Viral streptoderma. Streptoderma - what is it, symptoms in adults, types and treatment. Why do relapses and persistent course of streptoderma occur in children

Streptoderma is an infectious and inflammatory disease with a purulent lesion of the skin, caused by exposure to beta-hemolytic pyogenic streptococcus. It develops as a result of damage by the causative agent of sweat glands and sebaceous-hairy skin structures (photo).

It is manifested by a superficial lesion, mostly smooth skin. The primary elements of impetigo are conflicts (flaccid vesicles) filled with transparent exudate, prone to rapid growth and fusion. The delicate structure of the dermis is affected, which is the reason for the predominant lesion of female and children's skin.

The disease is contagious, the pathogen has an easy introduction into the child's body when in contact with an infected child, through toys, clothing or common household items. Infection can be transmitted through insect bites and contaminated hands. The impetus for the development of infectious pathology can be:

• skin combs;
• maceration of the upper layer of the skin;
• disturbances in its alkaline balance;
• damage to the mucous layer with rhinitis or otitis media;
• decreased immune function.

Streptoderma and its features

The causative agent is streptococcus. Getting on damaged skin, this bacterium begins to multiply rapidly, which leads to the occurrence of a purulent inflammatory process - streptoderma. The infection easily spreads to neighboring areas of the skin and is transmitted from one person to another.

Streptoderma often affects children. There are several reasons for this:

• in children, the immune defense is much weaker than in adults;
• they have thinner and more vulnerable skin;
• children are active, their skin is often injured;
• are in close contact with each other and become infected with streptoderma in children's institutions;
• It is not always possible to ensure that children follow the rules of hygiene.

Streptococcus is a representative of conditionally pathogenic microflora, that is, in small quantities it is always present in the body and on the surface of the skin. The immune system protects the body from its effects. When the skin is damaged, the bacteria enter favorable conditions for themselves and begin to multiply rapidly. The weaker the immune system, the more severe streptoderma occurs. The incubation period of the disease is 3-10 days.

How to distinguish herpes from streptoderma

Streptococcal dermatitis can begin with the appearance of small-sized conflicts - vesicles filled with cloudy contents. Because of this, it is often confused with herpes and is not treated. However, these diseases have significant differences:

• zaeda differs from herpes by the rapid opening of liquid capsules; with herpes, the vesicles remain on the lips much longer;
• streptoderma in a child develops around an already affected area of ​​\u200b\u200bthe skin, and herpes affects healthy skin;
• with herpes, itching appears much earlier than conflicts, while with streptoderma, itching will begin only after the appearance of a rash.

Causes

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.

The occurrence of streptoderma is always associated with a violation of the integrity of the skin (microtrauma or abrasion is enough for infection to penetrate), a change in local immunity and a violation of the activity of the body's immune system as a whole.

Experts consider the fact that streptoderma most often develops in children to be direct evidence of this statement - in the vast majority of cases, an epidemic outbreak occurs in an organized children's team (nurseries and kindergartens, elementary grades of schools, children's sections of interest. However, a child who is sick streptoderma, becomes a source of infection and can infect any of his relatives in close contact with him.

Predisposing factors, the presence of which increases the likelihood of developing the disease, are:

• neglect of the rules of personal hygiene;
• acute and chronic overwork;
• stressful situations;
• any condition that can cause a decrease in immunity;
• insufficient amount of vitamins in the patient's food and his body
• skin injuries (even the smallest ones).

Possible routes of infection

How is the transmission of infection with streptoderma and other diseases caused by streptococci? There are three routes of infection transmission:

• contact path: when touching, skin-to-skin contact of a sick or carrier and a healthy person, with joint games of children, kisses of adults, etc .;
• contact-household spread of infection occurs when using the same household items: dishes, toys, books, towels, etc.;
• The most rare is the airborne method of transmission of infection, when streptococcus moves from a sick person or carrier during coughing, sneezing to the area of ​​\u200b\u200bdamaged skin.

First signs

After streptococcus enters the body of a child, the clinical picture begins to appear only after a week - this is how long the incubation period of the disease lasts.

Dermatologists divide all the symptoms of streptoderma into two groups - the main ones (specific, characteristic of such an infection) and additional ones (they appear in almost any childhood illness).

The main signs of streptoderma in a child:

• the formation of redness in various parts of the body;
• a little later, bubbles jump up in their place, inside of which a yellowish liquid is visible;
• after 2 days they increase in size;
• then burst;
• after that, erosion with uneven edges is formed;
• it dries up to a yellow crust within a day;
• the latter soon disappears by itself;
• all this time the child's skin itches unbearably;
• if you let him comb the affected areas, the recovery is delayed, since in this way he spreads the pathogen throughout the body;
• many parents are worried about how long streptoderma lasts in a child: this whole process lasts from 3 days to a week, but only if all medical recommendations are followed.

Additional symptoms:

• temperature rise;
• enlarged lymph nodes;
• vomiting and nausea;
• general malaise: lethargy, feeling unwell, lack of appetite, weakness, sleep disturbances.

People who do not have a medical education (including most parents) are very easy to confuse the signs of streptoderma with symptoms of other skin diseases - urticaria, pityriasis, eczema, atopic dermatitis, pyoderma.

Since different means are used for their treatment, independently (“by eye”), it is impossible to make a diagnosis. Moreover, this is one of the most insidious diseases, which is very many-sided - this can be judged by various forms of infection with streptococci.

Symptoms of streptoderma in children

Based on the current pathological processes and the degree of depth of the lesion of the dermis, there are three stages of streptoderma, symptoms in children appear:

1) Vesicular streptoderma(bullous - from the term bulla-bubble). It is characterized by a superficial lesion of the dermis with the formation of small vesicles and small islands of inflamed skin.

Signs of cystic streptoderma are due to the appearance of a small red spot on the child's skin. During the day, a conflict (blister) is formed on the spot, surrounded by a bright red rim and filled with purulent-serous exudate. As the disease progresses, the number of blisters increases. They can be of the most unexpected sizes - from scanty, up to one and a half centimeters in diameter.

The first bubbles that appear burst, pouring out a yellow-brown exudate, which forms crusts in the form of a scab. At the slightest injury, or awkward movement, they easily move out of place, exposing the inflamed erythematous surface of the skin. The blister rash is able to merge, forming lesions of various sizes and configurations.

The usual localization of rashes is the skin of the face and hands of the child. When the elements of the rash are located in the folds of the nasolabial triangle, the infection very often penetrates the mucous membranes of the nasal cavity and mouth, covering them completely. The process of crust formation is accompanied by severe itching.

On the head of a child, streptoderma, in the form of clearly defined foci, appears precisely as a result of scratching and introducing infection to healthy areas of the skin.

In recent years, the vesicular stage of impetigo has begun to manifest itself differently; changes in the very structure of the vesicles are often found. Their tire has become more dense, they do not increase in size and do not open.

Such a bubble variety occurs when the periungual roller is damaged. A bubble filled with exudate goes around the base of the nail, taking the shape of a horseshoe; in medicine, this shape is called a tourniole.

Often there are large blisters with a drying core surrounded by a roller filled with purulent fluid. If you do not start treating streptoderma in children in time, then with extensive skin lesions and the addition of background pathologies, the child's condition may deteriorate sharply and manifest itself:

• feverish state with febrile temperature;
• loss of strength (muscle weakness) and muscle pain;
• signs of lymphadenopathy in areas adjacent to the focus;
• apathy for food and nausea.

When recovering, no traces remain at the site of pathological foci.

2) Stage of non-bullous development due to deep damage to the epidermis and the development of poorly healing large blisters and painful ulcerative formations - streptococcal ecthyma.

With the non-bullous stage of streptoderma in children, the symptoms are manifested by a rapid increase in bubble formations. Soon they dry out, turning into a yellow-green crust that sits tightly on the skin. With its rejection, an ulcerative unevenness covered with pus remains.

Since at this stage the deep layer of the dermis is affected, during healing, well-marked scars remain. This skin lesion is observed mainly on the extremities.

3) Chronic stage, as a result of the neglect of the process or ineffective therapy of streptoderma.

The chronic stage is due to episodic manifestations on the dermal layer of large focal inflammations and weeping rashes located on them. The opening of the blisters is accompanied by the formation of yellowish transparent crusts. If they are removed, a purulent-bloody exudate is released.

After healing, the foci of inflammation are covered with slightly pink flaky skin. With timely and properly selected treatment of streptoderma in children, relapses of the disease and a long-term chronic process can be prevented.

