns red and takes the form of a spot with uneven borders, which looks like flames. The edges of the spot rise, forming an infiltration ridge. In patients with this form of erysipelas, a feverish state and symptoms of intoxication of varying severity are observed during the week, as well as an increase, thickening and soreness of regional lymph nodes. It should be noted that in this form, erysipelas is not contagious.

Erythematous bullous form characterized by the development of redness and the formation of various sized vesicles filled with colorless contents. After some time, they spontaneously open, after which the necrosis and exfoliation of the upper layer of the skin occurs. In this place, crusts are formed that do not leave scars behind. In this case, there is also a feverish state and an increase in lymph nodes.

Erythematous-hemorrhagic form erysipelas is the most common in clinical practice. It is accompanied by hemorrhages of various sizes (from 1-2 mm to several cm) that occur against the background of redness, a prolonged (up to two weeks) fever, and necrotic changes on the skin.

It is considered the heaviest bullous-hemorrhagic form. In this case, the inflammation proceeds with damage to the small blood vessels of the skin, and is accompanied by the formation of blisters filled with serous-hemorrhagic contents. After opening them, necrotic areas and scars remain on the body.

Most often, the disease affects the skin of the lower extremities, less often - the face and hands. Sometimes erysipelas can occur on the skin of the trunk. Infectious lesions of the upper extremities are more common in women after breast surgery (as a result of postoperative lymphostasis). In the event that the erysipelas is localized on the face, the inflammatory process can spread to the retina, provoking the development of neuritis. In men, erysipelas develops less frequently (as a rule, it appears in representatives of certain professions at the age of 20-30 years and is associated with harmful production factors).

It should be noted that in a child, erysipelas proceeds very easily. At the same time, older people and patients diagnosed with immunodeficiency usually have more complex disorders.

Complications

Causes of erysipelas and predisposition factors

The source of infection can be a sick person, or a bacteriocarrier of various forms of streptococcal infection. The main route of transmission of infection is airborne, but at the same time, sometimes erysipelas is transmitted by contact, penetrating through various lesions of the skin and mucous membranes. Due to the fact that very often hemolytic streptococcus is able to “settle” on the skin and mucous membranes of absolutely healthy people, failure to follow basic rules of personal hygiene can cause erysipelas.

According to experts, erysipelas is a skin infection, which is characterized by hereditary predisposition. Most often, this disease develops in people who have reached the age of 50, suffering from certain pathological conditions associated with the aging process, and in HIV-infected patients. In children, erysipelas is very rare.

Predisposing factors:

Concomitant pathologies (diabetes mellitus, foot fungus, osteomyelitis, eczema, trophic ulcers, thrombophlebitis, obesity, chronic lymphovenous insufficiency, etc.)
Occupational hazards (skin pollution, increased trauma)
The presence of foci of chronic streptococcal infection
Weakened immunity after an infectious disease (especially in old age)
Impaired integrity of the skin and mucous membranes
Insolation
Overheating or hypothermia
The development of inflammation at the site of injuries or bruises.

Diagnostics

Treatment

The main method of treatment is antibiotic therapy (it is prescribed after an allergic test for antibiotics).

Interesting data
As paradoxical as it sounds, erysipelas can lead to the complete disappearance of malignant tumors and chronic inflammatory processes, and it also prevents the development of skin diseases and lymphadenopathy and has a beneficial effect on severe psychoses observed in mentally ill people.

With erysipelas complicated by the development of a fungus, patients are advised to take antifungal agents.

Antiseptic solutions are used as preparations for local treatment (ointments for erysipelas are prescribed very rarely, as they slow down reparative processes and increase exudation).

Physiotherapeutic treatment (UV irradiation, paraffin, ozocerite, UHF, etc.) are prescribed to eliminate residual effects.

As for non-traditional methods of treatment, they can only be used with the permission of a doctor as an aid. Unfortunately, it is impossible to cure erysipelas with herbal infusions and ointments of traditional healers, without the use of antibacterial drugs. Therefore, traditional medicine does not recommend using folk remedies as the main treatment.

Prevention of erysipelas

Patients suffering from a recurrent form of erysipelas require regular prophylaxis with medications (anti-relapse treatment), and they are also strongly advised to reconsider the hygienic aspects of work and life. Such measures will not only remove the cause of infection, but also help to completely get rid of the disease.

Some factors will contribute to the development of erysipelas, in particular, a violation of the integrity of the skin, which can occur when injured or scratched.

Speaking of this, they mean eczema, neurodermatitis, psoriasis and even contact dermatitis.

