What is erysipelas. Erysipelas - what is this disease and how to treat it? In what areas does it develop more often?

Erysipelas (erysipelas) is an infectious-allergic disease that affects the mucous membranes, subcutaneous fat, and skin. It is caused by beta-hemolytic streptococcus, which is why it often recurs. A contagious infectious disease is accompanied by a bright red edema of the affected tissues, intoxication, fever, high temperature. With improper or delayed treatment, erysipelas is complicated by an abscess, secondary pneumonia, purulent inflammation of the fiber (phlegmon).

Erysipelas disease - what is it

Infectious pathology is provoked by pyogenic streptococcus, which affects:

• mucous membranes;
• skin;
• subcutaneous fat.

In the people, erysipelas is called erysipelas. The incubation period ranges from 5-6 hours to 5 days.

What does the lesion look like:

• erythematous (red) spots form on the skin;
• infected tissues swell;
• serous-hemorrhagic foci with vesicles are formed.

In terms of prevalence, erysipelas ranks fourth among other infectious pathologies.

Causes leading to erysipelas

Streptococcus pyogenes is the causative agent of erysipelas, which belongs to opportunistic pathogens. It is a representative of the normal microflora of the laryngopharynx and skin of more than 75% of people. The main source of infection is a carrier of pyogenic streptococci or a person with erysipelas.

Pathogenic microorganisms are transmitted by contact and aerosol, that is, by airborne droplets. The risk of penetration of erysipelas into the body increases when the integrity of the skin is violated. The entry gate for Streptococcus pyogenes is:

• scratches;
• abrasions;
• ulceration on mucous membranes;
• microcracks on the genitals, etc.

With proper timely therapy, erysipelas ends in complete recovery. But with complications, the prognosis is not so optimistic. The disease occurs with a strong weakening of the immune defense. The provocateurs of erysipelas include:

• vitamin deficiency;
• chronic tonsillitis;
• rheumatism;
• scarlet fever;
• myocarditis;
• hypovitaminosis;
• glomerulonephritis.

Streptococci secrete toxic substances (pyrogenic exotoxins, streptolysin), which destroy the cells of the body. They increase vascular permeability, so severe swelling occurs in the affected areas.

Who is more susceptible to the disease

The incidence of erysipelas is on average 20 cases per 10,000 population. Women get sick much more often than men, which is associated with the instability of the hormonal background, the use of contraceptives. In 30% of cases, the pathology is caused by impaired lymph flow and blood flow in the lower extremities.

The risk group includes:

• women after 55-60 years;
• newborns with an umbilical wound;
• suffering from chronic diseases;
• people with the third blood group.

Much more often, erysipelas occurs in people with varicose veins, pathologies of the upper respiratory tract - tonsillitis, sinusitis, chronic rhinitis. Erysipelatous infection enters the body through postoperative wounds, post-traumatic scars, etc.

Classification and symptoms of erysipelas

The modern clinical classification includes various forms of erysipelas, depending on the location, the extent of the foci, the nature of local manifestations, etc. According to the multiplicity of the flow, the following types of erysipelas are distinguished:

• primary - manifests itself for the first time, affects mainly the skin of the face;
• repeated - occurs 2-3 years after the primary infection, but with a different localization;
• recurrent - the infection worsens at intervals of 3-4 months, sometimes more often.

Depending on the localization, there is an erysipelas on the face, legs, back, arms. In adults, the first two types of pathology are more common.

According to the nature of local symptoms, the following forms of erysipelas are distinguished:

• erythematous form. It begins with severe itching, redness and pain in the infected tissues. The first signs appear within 5-6 hours after the penetration of streptococcus into the skin. A day later, a spot with uneven edges forms in the lesion. Due to severe redness and swelling, pain worsens, a feeling of fullness. The patient feels unwell, fever, weakness in the body. In the acute period, an increase in lymph nodes is possible, which are located next to the focus of erysipelas.
• Erythematous bullous. Bubbles with a clear (serous) fluid appear on the skin and mucous membranes. The bullous form is characterized by ulceration of the tissues against the background of the opening of the vesicles. There are also symptoms of fever and lymphadenitis, that is, inflammation of the lymph nodes.
• Erythematous-hemorrhagic. It is diagnosed most often in women over 50 years of age. Erysipelas often affects the perineum, face, and legs. At the site of erythematous spots, hemorrhages occur, which is associated with damage to superficial vessels. The hemorrhagic form is characterized by prolonged fever (up to 14 days).
• Bullous-hemorrhagic. The most severe form of erysipelas, in which vesicles with serous-bloody contents form in the lesions. When the cheeks are infected, areas of necrosis are formed. Because of this, noticeable scars and scars remain, which do not resolve for a long time.