Classification

Streptoderma has a large number of types. All of them differ from each other by the place of origin, external signs, and the severity of the process. Let's move on to a direct description of the varieties of pyoderma:

• Streptococcal impetigo. Conflicts are characteristic - vesicles with purulent contents. After opening, yellow crusts remain in their place. When the latter fall off, light spots appear, which disappear after a while. Standard localization - on the face.
• Bullous impetigo. A more severe form of the disease. The vesicles first contain serous fluid, then it transforms into purulent. In place of the opened bula, an erosive painful surface, ulcers remain. Gradually, intoxication of the body increases (the temperature rises, weakness appears, lymph nodes increase). This type of streptoderma lasts for about 2 months.
• Dry streptoderma. This form does not form bubbles. Reddish spots appear on the skin, covered with several layers of scales, there is no itching. Children tolerate the dry form of streptoderma quite easily. Often confused with allergic dermatitis
• Slit impetigo. It is popularly known as "jam" (we recommend reading: zaeda in a child: causes and treatment). The skin of the face is affected, especially in the corners of the mouth, eyes, wings of the nose. Cracking conflict gives the baby pain and discomfort. If treatment is started on time, all symptoms disappear without a trace. Otherwise, the disease becomes chronic.
• Superficial panaritium (periungual). The name speaks for itself. The skin around the nails on the hands and feet is affected. Streptococcus penetrates into the deep layers of the epidermis, causing inflammation and suppuration. Without treatment, nail rejection can occur.
• Vulgar ecthyma. Severe streptococcus infection. The deepest layers of the skin are involved in the pathological process. Requires urgent therapy. This type of streptococcal infection can cause sepsis, tissue necrosis. Symptoms do not recede for a long time.
• Streptococcal stomatitis. Manifested by a lesion of the mucous membrane in the mouth.

What does streptoderma look like in children - photo of symptoms?

Bubbles that initially appear on the skin of a child with streptoderma are called impetigo. Then erosion appears in their place - sores with a weeping surface.

How to make a diagnosis

If you suspect that your baby has streptoderma, you should immediately contact a specialist - a pediatric dermatologist.

A competent doctor will rely on the data of several diagnostic methods:

1. Clinical signs. According to the external manifestations of the infectious process (the nature of the rash, localization), it is possible to establish the nature of the disease.
2. bacteriological method. For sowing, scrapings are taken from the skin, the contents of the vesicles or purulent discharge of erosive skin lesions. For the correct appointment of therapy, sensitivity to antibiotics is determined.
3. Additional diagnostic methods. They do an analysis for worm eggs, a general and biochemical blood test, a general urine test. Based on the results, the activity of the inflammatory process is judged and the selected treatment is adjusted.
4. Differential diagnosis. We must not forget that other diseases are “disguised” as streptoderma, such as: fungal infection of the epidermis, syphilis, staphylococcal pyoderma, chickenpox, herpetic eruptions in the corners of the mouth.

How to treat streptoderma?

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

hygiene rules

Sometimes parents neglect the doctor's recommendations regarding hygiene and handling household items, believing that the main thing is to anoint three times a day, the rest is unimportant. 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. Compliance with hygiene recommendations is no less important part of the treatment than an ointment for streptoderma or an antibiotic.

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

In some sources on the network, recommendations for the treatment of streptoderma in a child are constantly being rewritten from outdated sources, so there are recommendations for lubricating the lesions with mercury ointment or silver nitrate. One of the drugs has been discontinued and is available only for animals as a chemical reagent, the second is banned due to its high toxicity.

Modern antibiotic ointments and antiseptics are much more effective, safer and more convenient to use. Local therapy involves opening conflicts in compliance with all aseptic rules and their further processing with ointments or liquid antiseptics.

Antiseptics

• hydrogen peroxide 1%
• brilliant green, 2% aqueous solution (brilliant green)
• fucorcin or boric acid
• salicylic alcohol 2%

They are applied to the affected areas of the skin with the capture of some area around with a cotton swab or swab 2-4 times a day, at the beginning of the treatment, the child will feel a burning sensation and pain for a short time. After the liquid antiseptic has dried, ointment can be applied to the skin.

From folk remedies that have long been adopted by official medicine, the doctor can recommend you decoctions of chamomile, string or oak bark, which are well-known antiseptics. Use them as lotions, for rinsing healthy skin, compresses and dressings on affected areas, but not as a main treatment, because. with this pathology, antibiotics are indispensable.

Antibiotics in the treatment of streptoderma

Antibiotics in the treatment of childhood streptoderma are used as local treatment and systemic treatment only if there are strict indications. No doctor will prescribe systemic antibiotic treatment in case of single rashes on the hands or face that respond well to topical treatment. At the same time, it is at least not reasonable to completely abandon this method of therapy in the presence of common forms, and especially when general symptoms are attached, and even more so in severe cases of the disease.

A special group of drugs includes ointments with hormones, which can be prescribed only for a short time and only in especially severe cases. With prolonged use of such drugs, they can provoke a decrease in the protective functions of the skin and increase the body's vulnerability to any infections, therefore, in the case of streptoderma, such drugs can be prescribed only for certain symptoms and only for a short course.

It is possible to carry out such an inexpensive local treatment for mild forms of streptoderma. You will need: zinc ointment (30 rubles), levomycetin tablets (20 rubles), levomycetin alcohol (20 rubles). First, the affected area and the surrounding tissue are treated with chloramphenicol, the wound is treated with fucorcin or brilliant green, then allowed to dry. Next, make a mixture of zinc paste / ointment with chloramphenicol tablets crushed into powder, mix thoroughly. And lubricate the wound with this composition in the morning and evening.

Systemic treatment

1. The use of antibiotics. Most often, with streptoderma, children are prescribed antibiotic derivatives of penicillin (amoxiclav, amoxicillin) for oral administration. If a child is allergic to these drugs or has recently had to take them for another reason, then antibiotics of a different type are prescribed (cephalosporins - ciprofloxacin, suprax or macrolides - erythromycin, sumamed, clarithromycin).
2. Preparations with useful lacto- and bifidobacteria. In order to preserve the normal intestinal microflora and prevent intestinal disorders, agents containing beneficial bacteria are prescribed in parallel. With the use of antibiotics, their content in the body is sharply reduced, which can cause indigestion and the occurrence of infectious diseases of internal organs. As such drugs, duphalac, linex, acipol, hilak-forte, bifidumbacterin are used.
3. Antihistamines. They are prescribed to children to eliminate itching and improve sleep. When choosing drugs, the age and weight of the children must be taken into account. If earlier only diphenhydramine, suprastin, pipolfen were prescribed, now drugs are prescribed that have an effective effect with a lower content of the medicinal substance, such as zirtek, claritin, telfast.
4. Means to strengthen the immune system. In the treatment, multivitamins are prescribed ("Alfavit", "Supradin", "Centrum"), as well as immunomodulating drugs (arbidol, anaferon, viferon), which are necessary to strengthen the body's defenses.

Folk remedies and home treatment

In addition to the main course of therapy, parents can treat the child with folk methods. A good effect is the use of compresses, applications and lotions from herbal decoctions, which have antiseptic and anti-inflammatory properties.

1. Eucalyptus ointment. It has a pronounced healing effect. For its preparation, eucalyptus leaves are crushed, poured with sunflower or olive oil in a ratio of 1: 1 and insisted for three days. Oak bark should be added to the finished mixture. To do this, the oak bark is crushed, dried in the oven and ground to a powder. The powder is steamed in boiling water for 40 minutes and added to the vegetable-oil mixture. The ointment thus obtained is applied to the affected areas of the skin once a day.
2. Ointment of honey and pomegranate. It has a healing and antiseptic effect. An equal amount of honey and unripe pomegranate juice is thoroughly mixed and applied to the lesions several times a day.
3. Tincture of calendula. Well disinfects and dries the affected areas of the skin. To prepare it, calendula flowers are lightly rubbed, poured with medical alcohol in a ratio of 1: 1 and infused in a dark place for 5 days. The finished tincture is filtered and used to treat the skin.
4. A decoction from a string. A tablespoon of dry vegetable raw materials is poured into 200 ml of water and simmered in a water bath for 20 minutes. The finished broth is cooled, filtered and used for lotions. The sequence relieves inflammation, softens and disinfects the skin.
5. Decoction of oak bark. It has an astringent and antiseptic effect. A tablespoon of dry chopped bark is poured into 500 ml of boiling water and simmered for 30 minutes. The finished broth is cooled and lotions are made several times a day, treating the affected skin.