No less significant factors are type 1 and 2 diabetes, varicose veins, thrombophlebitis. Also, experts pay attention to:

1. Accession of obesity even at the initial stage.
2. Skin injuries of a professional nature and the influence of not the most favorable factors of production, such as dust or chemical constituents.
3. Aggravation of the immune status after illnesses, hypothermia, hypo- and beriberi.
4. Severe chronic diseases.
5. The presence of foci of chronic infections (trophic lesions, tonsillitis, caries, and sinusitis, which could not be cured for a long period of time).

We should not forget about old age and pregnancy. The causative agent on the skin with direct infection are streptococci.

Approximately 15% of people are carriers of spherical bacteria, while managing not to get sick with streptococcus. The rest of the majority becomes infected through scratches on the legs, insect bites, various diaper rash and burns, bruises, cracked heels.

The latter confirms the seasonality of the disease, because everyone wants to walk without shoes on green grass, and mosquito bites do not look so harmless.

Perhaps someone has awakened an old inflammation of the tonsils or increased decay of the tissue of the teeth - caries. Once in a favorable environment, streptococci enter the bloodstream and spread through the body in a stream, looking for a place to nest.

Having found a loophole in the body, they come out in the form of various dermatological diseases.

The process of cell maturation will last up to three days, and the only reliable obstacle to the disease can be a healthy immune system. In case of its weakening, for any reason, dermatitis on the leg is provided to a person.

Protective functions weaken:

• due to frequent hypothermia;
• sufficiently strong exposure to ultraviolet radiation;
• frequent change of high or low temperature;
• nervous tension.

The main and only cause of this disease is erysipelas. Men from eighteen to thirty-five years old, as well as adult women, are most susceptible to it.

In men, an increased risk of infection is primarily associated with their professional activities, if it involves frequent microtraumas, temperature contrasts and prolonged skin contamination.

The main culprit of erysipelas on the leg is a streptococcal infection. Most often, its causative agent - streptococcus - enters the body through such "gates" as:

• scratches;
• combing;
• insect bites;
• burns;
• diaper rash;
• injuries and bruises;
• cracked heels, etc.

Varieties

A disease such as erysipelas can have a different location of the inflammatory process. Thus, erysipelas of the leg is most often diagnosed - often the result of a fungal infection or injury.

The formation of this disease is facilitated by disorders that cause impaired blood circulation in the lower extremities. These diseases include - varicose veins, atherosclerosis and thrombophlebitis.

These pathologies often lead to erysipelas of the lower leg.

An erysipelatous pathological process on the legs is characterized by forms of local changes in the manifestation of the disease, such as:

1. Erythematous proceeds with redness of the infected area and the formation of dilated capillary vessels in the form of a tumor. Differs in clear boundaries, bright color, irregular shape of the area.
2. Erythematous bullous at first is no different from the one described above, but after 2-3 days the upper layer of the epidermis exfoliates and bubbles with a clear liquid appear. After their rupture, the affected area is covered with brown keratinization, covering the young formed skin. In case of untimely treatment, the damaged area threatens to develop into a trophic ulcer.
3. Erythematous-hemorrhagic causes many hemorrhages from dilated capillary vessels.
4. Bullous-hemorrhagic in the form of leakage is similar to erythematous-bullous with the same vesicles formed. Only in this case they are filled with a cloudy blood-containing fluid.

Also, erysipelas is classified according to other criteria, for example, according to the severity of the course, it happens: mild, moderate and severe. According to the frequency of manifestation - primary, recurrent, repeated.

Erysipelas on the leg initial stage: Photo

On the infected area of ​​the limb, a burning sensation, unrelenting pain, tightness, and tension of the skin cover appear first. After a short time, a small pink or red spot with clear boundaries appears on the lower leg.

The area of ​​the erysipelas on the leg of the initial stage gradually increases, looks like swelling and is hot to the touch. Due to the expansion of capillary vessels, numerous bruises, vesicles with cloudy whitish lymph may appear.

After a certain period of time, they pass, leaving behind a pronounced red inflamed spot.

Forms of erysipelas of the legs are classified according to the nature of local changes.

Erysipelas disease has several clinical forms. It is classified:

There are several classifications of erysipelas on the legs:

1. The first stage is classified according to the severity of the disease. There are light, medium and heavy.
2. The second stage of classification is due to the scale of the affected areas. There is a localized, limited and extensive form.
3. The third stage is determined depending on the nature of the manifestation. There is a primary, recurrent and repeated form of the disease.

What does the initial stage of erysipelas of the leg look like?

With standard erysipelas, the skin will acquire a bright red hue and well-defined borders with intact tissues. The edges of the lesion will be uneven, resembling flames.

It should also be borne in mind that the site of inflammation will rise above the level of healthy skin and surrounding tissues.