Erysipelas goes through four stages: redness, blistering, ulceration, wound healing. The likelihood of complications depends on the severity:

• Light. Erythematous rashes are limited to small areas of the skin, the symptoms of intoxication are mild. Feverish condition with subfebrile temperature (up to 38°C) lasts no more than 3 days.
• Average. The fever lasts up to 5 days, and the temperature rises to 40°C. Other manifestations of erysipelas are pronounced: weakness, vomiting, headache. The lesions are represented by bullous-hemorrhagic or erythematous-bullous rashes.
• Heavy. Intoxication is pronounced strongly, due to which loss of consciousness is possible. High temperature lasts more than 5 days. In places of tissue infection, complications arise - phlegmon, gangrenous changes.

If the focus goes beyond the anatomical zone, erysipelas infection is considered common (diffuse). A migratory form of erysipelas is also distinguished, in which inflammation subsides in one and aggravates in another part of the body. The most dangerous is metastatic erysipelas. It is characterized by simultaneous damage to tissues remote from each other.

Possible Complications

Hemolytic streptococcus provokes inflammation of damaged blood vessels and tissues. In this regard, erysipelas are complicated:

• purulent pustules;
• phlebitis;
• secondary pneumonia;
• sepsis.

The recurrent form is accompanied by stagnation of the lymph, which causes lymphedema. Also, the possible consequences of erysipelas include phlegmon, persistent skin pigmentation, hyperkeratosis (thickening of the outer layer of the epidermis), eczema. If untreated, erysipelas infection leads to gangrenous changes in the skin and mucous membranes.

Diagnosis of erysipelas

At the first symptoms of erysipelas, they turn to a dermatologist or an infectious disease specialist. The doctor draws attention to the acute onset of pathology, intoxication, severe edema, reddening of tissues, regional lymphadenitis. To determine the causative agent of infection is carried out:

• PCR diagnostics;
• blood chemistry;
• general urine analysis.

The presence of beta-hemolytic streptococcus is indicated by a decrease in the level of antistreptococcal antibodies. Erysipelatous infection should be distinguished from anthrax, scleroderma, dermatitis, Lyme disease, thrombophlebitis, lupus erythematosus.

How is erysipelas treated

The first manifestations of erysipelas are a significant reason for going to the doctor. In 73% of cases, pathology is treated on an outpatient basis. With a severe course of pathology, purulent-necrotic complications, patients are placed in a hospital.

Specific therapy involves taking systemic antibiotics. In the bullous form, physiotherapy is prescribed with the opening of the blisters and local treatment of wounds with antiseptics.

How to treat erysipelas with antibiotics

Treatment of erysipelas is carried out with antibiotics from the group of fluoroquinolones, macrolides, tetracyclines, penicillins, cephalosporins. To destroy a streptococcal infection, the following drugs are used:

• Erythromycin;
• doxycycline;
• Ciprofloxacin;
• Benzylpenicillin;
• Levomycetin;
• Sulfadiazine;
• Azithromycin.

With frequent relapses of erysipelas, antibiotics of two different groups are used simultaneously. Bullous erysipelas is treated with beta-lactams and lincosamides, which include Lincomycin, Clindamycin, Dalacin, etc. The course of antibiotic therapy is from 5 to 10 days.

Medications to relieve symptoms

Pathology is accompanied by severe pain, nausea, itching, malaise, fever. To stop the main manifestations of erysipelas, the following are used:

• antiallergic drugs (Diazolin, Zirtek) - reduce swelling, itching and burning;
• nitrofuran antibiotics (Furadonin, Furazolidone) - inhibit the reproduction of streptococci, destroy their membrane membranes;
• glucocorticosteroids (Betamethasone, Prednisolone) - eliminate puffiness, normalize the outflow of lymph from the lesions;
• proteolytic enzymes (Hyaluronidase, Trypsin) - improve tissue nutrition, dissolve infiltrates.