Diet

With streptoderma, a child is rarely hospitalized. As a rule, treatment is carried out at home, under the watchful supervision of parents. And the key point here is the observance of a special diet.

Prohibited products:

• chocolate;
• jam;
• ice cream;
• muffin;
• roast;
• acute.

• fresh berries (cranberries, lingonberries, blueberries, blackberries, raspberries, strawberries) as sources of antioxidants;
• white cabbage, which contains a lot of natural antibiotics;
• dairy products rich in protein, calcium, vitamin D - everything you need to restore the epidermis and the immune system;
• whole grains (flax seeds, brown rice, sesame seeds);
• carrots - a source of carotene, which is an antioxidant and copes well with infection;
• garlic is a natural antiviral, antifungal and antibacterial product;
• coconut milk - antimicrobial agent;
• greens (spinach, parsley, celery) are rich in iron, vitamin C, magnesium;
• lemon - strengthens the immune system, which is usually weakened after streptoderma.

If this diet is observed by the child from the first days of illness, he will quickly recover. An increase in healthy foods in his diet will allow the skin to recover faster after such a serious lesion. In the treatment of streptoderma, water procedures also play an important role.

Causes of relapses and complications in the treatment of streptoderma

In some cases, streptoderma in children occurs for a long time, with relapses and is difficult to treat. This occurs in the absence of therapy, as well as in cases where the patient's body cannot independently resist the pathogen due to the following reasons:

• the presence in a child of diseases that damage the skin: allergic, atopic dermatitis, pediculosis, scabies or a tendency to comb bites, wounds, picking off crusts, etc .;
• with a general decrease in immunity against the background of chronic or frequent diseases, anemia, helminthiases, inflammatory processes in the oral cavity with slit-like streptoderma (“jam”), with prematurity, malnutrition and other factors that inhibit the development of the immune system or reduce its protective functions;
• streptoderma in the nasal passages, in the auricles is difficult to cure in the presence of otitis, rhinitis, accompanied by secretions that irritate the mucous membranes and skin and promote the growth of bacteria;
• under adverse living conditions: low hygiene, as well as exposure to low or high temperatures that damage the epidermis, sunburn, constant or prolonged contact of the damaged surface with liquids, water (when bathing, rare diaper changes, etc.);
• the addition of a secondary infection, staphylococcus aureus, causes streptostaphyloderma, impetigo vulgaris, requiring complex therapy directed against two pathogens.

What to do if streptoderma does not go away for a long time or has recurred?

With timely and proper treatment, streptoderma is usually well cured, and recovery occurs in a week. But there are situations when streptoderma drags on for several weeks, and even for months.

Reasons for ineffective treatment of streptoderma:

1. A chronic course of streptoderma developed. In this case, long-term treatment by a dermatologist and family doctor (or pediatrician) with the use of hormonal drugs and immunomodulators, as well as treatment of concomitant diseases, is required.
2. Lack of treatment or the use of counterfeit drugs (fakes). In order to avoid the purchase of dummy drugs, all medicines must be bought only in official certified pharmacies.
3. Non-compliance with the rules of personal hygiene, bathing, combing the rashes leads to the appearance of new foci of the rash.
4. The use of antibiotics (both externally and internally) that do not act on the pathogen. If streptoderma does not go away for a long time, then it is simply necessary to find out the sensitivity of bacteria to antibacterial drugs (unfortunately, an antibiogram is rarely performed in our country). Only properly selected antibiotics can cope with infectious diseases.
5. Weakened immunity as a result of concomitant diseases or past viral and other infectious diseases. With reduced body defenses, it is difficult to cure any infectious pathology, even when using the most “powerful” antibiotics.
6. This is not streptoderma. Some skin diseases are very similar to streptoderma, which can lead to misdiagnosis and, consequently, inadequate treatment. Therefore, do not self-medicate, but seek help from experienced professionals.
7. The re-development of streptoderma (relapse) usually indicates reduced immunity. In this case, you just need to see a doctor, undergo a full examination and eliminate the causes of the body's poor resistance to infections.

Streptoderma and similar diseases

There are a number of diseases with manifestations on the skin, which at different stages of development can look like streptoderma. Most of the coincidences occur in the first stage of vesicle formation, however, there are variants of diseases similar to any stage in the development of streptoderma. It is for this reason that the diagnosis and choice of the method of therapy should be carried out by a specialist.

pyoderma

If we speak absolutely precisely, then streptoderma is one of the types of pyoderma - in medicine, all skin pustular diseases of an inflammatory nature belong to the group of pyodermas. But there is also a distinctive feature of the disease in question - the contents of streptoderma vesicles are never purulent, only serous. Even if there is some presence of pus in the liquid, it is minimal and does not make the contents cloudy.

The greatest similarity is observed between pyoderma and impetigo vulgaris - the symptoms are almost the same, even the treatment will be identical. It is important at this moment to accurately determine the type of pathogen and choose the right antibacterial agents for the course of treatment.

Herpetic eruptions

Manifestations of the activity of the human herpes virus on the lips are often confused with streptococcal congestion. When differentiating, it is worth paying attention to three main differences:

• herpes rashes are localized on an intact area of ​​the skin, all forms of streptoderma require skin injuries for development;
• the stages of development of streptoderma proceed faster, the vesicles fall off or open for a much shorter period than with a herpes infection;
• with herpes, itching precedes the onset of rashes, with streptoderma, itching occurs only in the presence of skin manifestations.

Thrush or candidiasis

Candidiasis of the oral cavity can spread to the corners of the lips and form cracks in the skin. Differentiation from pyoderma is carried out by the presence of characteristic white dotted rashes on the internal oral mucosa, white plaque, and an ulcerated mucosal surface underneath.

Allergy manifestations

Some children may have a non-classical manifestation of a skin rash of allergic etiology in the form of small vesicles with transparent contents. In particular, photodermatosis, an "allergy" to solar radiation, which at an early stage looks like one of the forms of pyoderma, can manifest itself in this way in infants.

To distinguish, you must gently press the element of the rash with your finger. If the rash is allergic, the skin around the inflammation will lose its pink or red color. With streptoderma, the color after pressing remains unchanged.

Chickenpox

Since the first rashes in this disease usually appear on the skin of the face and head, in the first hours you can mistake chickenpox for streptoderma. However, after a few hours, other characteristic signs of chickenpox begin to appear - it is almost impossible to confuse it with streptoderma.

Prevention

Since streptoderma is a contagious disease, it implies the isolation of the child from the team, while the peers in contact with the affected person are quarantined for 10 days. During this time, symptoms of pathology may also occur in other children. In most cases, outbreaks of streptoderma occur in kindergartens, because young children do not particularly follow the rules of personal hygiene, love soft toys and are in close contact during joint games.

When treating streptoderma at home, careful prevention of the spread of infection is needed. Compliance with hygiene is extremely important both for the victim himself and for the rest of the family, in order to exclude the possibility of infection. This is no less important than local therapy and drug treatment.

In general, the prevention of pathology outside of contact with the victim comes down to careful observance of hygiene rules, hardening (sun and air baths) and a complete balanced diet, which is enriched with vitamins.

and is characterized by rashes in the form of bubbles and blisters ranging in size from a few millimeters to several tens of centimeters.

Most often, streptoderma affects children, which is associated with a high contagiousness (contagiousness) of the disease and close communication of children (schools, kindergartens). In adults, mass outbreaks of the disease are observed in closed groups (military unit, prison). The infection is transmitted by contact through tactile contact with the patient, through bed linen and personal belongings.

Kinds

From the point of view of the course of the disease, acute and chronic streptoderma are distinguished.

According to the depth of skin lesions, superficial (streptococcal impetigo), ulcerative or deep, as well as dry streptoderma (ordinary ecthyma) are distinguished.

A separate item is the intertriginous form: the rash appears in skin folds or rollers.

The reasons

The etiological factor of streptoderma is group A beta-hemolytic streptococcus, which affects damaged skin surfaces.

Predisposing conditions for the onset of the disease are:

• violation of the integrity of the skin (abrasions, cracks, bites in the corners of the mouth, insect bites);
• non-compliance with 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 ones, the protective film is washed off the skin, and with rare ones, dead epidermal cells and opportunistic microorganisms are not removed);
• circulatory disorders (varicose veins);
• intoxication;
• burns and frostbite.