Erysipelas on hand

A change in the color of the skin on the arm to red will occur approximately 24 hours after the onset of the disease. Talking about the symptoms of erysipelas in this case, it must be borne in mind that:

The first symptom of erysipelas is a general malaise in the patient, which is accompanied by:

• headache;
• chills;
• weakness in the whole body;
• pain in the muscles;
• a sharp increase in body temperature up to 40 degrees;
• sometimes vomiting and diarrhea;

The next symptom of the disease is a rash on the skin in the form of redness and swelling. Often the appearance of spots is accompanied by a burning sensation of the affected areas of the skin with characteristic pain.

Erysipelatous inflammation manifests itself in the form of erythema of a bright red color with jagged edges that resemble flames. From healthy skin, erythema is separated by a skin roller with clear limited edges.

Further symptoms depend on the form of the disease.

The first signs that you have an erysipelas on your leg

The initial stage of this disease is characterized by the presence of high fever, chills, pain in the muscles and head. Erysipelas on the skin does not appear immediately, but only after a few hours, and sometimes
and days. Additional symptoms in some cases are vomiting, general malaise and convulsions. The inflammation itself is also accompanied by itching and swelling. According to the nature of the local changes caused on the skin or mucous membranes, erysipelas is divided into four types:

• erythematous form is characterized by the presence of a uniform area of ​​redness with clear
  borders and edges of irregular shape;
• with an erythematous-bullous form, approximately on the third day of the disease on the spot
  redness, the top layer of the skin exfoliates and bubbles form with a transparent
  content inside. In place of the bursting bubbles, brown crusts form,
  which die off, and young healthy skin remains. There are cases when
  trophic ulcers can form in the place of the bubbles;
• the distinctive features of the erythematous-hemorrhagic form include hemorrhage in the affected areas of the skin;
• in the bullous-hemorrhagic form, the development of the disease is similar to the erythrematous-bulous,
  except that the inside of the bladder is not transparent, but bloody.

After the infection enters the body, it can take from five to seventy-two hours. After the end of the incubation period, the first symptoms of the disease are general malaise, weakness in the body, as well as a feeling of depression and weakness.

Subsequently, a sharp and severe headache, severe chills and a very high temperature add to the listed symptoms. In some cases, it reaches forty or more degrees Celsius.

Against the background of all this, intense pain develops in the lower back, knee and elbow joints, as well as muscle spasms.
.

Symptoms

The symptoms of erysipelas, although quite characteristic, can sometimes confuse the doctor, which is fraught with an erroneous diagnosis. Nevertheless, knowledge of them allows you to accurately determine what the patient is suffering from.

As the presented disease is also called - swine erysipelas - it can also be associated with some other symptoms. In particular, in the area of ​​​​the skin affected by erysipelas, itching and burning of the skin is formed from the very beginning. As the disease develops, within 24 hours, the development of all signs of inflammation, typical of the first stage, begins. We are talking about redness, heat and pain.

At the same time, the lesion will rapidly spread and even increase in size, it may well swell.

Depending on the individual characteristics of the body and symptoms, a variety of methods for treating erysipelas (antibiotics, ointments), including folk remedies used at home, can be used.

The initial stage of dermatitis is characterized by poisoning of the body with harmful substances that it itself produces.

This is usually accompanied by:

• elevated temperature;
• chills;
• headache;
• general malaise;
• muscle pain, weakness.

Not infrequently, diarrhea, vomiting, nausea and a complete lack of appetite are added to the symptoms. A few hours later, a pink or red spot appears on the affected area, accompanied by pain, burning, and swelling. The further course of the disease depends on the type of inflammatory process.

Erysipelas has a fairly long incubation period - about 10 days. After this time, the symptoms begin to manifest themselves. As a rule, at the first stage, a person feels signs of general malaise:

• headache;
• pain in the muscles;
• chills;
• weakness and impotence;
• increased body temperature (sometimes up to 39-40 degrees);
• in some cases - nausea, vomiting, diarrhea and sometimes even anorexia.

Not later than a day later, local signs are added to these general symptoms: burning, pain, tension are felt on the infected area, it begins to redden and swell.

Further signs of erysipelas depend on the specific form of the disease.

Erysipelas begins acutely, with general non-specific signs of intoxication appearing 12-24 hours before local skin changes.

The body temperature rises sharply to febrile figures, which is accompanied by chills, headache, weakness, palpitations. In some patients, against the background of severe intoxication, oneiroid or hallucinatory-delusional syndrome develops.

Sometimes, already in the prodromal period, signs of toxic damage to the liver, kidneys, and heart are noted. There may be excessive drowsiness, nausea with vomiting that does not bring relief.

So the initial stage of erysipelas is nonspecific, the patient may take its manifestations for flu symptoms.

Local changes are the main symptom of the disease. In the classical course, they are local in nature and are clearly demarcated from neighboring areas of the skin.