Also, the treatment of erysipelas involves the use of biostimulants that accelerate tissue healing - Pentoxyl, Methyluracil, etc.

Treatment of the skin around the lesion

To prevent the spread of streptococcal infection, topical antimicrobials are used. For the treatment of the skin of the face and body with erysipelas, the following are used:

• Enteroseptol;
• Oxycyclosol;
• Dimexide;
• microcide;
• Furacilin.

Sterile gauze soaked in an antiseptic is applied to the focus so that the edges of the bandage capture 2 cm of healthy skin. The procedure is performed twice a day for 1.5-2 hours. Erysipelas on the legs and back are treated with powder from crushed Enteroseptol tablets. If the lesion occupies more than 20 cm 2 of the skin, Oxycyclozol spray is used.

Local hygiene

During the period of exacerbation of erysipelas, the patient does not pose a danger to others. But to prevent the spread of infection, he must:

• Change underwear and bedding once a day;
• wear clothes only from natural fabrics;
• take a shower daily without using washcloths;
• wash the area of ​​​​inflammation with a decoction of coltsfoot three times a day;
• at the healing stage, treat ulcers with Kalanchoe juice.

It is undesirable to wet damaged tissues with water until they are completely healed. If an erysipelas infection is localized in the groin area, the skin is washed twice a day with a decoction of calendula.

Physiotherapy

The principles of physiotherapy treatment are determined by the stage of the disease. To combat erysipelas and local manifestations, apply:

• UVI - irradiation of blood with ultraviolet light. It is used at the first sign of erysipelas to reduce inflammation, fever, intoxication, and edema.
• Magnetotherapy - irradiation of the adrenal glands with electromagnetic radiation. Accelerates the production of steroid hormones that eliminate inflammation.
• Ronidase electrophoresis is the introduction of a drug into the body by means of an electric current. Stimulates the outflow of lymph from the affected areas, reduces swelling.
• UHF - heating of tissues with electromagnetic waves of ultrahigh frequency. It is prescribed on the 7th day of illness to improve blood circulation in superficial tissues.
• Infrared therapy - exposure of the skin with an infrared laser. Stimulates local blood circulation, increases the activity of immune cells.

At the healing stage, paraffin applications are used. They eliminate residual effects, prevent the exacerbation of inflammation.

How to boost immunity

Dermatological disease of erysipelas is prone to recurrence. The rate of recovery and the risk of re-infection of tissues depends on the immune status of the patient.

To prevent the reproduction of streptococci, it is necessary:

• Identify and eliminate foci of sluggish inflammation. Carry out antibacterial therapy of chronic tonsillitis, rhinorrhea, sinusitis.
• Restore the intestinal microflora. It is recommended to take drugs with lactobacilli, include fermented milk products in the diet.
• Stimulate the activity of immune cells. To strengthen the immune system, take supplements with echinacea, pink rhodiola.

To restore strength, you need to normalize sleep and wakefulness. At least 8 hours a day are allocated for rest.

How to get rid of erysipelas with folk remedies

Alternative medicine stimulates tissue healing and inhibits the reproduction of pyogenic streptococcus. To combat erysipelas, the following recipes are used:

• Beans. Dried fruits are crushed in a meat grinder. Wet wounds on the body are sprinkled with powder 2 times a day.
• A mixture of herbs. Celery juice and chamomile infusion are mixed in equal proportions. 1 tsp liquids are poured into 15 ml of melted butter. Leave the product in the refrigerator until completely solidified. Ointment is used to treat wounds with severe pain.
• Celery. A bunch of greens is crushed in a blender. The pasty mass is wrapped in gauze and applied to the lesion for 1 hour. Perform the procedure twice a day.

It is undesirable to use folk remedies for purulent and hemorrhagic complications.