Symptoms of streptoderma in children and adults

Often the infection of an adult comes from a sick child. However, the disease is more severe in children.

Streptoderma in children is often accompanied by:

• temperature rise to 38-39°C;
• general intoxication of the body;
• enlargement of regional lymph nodes.

The incubation period of the disease is 7-10 days.

surface form

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 turn into blisters (conflicts), the contents of which have a cloudy color.

Conflicts very quickly increase in diameter (up to 1.5-2 cm), after which they burst with the formation of a dry honey-colored crust. At the same time, the patient feels unbearable itching in the affected areas, combs the 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) left - this is a superficial form of streptoderma (impetigo).

A photo:

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, quickly spreading over all skin (usually arms and legs).

The dry form refers to deep streptoderma, as the germ layer of the skin ulcerates, and scars remain after healing. The affected areas after recovery remain unpigmented and do not sunbathe under the action of sunlight. After a while, this phenomenon disappears.

Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Streptococcal congestion (angular stomatitis, slit-like impetigo)

The corners of the mouth are often affected, as a rule, this is due to a lack of B vitamins. Due to the dryness of the skin, microcracks form there, where streptococci penetrate.

First, redness occurs, then - purulent rollers, which subsequently become covered with honey-colored crusts. The patient complains of pain when opening the mouth, intense itching and salivation.

Perhaps the appearance of slit-like impetigo in the wings of the nose (constant stuffiness and pain when blowing your nose) and in the outer corners of the eyes.

Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Superficial panaritium (streptoderma of skin rollers)

It develops in people who have the habit of biting their nails. Tourniol is characterized by the appearance of conflicts around the nail folds. 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 they are opened, weeping pink surfaces are formed in the skin folds.

If the treatment of streptoderma is inadequate or the patient's immunity is reduced, the disease becomes chronic, which is difficult to treat.

* You can find out the specific details of the course of streptoderma in the 2013 Federal Guidelines, in accordance with which this article was written.

Diagnostics

Conduct 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 visual examination (characteristic vesicles and yellowish-honey crusts after they are opened).

From laboratory methods use:

• microscopy of smears of the affected area of ​​the skin;
• bacteriological analysis (sowing crusts on nutrient media).

Microscopy and bakposev should be carried out before antibiotic treatment and in the absence of self-medication.

Treatment of streptoderma

Streptoderma is treated by a dermatologist.

First of all, especially for children, a hypoallergenic diet is prescribed with a restriction of sweet, spicy and fatty foods.

For the period of treatment, water procedures (bath, shower) are prohibited in order to prevent the spread of the disease. Healthy skin is recommended to be wiped with a decoction of chamomile.

It is important to avoid wearing clothes made of synthetics and wool, as this provokes sweating and contributes to the increase and spread of lesions. Patients are strongly advised to give preference to natural fabrics.

After opening the blisters with a sterile needle and emptying them, the infected areas of the skin are treated with aniline dyes (methylene blue or brilliant green) twice a day.

In order to stop the growth of lesions, 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 seizures and foci of streptoderma on the face is also carried out with silver nitrate (lapis).

Bandages with antibacterial ointments are applied to the crusts:

• chloramphenicol;
• tetracycline;
• erythromycin;
• physiderm;
• ficidin.

After 7, maximum 14 days after appropriate local treatment, the symptoms of streptoderma disappear.

In difficult cases, antibiotics are prescribed systemically (amoxiclav, tetracycline, chloramphenicol) for a period of 5-7 days.

To relieve itching, desensitizing drugs (claritin, telfast, suprastin) are prescribed. At the same time, immunostimulating therapy is carried out (immunal, pyrogenal, autohemotherapy), the appointment of vitamins A, C, P, group B.

At high temperatures, antipyretic drugs (paracetamol) are indicated.

During the treatment of streptoderma, the use of herbal medicine is allowed (dressings with infusions of onions, garlic, burdock, yarrow).

Complications and prognosis

Symptoms of streptoderma with adequate treatment disappear after a week, but in some cases (with a weakened immune system or the presence of chronic diseases), complications are possible:

• transition to a chronic form;
• guttate psoriasis;
• microbial eczema;
• septicemia - infection of the blood, in which a huge number of streptococci circulate;
• boils and phlegmon.

The prognosis for this disease is favorable, but after suffering a deep form of streptoderma, cosmetic defects remain.

*This article is based on the Federal Clinical Guidelines adopted in 2013. management of patients with pyoderma.

Update: October 2018

Streptoderma is any form of purulent-inflammatory skin diseases caused by streptococci. For the development of the disease, two factors are necessary: ​​the presence of streptococcus and damaged skin with reduced protective properties. Most often, streptoderma occurs in children. The reasons for this are the imperfection of the protective function of the skin and the inability to fully control the hygiene of a small child.

The first factor: streptococcus

Streptococci are opportunistic pathogens that are almost always in contact with humans. They live on the skin, any mucous membranes, in the respiratory tract, the human gastrointestinal tract. Almost every person temporarily becomes a carrier of streptococci several times during his life, there are also permanent carriers. Moreover, staphylococcus often joins the hemolytic streptococcus, which is the causative agent of streptoderma.

Streptococci are quite stable in the environment: they tolerate drying well and remain in dust and on household items for months. When exposed to disinfectant chemicals, they die in 15 minutes, when boiled - immediately, at a temperature of +60 ° C - after 30 minutes.

Streptococcus can cause many diseases in humans: tonsillitis, scarlet fever, tonsillitis, pharyngitis, erysipelas, streptoderma, abscesses, pneumonia, bronchitis, lymphadenitis, meningitis, glomerulonephritis and others.

Second factor: skin damage

While the skin and mucous membranes perform their barrier functions, streptococci do not cause any problems to a person, however, with any damage, the skin may lose its protective properties, and the affected area will become the entrance gate of infection. In this case, streptoderma develops.

• This usually happens with wounds, cuts, abrasions, insect bites, scratching in allergic and inflammatory diseases (allergic dermatitis), with a rash (for example, with urticaria or chickenpox).
• Sometimes the skin is affected, which outwardly seemed intact, but in this case there are microtraumas that are not visible to the eye, or a slight local inflammation that could be ignored.

Getting on the damaged area of ​​the skin, streptococci, which previously most often peacefully existed on the skin or in the nasopharynx and did not cause diseases, become active, begin to multiply rapidly and cause inflammation, prone to a persistent long course.

Sources of infection

Streptococcus can get on damaged skin from various sources:

• Upholstered in the skin of the child itself
• With household items (toys, dishes, towels)
• From a healthy carrier with no disease
• From a patient with streptoderma, streptococcal pharyngitis, tonsillitis, scarlet fever or bronchitis, less often - other diseases caused by streptococcus

In the latter case, the causative agents of the disease are more aggressive, as they have already multiplied in favorable conditions and have become stronger and more resilient.

Quite often, streptoderma in children occurs as an epidemic outbreak in kindergarten, children's sports sections, and school. A sick child in this case is a source of infection. The incubation period for streptoderma is 2-10 days.

Ways of infection

Routes of infection are ways of transmitting an infection from a source to a sick person.

• The contact path - with direct contact of the carrier's skin with the damaged skin of the child (during joint games, hugs, kisses).
• Contact household - through shared toys, household items, towels, dishes.
• Airborne (less often) - when the pathogen enters the damaged skin directly during sneezing and coughing of the carrier or the patient.

Why do relapses and persistent course of streptoderma occur in children?

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 has impaired immunological reactivity: premature babies, with anemia, with helminthiasis (see), with common infections.
• In children with chronic skin diseases: ), ), 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.

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.

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.

Most often, this form of the disease occurs because it is the most limited, the pathogen does not penetrate beyond the surface layer, since in most cases the skin still performs its protective functions, and the local mechanisms for limiting inflammation work well and turn on quickly enough.

If the disease is noticed at the stage of the first element, treatment and prevention of spread are started, streptoderma on the face of a child may end there. But most often they don’t pay much attention to such a sore, they wait until it “passes by itself”, or they are afraid to touch it.

The child combs the itchy element, washes, rubs his face, leaves the contents of the bubble on the pillow, toys and towel, and the pathogen begins to spread over the skin with the appearance of new elements that can be located separately or merge with each other.

With not very thorough treatment and hygiene, the disease lasts 3-4 weeks, sometimes longer, complications may develop.

This is a more severe form of the disease and requires more intensive treatment.