Erythematous erysipelas is characterized by the appearance of a sharp bright hyperemia (erythema) with clearly defined edges and even with a small roller on the periphery. The lesion has irregular jagged borders.

Sometimes it resembles the outlines of the continents on a geographical map. The inflamed skin looks dense, swollen, as if stretched and slightly shiny.

It is dry and hot to the touch. The patient is worried about burning pain, a feeling of tension and sharp hyperesthesia in the area of ​​erysipelas.

Bright redness can be replaced by a bluish-stagnant shade, which is associated with increasing local microcirculation disorders. Often there are also diapedetic and small hemorrhagic hemorrhages, which is explained by sweating and rupture of blood vessels.

On the 2nd-3rd day of the disease, signs of lymphostasis often join with the development of lymphedema (dense lymphatic edema). At the same time, blisters and pustules may appear within the focus, in which case bullous erysipelas is diagnosed.

After opening them, a dense brown crust forms on the surface of the skin.

Resolution of erysipelas occurs gradually. With adequate treatment, the temperature returns to normal within 3-5 days. Acute manifestations of the erythematous form disappear by 8-9 days, and with hemorrhagic syndrome they can persist for 12-16 days.

Puffiness and hyperemia of the skin decreases, its surface begins to itch and peel off. In some patients, after the disappearance of the main symptoms, uneven hyperpigmentation and dark congestive hyperemia are noted, which disappear on their own.

But after a severe bullous-hemorrhagic erysipelas, it can persist for years and even decades.

The incubation period of such a disease lasts from several hours to three days. After this period, the patient shows symptoms, including general weakness, weakness and malaise.

After that, quite suddenly, the temperature rises and chills and headache appear. The first few hours of manifestation of erysipelas are characterized by a very high temperature, which can reach forty degrees.

There is also muscle pain in the legs and lower back. In addition, the joints hurt.

In the leg in which the erysipelas appears, the patient feels pain and burning, a feeling of fullness. After a while, a pink or red spot of a small size appears in this place.

This spot has clear boundaries and is expanding. At the site of the lesion, the skin is hot to the touch, tense and slightly elevated above non-inflamed skin.

Some time later, blisters and bruising sometimes appear on the affected areas. Nearby lymph nodes may also become inflamed.

Some types of erysipelas may be accompanied by blisters with a clear liquid. These blisters go away after a while, but in their place there are red crusts, which will also go away after a few weeks. As a complication, erosions and ulcers can form at the site of the erysipelas.

How the disease manifests itself at the initial stage and beyond: photo

The initial symptomatic manifestations of erysipelas are:

• headache and general weakness;
• temperature increase up to 40 degrees;
• aches in the joints, lower back, muscles;
• burning sensation;
• gagging;
• swelling in the area of ​​damage;
• tachycardia.

There may be pain in the scalp, often in inflamed areas.

Diagnosis of erysipelas

What is erysipelas, how to properly diagnose and treat it, the therapist knows. For an experienced specialist, it will not be difficult to identify diseases by the expression of characteristic external symptoms.

First, the doctor conducts a complete examination of the patient and the affected area of ​​\u200b\u200bthe skin. Additionally, blood tests may be needed to determine its coagulability.

Urine tests are needed to detect protein and red blood cells, the presence of which is characteristic of this disease.

Laboratory studies of the contents of the vesicles are necessary to identify the pathogen and its sensitivity to antibiotics. In addition, consultations of such specialists as an infectious disease specialist and a dermatologist may be needed.

After receiving all the test results, the attending physician prescribes the most effective tactics for the treatment of erysipelas.

The diagnosis of erysipelas is made on the basis of the patient's complaints, information about the development of the disease, anamnesis of life and data from an objective research method.

Differential diagnosis of erysipelas is carried out with a number of diseases that occur with damage to the skin. The bacteriological method of research is used in case of difficulty in making a diagnosis.

Rice. 2. In the photo, erysipelas of the skin. Redness and swelling, burning sensation and bursting pain, a rapid increase in the lesion are the first local symptoms of the disease. The erysipelatous plaque is delimited from the surrounding tissues by a roller, has jagged edges and resembles flames. The disease proceeds against the background of fever and toxicosis.

Rice. 3. Phlegmonous-necrotic form of the disease (photo on the left) and gangrene of the lower limb (photo on the right) are formidable complications of the bullous-hemorrhagic form of erysipelas.

Differential diagnosis of erysipelas is mainly carried out with dermatitis and erythema of various origins - eryzepeloid, cutaneous anthrax, abscess, phlegmon, panaritium, phlebitis and thrombophlebitis, endarteritis obliterans, acute eczema, toxicoderma, systemic lupus erythematosus, scleroderma, Lam's disease (borreliosis) , shingles.