Prognosis of treatment and prevention of erysipelas

Erysipelatous disease with adequate antibiotic therapy ends in complete recovery. The prognosis worsens with weakened immunity - hypovitaminosis, HIV infection, chronic pathologies. Mortality from complications (gangrene, phlegmon, sepsis) does not exceed 4.5-5%.

To prevent recurrence of erysipelas, you must:

• observe personal hygiene;
• avoid diaper rash;
• prevent trophic ulcers;
• wear loose clothing;
• use shower gels with pH up to 7.

Personal prevention consists in the timely disinfection of lesions of the mucous membranes and skin. Compliance with the rules of antiseptics when treating abrasions, eliminating foci of sluggish inflammation in the body prevents exacerbation of erysipelas.

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

Among other infectious diseases, erysipelas is (in terms of prevalence) immediately behind the leading three - respiratory, intestinal diseases and hepatitis. The largest number of cases of erysipelas (as the disease is usually called for brevity) occurs in summer and autumn, at this time about 20 people out of 10 thousand fall ill. In spring and winter, this figure is halved.

What it is?

The name of the disease in translation means - "red skin". Redness, which affects the face, legs (most often the lower leg and feet), and sometimes even mucous membranes, is accompanied by a sharp jump in temperature and general intoxication of the body.

Pathogenesis (the mechanism of the origin and development of the disease) was well known to ancient physicians, including Hippocrates. But only in 1882, Dr. Feleisen was able to prove that erysipelas is an infectious disease. Its causative agent - beta-hemolytic streptococcus from group A - appears in the body, taking advantage of scratches, abrasions and other damage to the skin.

The disease is omnivorous, but it has its own preferences. So, elderly people are at risk, but women are mostly prone to relapses. There is also medical statistics, according to which the owners of the III blood group are more susceptible to erysipelas than others.

In children under one year old, the disease can begin if streptococcus gets into the umbilical wound, for small patients this is a mortal danger.

ICD-10 code

Erysipelas, according to the international classification used by physicians, is included in the section "other bacterial diseases" (A30-A49) of class I. The code for erysipelas is A46.

Causes of erysipelas on the leg: what causes the disease?

Getting into the human body for infection is not difficult, even tiny skin lesions are enough, not to mention such ideal options as:

• scratches;
• insect bites;
• traces of scratching (after the same bites or allergic rashes);
• burns;
• diaper rash;
• trauma;
• cracks (usually on the heels).

There are other causes of the focus of the disease - for example, an old streptococcal infection in people with untreated caries. As long as a person's immunity is strong, he copes with such problems. However, if any chronic “sore” takes away all the strength from a person and the immune system is seriously weakened, then a microscopic bite, and even caries, can become provoking factors for erysipelas.

In addition to problems with immunity, the danger is:

• stress and strong feelings;
• a sharp change in the temperature regime in the environment;
• sunburn abuse;
• regular hypothermia of the legs.

All these factors favor the activation of the erysipelas pathogen. The infection actively "clings" to people suffering from obesity, diabetes, as well as to those diagnosed with thrombophlebitis and varicose veins.

Is it contagious to others or not?

Erysipelas is contagious, like any other infectious disease, transmitted from person to person. Ways of transmission of infection - contact and airborne. Therefore, those who care for the sick should beware of too close communication, avoid cuts and injuries, do not wear the things of the sick person, do not use his towel.

Fortunately, erysipelas is recognized as slightly contagious (this is how experts call diseases with a low degree of danger to others): in order for a person to get sick, it is not enough to get infected, it is necessary that the negative concomitant factors that we talked about in the previous chapter converge, and this happens extremely in practice. rarely.

Characteristic signs and symptoms

The incubation period lasts from 3 to 5 days. The onset of the disease, most often, is an acute period, with a sharp jump in temperature. Symptoms indicate a general intoxication of the body. It:

• excruciating headache;
• fever and chills;
• vomit;
• muscle aches;
• convulsions;
• severe weakness.

General symptoms are joined by local ones. For erysipelas, the local symptom is redness of the skin area, for example, on the leg - it not only changes its color, but also swells, begins to shine, due to the fact that the skin is very tense.