• This type of streptoderma most often occurs on the skin of the hands, feet and legs, sometimes on other parts of the body.
• Bubbles (bulls) are larger than conflicts, less intense, the inflammatory process is more pronounced.
• There may be a violation of well-being, an increase in body temperature, inflammation of the surrounding lymph nodes, changes in the analyzes.
• The blisters are filled with serous-purulent fluid, increase rather slowly, after the bullae burst, open erosion remains in their place.

Erythematosquamous streptoderma

• Dry streptoderma, most often develops on the face, less often on the trunk.
• With it, weeping elements are not formed, only pink or reddish spots, covered with exfoliating whitish scales.
• Despite the fact that the disease does not tend to spread rapidly and causes less discomfort compared to other forms, it is contagious, and therefore requires no less intensive treatment and isolation of the child from the team.

Tourniol (superficial panaritium)

Severe form, characterized by damage to the deep layers of the skin with decay and the formation of ulcers.

Diagnosis of streptoderma

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, cultures of the discharge from the elements are done on the microflora, 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:

• General and biochemical blood test
• General urine analysis
• Feces on worm eggs
• In rare cases, the Wasserman reaction (see) and a blood test for

Treatment of streptoderma in children

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

hygiene rules

Sometimes parents neglect the doctor's recommendations regarding hygiene and handling household items, believing that the main thing is to anoint three times a day, the rest is unimportant. 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. Compliance with hygiene recommendations is no less important part of the treatment than an ointment for streptoderma or an antibiotic.

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 the doctor prescribes, also help to reduce;
• 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

In some sources on the Internet, recommendations for the treatment of streptoderma in children are still copied from old sources, and there are tips to lubricate with silver nitrate or mercury ointment. The first drug has been discontinued, more precisely, it is produced only for animals or as a chemical reagent, the second has long been banned as highly toxic. Potassium permanganate (potassium permanganate) is available by prescription.

Modern antiseptics and antibiotic ointments are much more effective, easier to use and safer. Local treatment includes opening conflicts in compliance with aseptic rules and subsequent treatment of the affected skin with liquid antiseptic and ointment.

Antiseptics

• hydrogen peroxide 1%
• brilliant green, 2% aqueous solution (brilliant green)
• fucorcin or boric acid
• salicylic alcohol 2%

They are applied to the affected areas of the skin with the capture of some area around with a cotton swab or swab 2-4 times a day, at the beginning of the treatment, the child will feel a burning sensation and pain for a short time. After the liquid antiseptic has dried, ointment can be applied to the skin.

From folk remedies that have long been adopted by official medicine, the doctor can recommend you decoctions of chamomile, string or oak bark, which are well-known antiseptics. Use them as lotions, for rinsing healthy skin, compresses and dressings on affected areas, but not as a main treatment, because. with this pathology, antibiotics are indispensable.

Antibiotics in the treatment of streptoderma

Antibiotics for streptoderma in children are used in the form of local forms and orally (systemically) according to strict indications. No one will start systemic antibiotic treatment for a solitary rash on the face or hands that responds well to topical therapy. At the same time, to abandon this method in common forms, especially with the addition of general symptoms, and even more so in severe cases, is at least unreasonable.

A special group of drugs are ointments with hormones, which are prescribed in certain cases for a short time. With prolonged use, they cause a decrease in the protective properties of the skin and increase its vulnerability to any infection, therefore, with streptoderma, they are prescribed only in a short course, according to strict indications and with certain symptoms.

It is possible to carry out such an inexpensive local treatment for mild forms of streptoderma. You will need: zinc ointment (30 rubles), levomycetin tablets (20 rubles), levomycetin alcohol (20 rubles). First, the affected area and the surrounding tissue are treated with chloramphenicol, the wound is treated with fucorcin or brilliant green, then allowed to dry. Next, make a mixture of zinc paste / ointment with chloramphenicol tablets crushed into powder, mix thoroughly. And lubricate the wound with this composition in the morning and evening.

Systemic treatment of streptoderma with antibiotics

Most often, antibiotics of the penicillin series are used for these purposes. Other groups of antibiotics, macrolides or cephalosporins, are used if the child has recently received penicillins for some other reason, with allergic reactions to them, or in the absence of sensitivity to these drugs, detected by microbiological examination.

Similarities and differences of streptoderma from other diseases

There are many skin diseases that at one stage or another can be similar to streptoderma (dermatosis herpetiformis, which has nothing to do with herpes, juvenile pemphigoid, skin tuberculosis, exudative erythema multiforme, etc.), and the diagnosis can be difficult even for an experienced dermatologist, so it is better to leave this question, as well as the appointment of additional tests, to the doctor.

pyoderma

Strictly speaking, streptoderma is just one of the varieties of pyoderma. Any skin purulent-inflammatory disease is called pyoderma. But, since streptococcus, due to its specific properties, forms transparent, rather than cloudy pus, and a special kind of vesicles (more like viral than bacterial), streptoderma stands somewhat apart from other types of pyoderma, which are usually similar to each other regardless of the pathogen .

Mixed streptococcal-staphylococcal (vulgar) impetigo. The onset of the disease is absolutely identical, with the addition of a staphylococcal infection, the contents of the blisters become cloudy, acquire a yellowish color. The treatment is almost the same. In both cases, the exact selection of an effective antibiotic is possible only after a microbiological study, and before its results, an ointment with a broad-spectrum antibiotic, usually including both streptococci and staphylococci, is prescribed.

Herpes

Streptococcal congestion differs from herpes by the rapid opening of conflicts with the formation of cracks in the corners of the mouth, while with herpes, vesicles with transparent contents remain much longer, and after their opening, cracks, as a rule, do not occur (see).

The cutaneous form of streptoderma usually develops around an initially existing damage to the skin, herpes - on unchanged skin. Older children and adults may notice that the characteristic itching at the site of future rashes appears long before they appear, while with streptoderma, only already formed elements of the rash will itch.

Candidiasis of the corners of the mouth

At the same time, the cracks are deeper, and on the mucosa there are changes characteristic of thrush (white dotted rashes, similar to semolina).

Chicken pox

Since the rash with chickenpox begins on the face and head, at first it can be mistaken for the debut of streptoderma, but with the rapid spread of elements throughout the body and after the temperature rises, there is usually no doubt about the diagnosis of chickenpox (see).

allergic rash

There is an atypical allergic rash in the form of transparent vesicles, which is difficult to distinguish from the elements of streptoderma at the beginning, until the vesicles have formed. An allergic rash turns pale when pressed, in contrast to rashes with streptoderma (see).

syphilitic rash

In addition to the classic rash with syphilis, there are many atypical types of it. For example, erosive syphilitic papules of the corners of the mouth. Unlike the elements of streptoderma, they are surrounded by a more pronounced halo of inflammation, which extends far to the mucous membranes. Therefore, do not be surprised if your doctor prescribes such a serological test as the Wasserman reaction. How can a child have syphilis? In close contact with the patient, syphilis is transmitted by household means through common household items - dishes, towels, personal hygiene items, linen - if the patient has open syphilitic ulcers (see.

Prevention

Since streptoderma is contagious, it requires the isolation of a sick child from the team, and quarantine for 10 days is imposed on peers who have been in contact with him. During this time, symptoms of streptoderma may appear in other children. Most often, outbreaks occur in kindergartens, as young children do not follow the rules of hygiene, love soft toys and have very close contact with each other during play.

When treating streptoderma at home, careful prevention of the spread of infection is required. Compliance with hygiene is important both for the sick person himself, in order to avoid introducing the pathogen to healthy areas of the skin and re-infection, and for his family members in order to exclude their disease. This is no less important than drug therapy and topical treatment.

Prevention of the disease in general, without contact with the sick person, comes down to careful observance of the rules of personal hygiene, hardening (air, sunbathing) and a complete balanced diet rich in vitamins.

Streptoderma is an infectious disease caused by opportunistic pathogens. Severe skin lesions most often occur in children and women. In the absence of timely treatment, dangerous complications are possible.

Causes of the disease

The causative agent of the disease is group A hemolytic streptococcus. The pathogenic microorganism affects not only the skin.

The negative impact of streptococcal infection on the heart and kidneys was noted. Allergic dermatitis and serious autoimmune diseases often occur.

Factors provoking streptoderma:

• reduced immunity;
• sunburn;
• frostbite;
• stressful situations;
• skin microtrauma;
• chronic diseases;
• hormonal imbalance in the body;
• overwork;
• lack of vitamins;
• varicose veins;
• abrasions;
• obesity;
• inadequate skin care;
• use of shared dishes, towels, toothbrushes.