The main diagnostic signs of erysipelas:

• Acute onset of the disease, fever and intoxication, which often precede the appearance of a local lesion.
• Enlargement of regional lymph nodes.
• Decreased pain intensity at rest.
• The characteristic localization of the inflammatory focus is most often the lower limbs, somewhat less often the face and upper limbs, very rarely the trunk, mucous membranes, mammary gland, scrotum and perineum.

Rice. 4. In the photo there is an erysipelas on the face and arm.

Rice. 5. In the photo on the left, lesions with plague, on the right - with nodular erythema.

The optimal method for diagnosing erysipelas is to detect the causative agent of the disease and determine its sensitivity to antibiotics, which undoubtedly significantly improves the effectiveness of treatment.

However, despite the fact that a huge number of streptococci accumulate in the affected area, it is possible to identify pathogens only in 25% of cases. This is due to the effect of antibacterial drugs on bacteria, which quickly stop the growth of pathogens of erysipelas, so the use of the bacteriological method is considered inappropriate.

• The bacteriological method of research is used in case of difficulty in making a diagnosis. The material for the study is the contents of ulcers and wounds. An imprint technique is used when a glass slide is applied to the affected area. The smear is then examined under a microscope.
• The properties of bacteria and their sensitivity to antibiotics are studied during growth on nutrient media.
• Specific methods for laboratory diagnosis of erysipelas have not been developed.
• In the blood of patients with erysipelas, as with all infectious diseases, there is an increased number of leukocytes, neutrophilic granulocytes and an increase in ESR.

Rice. 6. In the photo on the left, streptococci under a microscope. Bacteria are arranged in chains and in pairs. On the right - colonies of streptococci during growth on nutrient media.

Treatment

The most important element in the treatment of erysipelas is rational antibiotic therapy. Prescribed drugs that specifically act on hemolytic streptococcus. These include Erythromycin, Azithromycin, Doxycycline, Biseptol, cephalosporin drugs. In the treatment of uncomplicated or mild forms of erysipelas, patients are prescribed tablet forms of drugs.

In case of complications or severe course of the disease, the patient is hospitalized. In this case, they switch to injectable forms of antibacterial agents - "Lincomycin", "Benzylpenicillin", cephalosporin antibiotics.

To reduce pain and the intensity of inflammation, a drug such as Indomethacin is used.
.

Topical treatment is used only if blisters are present. When they are opened, bandages with antiseptics that do not have an irritating effect are applied to these places. Usually it is "Furacilin", "Rivanol", "Vinilin".

Prevention of erysipelas

Due to the fact that the main link in the mechanism of development of erysipelas is an individual predisposition, it is impossible to develop a vaccine against erysipelas. Prevention of the disease consists in the timely treatment of all chronic infectious diseases - tonsillitis, pharyngitis, bronchitis, dental caries.

It is also important to fight fungal diseases of the feet, venous insufficiency of the lower extremities, and maintain personal hygiene.
.

In the treatment of the disease, the temperature is first brought down with the help of antipyretic drugs. Next, a course of antibiotics is prescribed, to which the causative agent of the disease is sensitive.

Penicillin preparations are usually used in large doses for one and a half weeks. With recurrent inflammation, hormonal drugs, such as prednisone, are added to antibiotic therapy.

Local treatment of the lesion is carried out with antiseptic solutions and ointments.
.

At the same time, vitamins, biostimulants and drugs that increase immunity are prescribed, if necessary, drugs are prescribed that reduce the permeability of small vessels.

Physiotherapy, cryotherapy, local ultraviolet irradiation, exposure to high-frequency current and laser therapy in the infrared range can also be prescribed.

Treatment of the disease does not cause any particular difficulties if it is not started and has not become severe.
.

Erysipelas disease is a serious infectious
a disease that can be contracted by airborne droplets. But if you
infected with the causative agent of erysipelas, it is not at all necessary that you have
inflammation will begin. Here genetics play an important role.
diseases and provoking factors (abrasions, scratches, stress,
hypothermia, overheating, sunburn and bruises).

• the disease with superficial processes requires the use of Enteroseptol as powders;
• along with this, it is permissible to use an ointment from crushed drugs and Erythromycin ointment;
• in the process of treating a recurrent form of the disease, the so-called physiotherapy is recommended, namely the use of UHF, quartz or even a laser;
• when the condition worsens, excellent results are demonstrated by the combination of antibacterial treatment with cryotherapy;
• it may be necessary to prescribe antihistamines as part of complex therapy along with antibiotics.

What antibiotics are taken

Given that erysipelas is an infectious contagious disease, it should be remembered that the basis of its treatment should be the use of various antibiotics.

These medications, used together with antibacterial compounds of other categories, will destroy the causative agent of erysipelas.

The most effective and safe in the treatment of erysipelas are injections of antibiotics, such as Oleandomycin or Penicillin.