Another characteristic feature is demarcation ridge formation with jagged edges on the border of healthy and diseased skin. If you press your finger on the red spot, it will turn pale for a few moments, and then the redness will return. To the touch it is warmer than undamaged areas of the skin. In addition, the patient experiences a strong burning sensation.

In this disease, there is also an inflammatory reaction to the infection of the lymph nodes under the knees and in the groin.

If the form of the disease is complicated, the following symptoms appear in the area of ​​\u200b\u200binflammation:

• hemorrhages;
• bubbles filled with clear liquid;
• blisters with bloody or purulent filling.

Classification: types, forms, stages

Inflammation begins and proceeds with varying degrees of severity. It largely depends on the form and stage of the disease.

Forms of the disease

Most experts adhere to the classification in which the disease presented in four forms:

In addition to those listed, experts have previously singled out one more, fifth form. It was called gangrenous (or necrotic). In the modern classification, this form is described as a complication caused by erysipelas.

stages

This classification takes into account the severity of the course of the disease. There are 3 stages of intoxication:

• mild (maximum temperature - 38.5 ° C, small areas of infection);
• medium (temperature about 40 ° C can last up to 5 days);
• severe (extensive area of ​​the lesion, critical temperature, loss of consciousness, signs resembling meningitis).

Kinds

Depending on the nature of the distribution of foci of inflammation, erysipelas can be:

• localized (foci of inflammation are grouped in one place - on the face, legs or back);
• migratory (the disease can change location);
• common;
• megastatic.

And according to the multiplicity of the course, the disease happens:

• primary (usually inflammation is localized on the face);
• repeated (the disease manifests itself after 2 years, the place of localization of inflammation may be different than the first time);
• recurrent (inflammation affects the same surfaces, the intervals between outbreaks of the disease may be different).

Photo of erysipelas on the leg (initial stage): what it looks like

Methods for diagnosing a skin disease

In the diagnosis of erysipelas, a visual examination of the patient is important. The doctor needs to exclude diseases with similar symptoms - for example, thrombophlebitis or an abscess.

In addition, a general blood test and a bacteriological examination are carried out to help determine the causative agent of the disease and which antibiotics it may be sensitive to.

Which doctor treats erysipelas of the lower extremities

The erysipelas is treated by a dermatologist and an infectious disease specialist. The involvement of such specialists as an immunologist, endocrinologist, allergist, phlebologist, surgeon (if the disease has caused complications and surgical treatment is required) depends on how the disease proceeds.

Erysipelatous inflammation of the skin of the legs: treatment of adults and children

The disease is treated comprehensively. Mild forms - on an outpatient basis, severe - in a hospital.

Any special therapeutic diet for a patient with erysipelas is not required. The main thing is that the food is liquid, varied and well absorbed.

Ointments

The focus of erysipelas is not recommended to be washed and wetted. It can be washed with a solution of some antiseptic (for example, potassium permanganate).

From ointments can be used:

• Iruksol (antibiotic) - the course of treatment is 7-10 days;
• Erythromycin (antibiotic);
• Tetracycline (antibiotic);
• Levomekol - stimulates regeneration;
• Naftalan - before use, it is heated to 38 o.

As for such popular remedies as Vishnevsky's liniment and ichthyol ointment, they are not used to treat erysipelas. Bandages with these drugs can provoke the formation of an abscess.

Antibiotics

Antibiotics are the most effective way to fight bacteria. The medicine can be prescribed in the form of injections (5 times a day) or tablets for up to 10 days. Among the recommended drugs:

• ceftriaxone,
• erythromycin,
• amoxicillin,
• Doxycycline.

If antibiotics are contraindicated for the patient, they are replaced with Furazolidone or Delagil.

Physiotherapy procedures

Depending on the severity of the disease, the doctor selects different types of physiotherapy:

Infrared laser therapy and paraffin therapy help to achieve a positive effect.

Surgical intervention

Surgery comes to the rescue in the treatment of the bullous form of the disease, in cases where there are purulent-necrotic complications. The doctor opens the bullae, drains the infected tissue.

How to treat folk remedies at home

Mild forms of erysipelas can be treated at home, including folk remedies. Since the impetus for the development of the disease is often the transferred stress, and the nature of the problems is psychosomatics, then the methods of influencing the infection can be psychotherapeutic. In folk medicine, these are conspiracies and various unusual manipulations that help, as a rule, those people who believe in their power.