Symptoms of the disease

The disease is characterized by unpleasant manifestations. There are painful sensations, the skin has a repulsive appearance. In many cases, the general condition of the patient worsens.

Signs of streptoderma:

• The skin turns red, a small bubble (conflict) appears on the affected area, filled with a muddy liquid of a dirty yellow color.
• Education increases rapidly, reaches 1-2 cm. With some types of disease, conflicts grow up to three centimeters.
• Sometimes a large number of blisters leads to the appearance of a continuous affected surface in a certain area of ​​​​the body.
• After maturation, the bubble bursts, an ulcer appears with remnants of the skin around the edges.
• The opened conflict dries quickly, dense crusts form.

All stages of the development of the disease are accompanied by burning, itching. The patient combs the skin, the infection spreads to healthy areas. How is streptoderma transmitted? When using shared pillowcases, household items, towels, the infection can affect family members.

Complications
Treatment must begin immediately. The tendency to allergies and the lack of timely therapy increases the sensitivity of the affected skin. Other pathogenic microbes penetrate through wounds and cracks.

Running dry streptoderma often leads to microbial eczema. The presence of a new form of the disease is evidenced by inflammation of the sores and separating drops of cloudy serous fluid.

Types of disease
The concept of streptoderma includes several types of infectious skin lesions. Streptococci are the causative agents of all types of the disease.

Varieties of pathology:

• Streptococcal impetigo. Localization of foci - the lateral surfaces of the face, trunk, limbs. Blisters often merge, annular impetigo appears.
• Simple deprive. Localization - the area of ​​\u200b\u200bthe lower jaw, skin areas on the cheeks, around the mouth. Most often, this type of streptoderma affects children.
• bullous impetigo. Conflicts are located on the back side of the cyst. In some cases - on the legs and feet. Bubbles increase to 2–3 cm, dried wounds itch and cause suffering.
• Streptococcal rash. Most of the sick are small children and obese people. Localization of foci - under the mammary glands, in the armpits, intergluteal or inguinal-femoral folds. Obesity affects the abdomen.
• Tourniol (impetigo of the nail folds). The causes of skin lesions are hangnails, wounds, injured areas through which streptococci penetrate.
• Angular stomatitis. This type of impetigo is known to most people. The manifestations of the disease are popularly called "zaeds". Conflicts are in the corners of the mouth. Occasionally, inflamed areas with dried crusts are located in the corners of the eyes and on the wings of the nose. Causes - prolonged wearing of prostheses, lack of B vitamins, rhinitis, eye infections, teeth affected by caries.

Treatment of streptoderma in children

The delicate skin of a child is poorly protected from the penetration of pathogens. Damage to vulnerable skin is easy. Due to age and misunderstanding of some things, children themselves often provoke the development of a streptococcal infection.

In kindergartens and schools, the risk of the disease increases. Microbes easily penetrate through cuts, scratches and abrasions. Lack of timely treatment leads to serious complications. The disease spreads easily among healthy children in contact with a carrier of streptoderma. So how to treat streptoderma in children?

The disease in children often occurs with complications. To the local inflammatory process and unbearable itching is added:

• heat;
• general weakness.

Diagnosis of streptoderma in children
A visit to a pediatrician and a dermatologist will help establish an accurate diagnosis. Before visiting a doctor:

• write down the date of detection of the first signs of the disease;
• assess the condition of the child;
• analyze the rate of spread of infection;
• measure the temperature.

Detailed information will help the specialist to establish the correct diagnosis. In addition to the examination, the doctor will prescribe a culture of the contents of sores and blisters.

Effective test:

• sets the pathogen;
• shows to what type of antibiotics in streptoderma the pathogenic microorganism is sensitive.

Important! Do not prescribe antibiotics yourself! Taking drugs will blur the picture of the disease and change the results of bacterial culture.

How and how to treat children's streptoderma
It is not worth joking with the disease. Many parents make the mistake of stopping therapy at the first sign of recovery. Microorganisms become resistant to antibiotics, the disease is more difficult to treat.

Basic rules for the treatment of streptoderma in children:

• limit contacts of a sick child with healthy peers;
• high temperature - the basis for bed rest;
• rubbing and bathing are prohibited - the infection can spread to new areas;
• watch the length of the nails and the cleanliness of the hands of the child;
• change underwear and bed linen every day;
• wash the floor well, ventilate the room;
• distract the child, do not let the sores be combed;
• prepare dietary meals for the patient;
• exclude spicy, sweet and salty foods from the menu;
• bake or boil food.

Medicines and folk methods:

How to cure streptoderma? Here are some ways:

• local treatment. Lubricate the affected areas with brilliant green, a solution of potassium permanganate, fucorcin;
• a good effect is given by antibacterial ointments for streptoderma: streptocid or tetracycline;
• wet-drying dressings with a decoction of plantain, chamomile, calendula will relieve itching and burning;
• jams are lubricated with 1 or 2% silver nitrate. The frequency of the procedure - up to three times during the day;
• prevents the spread of infection by lubricating the nails with iodine. The procedure is carried out daily;
• with a tendency to allergic reactions, antihistamines Suprastin, Diazolin, Claritin are prescribed. The dosage is determined by the doctor depending on the age of the patient;
• in severe cases, ultraviolet irradiation in the physiotherapy room may be required;
• strengthen immunity. Include in the menu in the absence of contraindications according to the age of the child garlic, onions, vitamin complexes;
• you need to drink plenty of water: a decoction of chamomile, linden or calendula, fruit drink and compote of their berries. Ask if your child is allergic to these foods and medicinal herbs.

Important! The serious condition of the child and large areas of skin affected by the infection are a reason for inpatient treatment in the infectious diseases hospital. Small children diagnosed with streptoderma are also observed in the hospital.

Treatment in adults

The propensity of many people to experiment often harms the sick. When the first signs of streptoderma are found, untested home remedies, dubious tinctures and ointments are often used. Many without culture results self-prescribe antibiotics. How to quickly cure streptoderma?

Remember! The advice of non-specialists often leads to complications. Visit a dermatologist and follow their recommendations.

How to treat streptoderma in adults:

• At the first sign of illness, apply dressings with an aqueous solution (0.25 silver nitrate or 1–2% resorcinol). As soon as the bandage dries, change to a new one. The duration of the session is one and a half hours, the break between procedures is 3 hours. Wet-drying dressings reduce inflammation, relieve itching, heal sores.
• While changing the bandage, wipe the healthy skin around the blisters with salicylic or boric alcohol.
• Lubricate the erosion sites with tetracycline or streptocid ointment. Each dressing is applied for 12 hours.
• Treat dried crusts with disinfectants: erythromycin ointment, rivanol (3%).
• With severe inflammation of the adjacent areas, the doctor will prescribe potent hormonal ointments Lorinden A, C, Triderm. Prolonged use leads to thinning of the skin. When using hormonal drugs, the control of a dermatologist is mandatory.
• With an increase in lymph nodes, an increase in temperature, take antibiotics. Preparations of the group of cephalosporins or penicillins will be prescribed by the doctor based on the results of bacterial culture.
• To reduce itching, take antihistamines: Claritin, Suprastin, Telfast.
• Follow a healthy diet. Steam or bake dishes.
• Take vitamins and immunomodulating drugs.
• The effective action of pyrogenal has been proven.

After removing the acute inflammatory process, the doctor often prescribes physiotherapeutic procedures. The greatest antibacterial effect gives UV irradiation of the affected areas.

Helpful Hints:

• Follow the rules of personal hygiene.
• Treat your hands with disinfectants. Lubricate your fingers with iodine solution.
• Do not share utensils and towels.
• Wash and iron bed and underwear frequently.
• Limit contact with family and friends.
• Strengthen your immune system.

Treatment during pregnancy

Infectious disease in the absence of timely treatment negatively affects the fetus. Symptoms of streploderma make the expectant mother nervous and worried about the health of the baby.

Basic rules for the treatment of strepdothermia during pregnancy:

• Seek medical attention at the first sign of skin lesions. Only a highly qualified dermatologist can treat pregnant women.
• Take antibiotics prescribed by your doctor. In most cases, the disease is successfully treated with topical antibacterial drugs.
• Do not pop bubbles yourself.
• Treat healthy skin with disinfectants.
• Cover affected areas with sterile dressings.
• Drink vitamin preparations.
• Try not to scratch the sores - the infection will spread to new areas.

How to get rid of the disease at home

Streptoderma is a disease in which the use of folk recipes must be approached very carefully. Properly selected remedies relieve inflammation well and dry the sores.