Is home therapy acceptable?

Home treatment for erysipelas is allowed, but only if such a course is supervised by a specialist. Speaking of this, they pay attention to the use of special dressings that are used both for the upper and lower extremities, and, for example, for fingers separately. Features of the use and preparation of the product are as follows:

Treatment of erysipelas is based on taking antibiotics, since the disease is infectious. Complex drug therapy includes the appointment of antibacterial and antihistamines to combat allergies, as well as vitamin and mineral complexes.

Sometimes a blood transfusion may be needed.

Physiotherapy is often used, which includes:

• skin exposure to ultraviolet radiation;
• the use of a magnetic field for medicinal purposes;
• quartzing;
• laser therapy.

In most cases, erysipelas are treated on an outpatient basis. But with a severe course, frequent relapses, the presence of concomitant ailments, as well as a gangrenous form, the patient must be hospitalized in the infectious diseases department.

In the bullous form, compresses with furacilin are prescribed. For the entire duration of therapy, the patient must be provided with rest, bed rest and a special diet.

It is necessary to increase the consumption of fresh fruits, vegetables and honey.

Treatment of erysipelas with folk remedies will be different depending on the location and type of disease. When the face is used:

• ointment made from honey, coltsfoot and chamomile;
• lotions based on a decoction of dandelion, calendula, blackberry, oak bark and calendula.

Erysipelas of the hand can be eliminated:

The prognosis for the course of the disease will be closely related to the stage of erysipelas and the right methods of treatment. Comprehensive treatment may include both antibiotic therapy and physiotherapy.

When the first signs of erysipelas on the leg are found, long-term use of antibacterial drugs (penicillin, tetracycline or erythromycin) can be dispensed with. The dosage and duration of the course (most often its duration does not exceed 10 days) is prescribed only by the attending physician!

In especially severe cases, the patient may be hospitalized in the infectious or surgical department (with purulent wounds). If the disease has acquired a recurrent character, then the patient is recommended constant prophylaxis with bicillin-5 for 2 years.

For preventive purposes, in order to avoid recurrence of erysipelas on the leg, it is recommended to follow the rules of personal hygiene, if possible, avoid hypothermia and injuries. Maintaining the integrity of the skin prevents infection and unwanted recurrence of the disease.

Treatment of erysipelas is most often carried out at home (outpatient). In case of recurrence of the disease, the development of complications, the presence of severe forms of concomitant diseases, as well as in the presence of the disease in children and elderly adults, the treatment of erysipelas is carried out in stationary conditions.

The regimen for erysipelas is determined by the localization of the pathological process and the severity of the patient's condition. When the disease does not require a special diet.

Antibiotics and other groups of antibacterial drugs destroy pathogens. Antibiotic therapy is a mandatory and leading component of the treatment process.

• The most effective in the treatment of erysipelas are beta-lactam antibiotics of the group of natural and semi-synthetic penicillins - Benzylpenicillin, Oxacillin, Methicillin, Ampicillin, Amoxicillin, Ampiox.
• A good effect is exerted by cephalosporins of the I and II generations.
• In case of intolerance to antibiotics of the penicillin group, macrolides or Lincomycin are prescribed.
• Less effective are antibacterial drugs of the nitrofuran group and sulfonamides, which are prescribed for antibiotic intolerance.

The course of antibiotic therapy is 7-10 days.

Antibacterial treatment for recurrent erysipelas

Treatment of recurrent erysipelas should be carried out in a hospital setting. In the treatment, the use of beta-lactam antibiotics is effective, followed by a course of intramuscular injection of Lincomycin.

The first course with 2-course treatment is better to start with cephalosporins. The second course of lincomycin is carried out after a 5 - 7-day break.

With each subsequent relapse of the disease, the antibiotic should be changed.

Rice. 7. In the photo, erysipelas in children.

Pathogenetic treatment of erysipelas is aimed at interrupting the mechanisms of damage, activating the adaptive reactions of the body and accelerating the repair process.

Early started (in the first three days) pathogenetic therapy prevents the development of bullae and hemorrhages, as well as the development of necrotic processes.

Detoxification therapy

Waste products and substances released during the death of bacteria cause the development of toxicosis and fever. Toxins, foreign antigens and cytokines damage the membranes of phagocytes.

Their immunostimulation at the moment can be ineffective and even harmful. Therefore, detoxification in the treatment of erysipelas is a paramount link in immunotherapy.

Detoxification therapy is carried out both in the primary episode of the disease and in repeated cases. Colloidal solutions are widely used for the purpose of detoxification: gemodez, reopoliglyukin and 5% glucose solution with ascorbic acid.

Non-steroidal anti-inflammatory drugs (NSAIDs)

This group of drugs is indicated for severe swelling and pain in the focus of inflammation. Taking NSAIDs in adequate dosages brings significant relief to the patient. Such drugs as Indomethacin, Ibuprofen, Voltaren and others are shown for 2 weeks.

Desensitizing therapy

Inflammation in erysipelas is infectious and allergic in nature. The release of large amounts of histamine leads to damage to the blood and lymph capillaries.

Increased inflammation. Edema develops.

Itching appears. Antihistamines inhibit the synthesis of histamine.

The preparations of the 1st and 2nd generations are shown: Diazolin, Tavegil, Claridon, Zirtek, etc. The duration of application is 7-10 days.

Immunocorrection

The use of glucocorticosteroids in the treatment of erysipelas

Physiotherapy is used to achieve the best effect in the treatment of erysipelas and prevent the development of undesirable consequences. In the acute period, physiotherapeutic methods such as UFO and UHF are used.

Physiotherapy in the acute period

With the erythematous form of erysipelas, local treatment is not required. Local treatment of erysipelas on the leg is carried out in case of development of a bullous form of the disease.

In case of development of abscesses, phlegmons and necrosis, surgical methods of treatment are used.

Since it is possible to treat erysipelas at home (according to modern recommendations of the Ministry of Health of the Russian Federation) with a mild and moderate course of the disease, in most cases it is possible to do without hospitalization of the patient.

He is under the supervision of a local therapist and receives the treatment prescribed by him at home. In the presence of blisters, a surgeon's consultation is required to open and empty large bullae, and select local therapy.

Indications for hospitalization are:

• advanced age of the patient;
• the development of erysipelas in a child;
• severe immunodeficiency in a patient;
• severe course of the disease: pronounced intoxication syndrome, sepsis, widespread bullous-hemorrhagic lesion, necrotic and phlegmonous forms of erysipelas, the addition of purulent complications;
• the presence of decompensated and subcompensated clinically significant somatic pathology - especially diseases of the heart, kidneys, liver;
• relapsing course.

In the absence of indications for surgical intervention, the patient is hospitalized in the infectious diseases department. And when placed in a surgical hospital, he should be in the department of purulent surgery.

How to treat erysipelas

In the treatment of erysipelas, the form, localization and severity of the disease are taken into account. Important points are also the age of the patient and the presence of concomitant somatic diseases.

It also depends on which doctor will treat erysipelas, whether surgery is required or whether conservative methods can be dispensed with.

In any form of the disease, a full-fledged systemic etiotropic therapy is required. Proper treatment of erysipelas with antibiotics is aimed not only at stopping current symptoms, but also at preventing relapses and complications.

After all, the task of antibiotic therapy is the complete elimination of the pathogen in the body, including its protective L-forms.

β-hemolytic streptococcus retained high sensitivity to penicillin antibiotics. Therefore, they are used as a first-line drug in the treatment of erysipelas.

If there are contraindications to penicillins or if it is necessary to use tablet forms, antibiotics of other groups, sulfonamides, furazolidones, biseptol can be prescribed.

Properly selected antibiotic allows you to improve the patient's condition within the first day.

In severe cases, antistreptococcal serum and gamma globulin may be used in addition to antibiotic therapy.

NSAIDs (with analgesic, antipyretic and anti-inflammatory purposes), antihistamines (for desensitization) are used as adjuvants.

With severe intoxication, infusions based on glucose or saline are indicated. For the treatment of severe bullous forms and the emerging pronounced lymphostasis, systemic short-term glucocorticosteroid therapy is additionally performed.

In some cases, measures are taken to activate the immune system. This may be the use of thymus preparations, biostimulants and multivitamins, autohemotherapy, plasma infusions.

Local therapy is also shown, which can significantly improve the patient's well-being and reduce the severity of inflammation. In the acute stage, wet dressings with dimexide, furacillin, chlorhexidine, microcide are used.

A dense ointment for erysipelas is not used at this stage, as it can provoke the development of an abscess and phlegmon. Powdering the focus of erysipelas with powdered antibacterial agents and enteroseptol, treatment with antiseptic aerosols is acceptable.

Treatment of erysipelas with folk remedies cannot act as the main method of fighting infection and cannot replace the complex therapy prescribed by the doctor.

In addition, when using herbal preparations, there is a risk of increased allergic reaction and blood flow in the affected area, which will negatively affect the course of the disease.

Sometimes, in agreement with the doctor, irrigation with infusion of chamomile and other agents with a mild antiseptic effect is used.

Physiotherapy is widely used: ultraviolet radiation in erythemal doses, electrophoresis with proteolytic enzymes and potassium iodide, infrared laser therapy, magnetotherapy, lymphopressotherapy.

How to treat the disease with folk remedies and at home

As a remedy, crushed and sifted chalk or rye flour is used. These remedies should be sprinkled on the affected areas every morning, then covered with a red woolen cloth and bandaged. After several such procedures, erysipelas disappears.