The use of unverified recipes will only harm the patient and cause complications. Doctors recommend the use of medicinal herbs.

Folk remedies and recipes

• Moisten wet-drying dressings with a decoction of chamomile or oak bark. These compresses have an excellent antiseptic effect.
• Bathing and showering during the treatment of streptoderma are prohibited. Clean healthy skin with wet wipes soaked in a decoction of chamomile or calendula.
• To increase immunity, take echinacea tincture, rosehip decoction, viburnum berries crushed with sugar, honey and lemon.

The precautions are very simple:

• Wash your hands regularly.
• Take care of your skin.
• Boost your immunity.
• Treat wounds, cuts, scratches in a timely manner.
• Monitor the work of the endocrine system.
• Eat right.
• Teach your children the rules of personal hygiene.
• Do not use someone else's dishes and towels.

Now you know how to treat streptoderma with medications and folk remedies. Try to prevent disease. At the first sign of skin lesions, consult a dermatologist.

TV show "Live healthy" about streptoderma:

The article tells about which microorganisms provoke the appearance of streptodermic rashes on the body. We will introduce you to the existing varieties of the disease. We will tell you why some people are vulnerable to streptococcal infection, while the immunity of others does not allow it to enter the body. After reading the article, you will learn what needs to be done to alleviate the course of streptoderma and quickly cure the disease.

What is streptoderma

Streptoderma (pyoderma streptococcus) is a group of skin infections caused by beta-hemolytic streptococci. This type of bacteria is part of the microflora of our skin. They behave "peacefully", as the immunity of a healthy person maintains a balance between opportunistic and beneficial microflora.

Streptococci begin to multiply actively when local immunity weakens. Bacteria enter the body through scratches, cuts, and even through microscopic breaks in the skin. After that, on certain parts of the patient's body, foci of inflammation characteristic of streptoderma appear.

Note. The penetration of a streptococcal infection into the human body is also possible if its skin is affected by atopic dermatitis, an allergic rash, chickenpox or other skin disease. Therefore, streptoderma in adults often develops as a secondary skin disease.

Causes

Streptoderma is a contagious disease. It is transmitted from person to person by airborne droplets (the patient coughs and bacteria get on the skin of healthy people) and household contact (through someone else's dishes, hygiene items).

If a person has a strong immune system, then it immediately suppresses the activity of infectious agents that try to penetrate his skin. But if streptococci got on the skin of a person with a weakened immune system, then the infection soon (after 7-10 days) makes itself felt by the appearance of a streptodermic rash (small acne with a clear liquid).

Streptoderma is one of the varieties of pyoderma. To find out what it is and how to treat this group of diseases, read this material.

Local (skin) immunity in an adult can decrease for the following reasons:

• Chronic skin diseases (psoriasis, atopic dermatitis).
• Hypothermia and overheating of the body (metabolic processes in the skin are disturbed).
• Lack of vitamins and minerals in the body.
• Violation of the pH of the skin (acid-base balance).
• Endocrine diseases (diabetes and diabetes insipidus, obesity).
• Hyperhidrosis (excessive sweating).
• Violation of the rules of personal hygiene.
• Unhealthy diet combined with physical exhaustion.

Any of these items can provoke the development of an infectious process.

Types of pathology

Streptoderma can be acute and chronic. The disease is also distinguished by the depth of the lesion of the skin, which is superficial and deep.

These factors have led to the fact that streptococcal infection was divided into types. The superficial form of pathology began to be called - streptococcal impetigo, deep - ecthyma vulgaris. These two types of streptoderma differ from each other in the symptoms of occurrence and the nature of the course:

• Streptococcal impetigo. The development of the disease begins with the appearance of small red spots on the skin. After a few hours, they are transformed into small blisters with transparent contents. At first, the blister covers are tense, then they become soft. Their contents become cloudy and turn into pus. Pimples either dry up and exfoliate without leaving scars on the skin, or burst, after which their contents dry up forming crusts, which then exfoliate without a trace.
• Ordinary (vulgar) ecthyma. Pathology begins with the appearance on the skin (more often on the lower extremities) of a large blister filled with pus, sometimes with an admixture of blood. A few hours later, the lid of the blister is opened, in its place an ulcerative wound is formed, from which purulent exudate is constantly released. After recovery, a rough scar remains at the site of the ulcer, as it heals for a long time.

From the following video, you will learn how weeping streptoderma differs from dry, and the deep form of the disease from the superficial one:

Note! The infectious process can be diffuse and intertriginous in nature. In the first case, the elements of a streptoderma rash occupy large areas of the skin of the body, in the second, purulent infectious foci are located in the folds of the skin. In this case, the infection does not affect the appendages of the skin (nail plates, hair), which distinguishes streptoderma from other infections (for example, staphylococcal impetigo, which affects the hair follicles).

Streptococcal impetigo

Pathology includes 5 clinical varieties, the symptoms of which most often occur in adults.

What is impetigo and how it can be cured, you can find out if you read this article.

bullous form

This type of disease has the following features of development and course:

• Bullae (blisters, blisters) slowly increase in size. They have dense walls and ripen for a long time.
• The appearance of blisters on the skin is accompanied by severe itching.
• Bubble formations are most often localized on the legs (feet, shins) and the outside of the hands.
• Inside the bullous blisters contains pus, sometimes with an admixture of blood.
• Bullae never appear on damaged skin, nor on the joints of the extremities.
• The disease does not take a chronic form.

Important! If left untreated, severely immunocompromised patients develop fever and swollen lymph nodes.

Patients with bullous eruptions are limited to water procedures. Their treatment takes place in a hospital according to the following scheme:

1. Bulls are opened. The weeping skin around them is treated with a disinfectant solution (hydrogen peroxide, brilliant green, boric acid lotion, etc.).
2. Healing ulcers and blisters that cannot be opened (without pus) are treated 3-4 times a day with anti-inflammatory ointments. At the discretion of the doctor, they can have a hormonal and non-hormonal basis (Triderm, Advantan, Skin-Cap).
3. With severe itching, the patient is prescribed an antihistamine (Cetrin, Zirtek).
4. If bullous streptoderma is severe, then the patient is prescribed drugs that suppress the immune system ("Dexamethasone" - a hormonal glucocorticoid or "Methotrexate" - a cytostatic drug).

Note! To eliminate the risk of skin infection, immediately after opening and treating the blisters, the patient is not allowed to go home. The patient is being dressed in the hospital.

Another name for the pathology is lichen simplex. Streptococcal disease develops in adults as follows:

1. Initially, scaly pink and white rounded spots appear on the skin of the face (under the nose, on the chin, behind the ears).
2. Then dry infectious foci quickly spread throughout the body (limbs, lower back, buttocks). The elements of the rash reach 3-4 cm in diameter. The patient is not bothered by anything other than a cosmetic defect.
3. In the presence of adequate treatment, the disease lasts 7-14 days. After exfoliation of flaky crusts, age spots remain on the skin, which disappear within 2-3 months.

Since with dry streptoderma there are no blisters with purulent contents on the diseased skin, then the treatment of this form of pathology will differ from the above:

• For the purpose of disinfection, the skin affected by dry streptoderma is treated with brilliant green or iodine solution (healthy areas that surround the foci are captured).
• Then apply the antibiotic ointment "Erythromycin" (applied to wounds 2-3 times a day).
• To accelerate epithelialization and restore the affected skin, an ointment with vitamins A and E (Radevit) is used.
• If a drug allergy occurs, antihistamines are taken (Diazolin, Claritin).

Recommendation. You can remove pigmentation and accelerate the restoration of the natural skin tone using ultraviolet irradiation, i.e. sunbathing or attending special physiotherapy sessions.

Superficial panaritium

Pathology is also known as tourniole (circumference) and impetigo of the nail folds. The infection affects the skin around the nails. The disease develops as follows:

• The nail folds become inflamed and turn bright red.
• Near the nail plate, blisters form with transparent serous contents, which quickly turn into pus.
• After the lid of the blister opens, an ulcer forms in its place.
• The infected finger remains swollen and painful all the time.

Note! In the absence of treatment, rejection of the nail plate, fever, general malaise, and an increase in the elbow lymph nodes are possible.

Treatment of superficial panaritium can occur as follows:

• If the disease is advanced, then surgical excision of the skin of the nail fold and its purification from pus is performed. In order to quickly heal the wound, the patient is prescribed disinfectant baths with a pale pink solution of potassium permanganate. Applying a bandage with antibacterial ointment ("Erythromycin", "Levomekol").
• Conservative treatment (without surgery) of impetigo of the nail folds is carried out with the use of local broad-spectrum antibiotics (2% "Lincomycin"), disinfectants ("Chlorhexidine"), as well as drugs that improve blood microcirculation and accelerate the recovery of damaged tissues ("Dipromonium" , "Trental").

slit-like impetigo

Another common name for this pathology is streptococcal seizure. The disease appears in adults due to a lack of B vitamins (vital nutrients) in the body. And also against the background of chronic infections (rhinitis - inflammation of the nasal mucosa, caries - destruction of tooth tissues).

Pathology develops as follows:

• An itchy tight nodule appears in the corner of the mouth.
• After some time, the knot bursts.
• In its place, a painful crack appears, which soon becomes covered with a crust.

It is best to start treating streptococcal seizures as soon as you feel itching in the corner of your lips. Thus, you can prevent the painful development of the process and the appearance of a cosmetic defect on the face.

For this purpose, it is enough to treat the itchy focus with an antiseptic (a solution of fucorcin, iodine) several times a day.

But if the streptococcal focus has managed to develop, then in order to heal it as soon as possible, in addition to the indicated antiseptics, an ointment (Triderm, Trimistine) should be applied 2-3 times a day.

Streptococcal diaper rash

The problem of body diaper rash occurs not only in newborns, but also in adults, usually in persons who suffer from obesity. Streptococcal diaper rash appears on those parts of the body where there are skin folds (on the neck, under the breast, under the armpits, in the sides, in the buttocks, abdomen and groin).

The development of the process of streptococcal diaper rash in adults:

• Inflammation of the skin folds - redness, swelling (cause of rubbing with clothes, lack of hygiene).
• If left untreated, small blisters appear in the folds of the skin, then cracks sometimes bleed.
• Pathogenic microorganisms (streptococci) penetrate the skin.
• The patient suffers from itching and pain, which are constantly present in the affected area.

Important! If the disease is not completely cured, then a secondary infection of the skin with streptococci occurs. As a result, the pathology takes a chronic form, from which it is almost impossible to get rid of.

For the treatment of different stages of streptococcal diaper rash, doctors recommend the following steps:

• The first stage (reddening of the skin). Wash your skin with laundry soap foam - it has a drying effect. You can also use talcum powder to dry diaper rash. 2 - 3 times a day, treat redness with sterile (boiled in a steam bath) vegetable oil.
• The second stage (redness, cracks, erosion). Treat the inflamed areas 3 times a day with antiseptics (calendula tincture, alcohol solution of salicylic or boric acid). Apply ointments with a regenerating effect (Panthenol, Solcoseryl) 2-3 times a day. The duration of treatment is 5 - 7 days. From burning and itching, an antihistamine drug, for example, Diazolin, will help.
• The third stage (secondary infection has occurred). In this case, the doctor prescribes physiotherapy sessions (UV irradiation, Minin lamp - blue lamp) - provides a disinfecting effect, improves blood microcirculation, and helps to restore the skin.

Important! At stage 3 of the disease, the use of oils, ointments and healing creams is contraindicated (slow down wound healing), such diaper rash is treated with lotions (1% tannin solution, 0.25% silver nitrate solution).

Ecthyma vulgaris

Ecthyma is a disease in which bacteria (streptococci, sometimes simultaneously with staphylococci) penetrate into the deep layers of the skin. Pathology is primary (appears due to skin injury, for example, after scratching insect bites) and secondary (occurs as a complication of a skin disease, for example, atopic dermatitis). Ecthyma has two stages of development: pustular and ulcerative.

Pustular

A dense painful knot appears on the skin. A few hours later, a small blister with bloody contents forms on its top. The blister gradually increases (can reach 2 cm in diameter). Its base acquires a bluish or bright red hue.

Within 5 - 7 days the blister dries up and turns brown. The dried element peels off the skin on its own 2-3 weeks after treatment. In its place remains a pigment spot.

It is very important to start treatment of a disease such as ecthyma as soon as possible, so as not to lead to a chronic form.

Pustules (from 1 to 6 elements appear with ecthyma) are treated with an antiseptic up to 4 times a day (furatsilin solution, Streptocid powder). The patient is prescribed vitamins of group B (they have a general strengthening effect on the body).

Ulcerative

If the crust is removed from pustular ecthyma immediately after it dries, then a wound with inflamed edges will appear in its place. Its bottom will consist of a purulent plaque.

Ulcerative ecthyma is difficult to heal, so antibiotics are used to treat it. In the absence of drug therapy, infection can enter the lymph nodes, which subsequently threatens the patient with blood poisoning.

For purulent wounds, the patient is prescribed antibiotics "Lincomycin" or "Cephalexin". Sessions of ultraviolet radiation or UHF therapy (ultra high frequency therapy). Local preparations: tetracycline ointment, Levomekol.

With any kind of streptoderma, there is a need for antiseptic solutions and local remedies. In the following video, a dermatologist will tell you the names of the most effective drugs:

Medicines for streptoderma, prepared according to folk recipes, can be ointments, infusions and decoctions. For their manufacture, special plants, bee products and vegetable oils are used.

Healing nut ointment

Ingredients:

1. Walnut leaves - 3 pcs.
2. Sunflower oil - 100 g.
3. Beeswax - 1 tsp

How to cook: chop green leaves with a knife, put in a glass jar, pour sunflower oil. Close the lid and put in a dark place for 7 days. Then sterilize the composition in a water bath for 3 hours. Strain through cheesecloth and sterilize for another 30 minutes. In order for the ointment to acquire the desired density, add beeswax to it.

How to apply: 2 - 3 times a day, treat the inflamed skin with the composition.

Result: walnut ointment has an antimicrobial, anti-inflammatory and wound healing effect. Stimulates and strengthens skin (local) immunity.

Compress for weeping erosions

Ingredients:

1. Garlic juice.
2. Ground black pepper.

How to cook: take the indicated ingredients in the same amount (1: 1), mix thoroughly.

How to apply: soak a bandage folded several times with a healing composition, apply it for 5 to 10 minutes to a weeping wound or abscess.

Result: the agent cleanses and disinfects the wound, improves blood microcirculation, and has a drying effect.

Cure for severe itching

Ingredients:

1. Series.
2. Sage.
3. Verbena.
4. Oak bark.
5. Steep boiling water - 1 l.

How to cook: pour 3 g of each herb into a thermos, pour boiling water over it and close the lid. Let the composition brew for 30 minutes, then strain.

How to apply: soak a piece of bandage with warm medicine and apply to the affected skin. If a streptodermic rash occupies large areas of the body, then take a therapeutic bath (add 1 liter of infusion to 10 liters of water).

Result: herbal collection helps with itching, relieves inflammation, dries abscesses, restores the skin.

Question answer

How long does it take to cure streptoderma in adults?

If skin treatment was started in the first days of the development of pathology, then recovery occurs after 7-14 days. If later, then the course of treatment can last more than 4 weeks.

Is it possible to use hormonal ointments to treat streptoderma?

Such drugs should be prescribed by a doctor after examining the patient. The indications for the use of hormonal ointment are the following symptoms: the development of streptoderma against the background of other skin diseases (atopic and allergic dermatitis), allergies to antiseptic and antibacterial drugs, chronic course of the disease.

Treatment of streptoderma can drag on for a long time if you choose the wrong ointment.

Is it possible to swim with extensive streptodermic rashes?

Since moisture and heat contribute to the active reproduction of streptococci, bathing should be abandoned in the first 3-5 days of illness. During this period, carry out hygiene procedures using decoctions of antiseptic herbs (chamomile, string).

How long after treatment with an antiseptic of the affected skin can an ointment be applied to it?

How long is a person infected with streptoderma infectious?

The disease is transmitted from a patient to a healthy person while the incubation period lasts (7-10 days), and also while acne and yellow crusts are present on the skin. It turns out that a person is a danger to others until he is completely cured.

What to remember

1. Streptoderma is a group of infectious diseases caused by streptococci on the skin.
2. Pathology affects the skin of the face, limbs, lower back and buttocks.
3. The disease is contagious, transmitted from a sick person to a healthy person for the entire period of illness (about 2 weeks).
4. The risk group includes diabetics, people with weakened immune systems, people suffering from other skin diseases (allergic and atopic dermatitis).
5. Streptoderma can be treated not only with medications, but also with folk remedies.