There is another way. To do this, insist twenty grams of dope seeds in a glass of boiling water. After that, this infusion should be filtered and half diluted with water. Compresses are usually made with such water and applied to the affected areas.

You can also take three grams of boric acid, twelve grams of xeroform, eight grams of white streptocide and thirty grams of white sugar. These ingredients should be mixed and sprinkled with this mixture on the affected areas of the skin.

Before this, it is necessary to treat the face with hydrogen peroxide and, before covering the wound, put a double layer of gauze on it. This powder should be used twice a day.

The material was updated on 04/25/2017

Complications of erysipelas

If the treatment of erysipelas was performed in a timely manner, complications are quite rare. The risk group for their manifestation is the elderly and people with weakened immune systems. Complications include:

• circulatory disorders;
• kidney failure;
• inflammation of the bronchi;
• thrombus formation;
• the formation of elephantiasis;
• the appearance of ulcers, necrosis and abscesses on the skin;
• blood poisoning;
• lymph stasis.

The most likely complications of erysipelas include:

• extensive phlegmon or abscess;
• thrombophlebitis of nearby veins;
• infectious-toxic shock;
• sepsis;
• TELA;
• arthritis;
• tendovaginitis;
• myocarditis;
• nephritis, glomerulonephritis;
• acute infectious psychosis.

The main consequences of erysipelas are persistent hyperpigmentation and elephantiasis.

Prevention

Speaking about prevention, I would like to note the following:

• it is very important to treat certain foci of chronic inflammation in time, because they contribute to a weakening of the immune system and from them bacterial components can spread through the circulatory system;
• it is necessary to remember about personal hygiene, in particular, to take a shower at least once a day. Contrast showers are also recommended;
• it is important to avoid the formation of diaper rash. For example, in the area of ​​skin folds, where the skin is permanently moist, it is advisable to use baby powder;
• it is necessary to treat damage to the skin with antiseptics, in particular, hydrogen peroxide or ioddicirin;
• it is important to treat fungal infections of the feet in a timely manner, even if they do not look bad. The fact is that they quite often turn out to be a kind of entrance gate for infectious lesions.

Preventive measures for erysipelas include:

• timely treatment of any inflammatory and infectious diseases that can reduce immunity;
• compliance with the rules of personal hygiene;
• wearing loose and comfortable clothing;
• avoidance of diaper rash;
• taking courses of therapeutic massages;
• elimination of fungal infections, to prevent erysipelas of the leg;
• limitation of overheating and hypothermia of the body.

Since erysipelas can affect absolutely every person, it is necessary, when the first signs appear, to seek help from a specialist. This disease can be overcome for two weeks and limit yourself from its recurrence.

An erysipelatous pathological process is a rather serious disease with severe consequences and complications. It should also be taken into account that a seemingly cured disease can simply leave the surface of the skin and settle somewhere in the body, waiting for its "finest" hour.

Therefore, a healthy person needs to focus on the prevention of disease. By the way, observing precautions against infection with such inflammation, you simultaneously protect yourself from other viral infections, the same flu.

Ever since the school family, we remember that cleanliness is the key to health. Cleanliness of the body, clothes, cutlery. In this case, cleanliness and proper foot care. Any hypothermia, cut, crack, open wound can serve as a "gateway" for bacteria to the body.

It is more difficult to protect yourself from infection for those suffering from:

• diabetes mellitus;
• immunodeficiency syndrome;
• allergies;
• varicose veins;
• Violation of the cardiovascular system;
• digestive tract.

List of preventive measures after recovery

Prevention of erysipelas includes the timely treatment of any foci of chronic infection, dermatitis, mycoses of the feet and varicose veins, and the achievement of compensation in diabetes mellitus.

It is recommended to follow the rules of personal hygiene, choose comfortable clothes made from natural fabrics, wear comfortable shoes. With the appearance of diaper rash, abrasions, corns, they must be treated in a timely manner, additionally treating the skin with antiseptic agents.

Erysipelatous inflammation with timely access to a doctor and strict adherence to his recommendations can be successfully treated and does not lead to permanent disability.

Since erysipelas is a contagious disease, it is necessary to reduce or cancel all contacts with infected people. Family members should prevent injuries to the skin and monitor the sanitary and hygienic condition of the skin.

For preventive purposes, it is better to follow certain rules:

• timely treat all painful conditions of the skin;
• observe the rules of personal hygiene, especially after visiting crowded places;
• prevent infection pathogens from entering small scratches or wounds;
• treat all violations of the integrity of the skin.
• timely treatment of fungal skin lesions and lymphovenous insufficiency.

You can avoid the likelihood of getting erysipelas if you follow the rules.