So, one of the means of treating erysipelas is a red rag (usually used cotton). Chalk is poured on it and bandaged to the sore leg. The bandage is changed twice a day and the redness disappears fairly quickly. Treat itching by rubbing apple cider vinegar on the affected area. In medicine, such manipulations are skeptical.

More traditional - compresses, whose task is to remove inflammation from the skin, have an antiseptic effect and accelerate regeneration. Here are a couple of options:

• burnet compress (prepared from a pharmacy tincture diluted with boiled water);
• from burdock (a fresh leaf is applied to the sore spot).

Possible consequences and complications

The disease is dangerous with relapses that occur even in cases where erysipelas has been well treated. According to medical statistics the relapsing form threatens almost a third of patients. At the same time, in 10% of them, an outbreak of infection will make itself felt in six months, and in 30% in 3 years.

A relapse can lead to diseases such as lymphostasis and elephantiasis, which are treated with medication, self-medication is excluded.

Other possible consequences of erysipelas are long-lasting redness, swelling and peeling of damaged tissues (treated with creams and infusions) and the formation of purulent wounds if the form of the disease was bullous (treated with anti-inflammatory drugs).

Prevention measures

Immunotherapy for this disease has not been developed. The only recommended pharmaceutical that can help the body resist infection is Bicillin, which is injected once a year. Prevention measures are practically the same as those that are useful for other infectious and skin diseases:

• carry out antiseptic treatment at home if one of the relatives is sick with erysipelas;
• strengthen immunity by playing sports;
• avoid stress, conflict situations as much as possible;
• in the presence of any streptococcal infection, without delay, proceed to treatment;
• be more careful in nutrition - stale foods are an ideal environment for hemolytic streptococcus;
• do not wear overly tight clothing that can rub the skin and does not allow air to pass through.

Millions of people in the world are infected with infectious diseases every day. One of them is erysipelas, which has long been known to medicine.

Erysipelas disease - what is it

Erysipelas is an acute infectious disease caused by beta-hemolytic streptococcus. It is characterized by the appearance of redness on the skin, accompanied by fever and general intoxication of the body (including headache, weakness and nausea).

There are 2 forms of erysipelas:

• Erythematous. In other words, the initial stage. The patient has a burning sensation, pain, swells and the place of inflammation becomes hot. Sometimes there are punctate hemorrhages.
• bullous. It is characterized by the presence of bubbles containing a clear liquid. After a few days, they dry out, forming a crust on the skin.

In both forms, inflammation is accompanied by damage to the lymphatic system.

Important! Primary erysipelas most often appears on the face, while relapses of the disease have "chosen" the lower limbs of a person. The duration of the disease is 5-8 days. Residual manifestations of erysipelas can remain for life if you do not resort to the help of cosmetologists.

Features of the structure of the skin on the legs, arms and face

The skin is the largest human organ and consists of three layers. It weighs approximately 15% of the total body weight. She has various structural features on her legs, arms and face. For example, the skin on the soles of the feet has a high concentration of sweat pores. In this place, its thickest layers.

The skin on the palms lacks hair follicles and sebaceous glands. The inner side of the hands is characterized by great elasticity, thinness and softness. On the face, or rather on the eyelids, there is the thinnest layer of skin on the entire human body. In the region of the eyelids, auricles, forehead and nose, the skin does not have a lower layer. Facial skin is the most susceptible to aging.

Causes of the disease

Erysipelas disease - is it contagious to others? The cause of the disease is a streptococcal infection that has entered the soft tissues. Its source is a streptococcus carrier. Most often, the “entrance door” for microorganisms into the human body is minor injuries, abrasions, cuts in the skin or mucous membranes.

Who is at risk?

According to statistics, people over the age of 18 most often suffer from erysipelas. Moreover, in 65% of cases, doctors diagnose erysipelas in people older than 50 years. Often, men and women are infected with the infection, whose work is associated with microtraumatization and contamination of the skin. Erysipelas can also provoke neglect of personal hygiene.

Symptoms of erysipelas

There are 7 main symptoms of erysipelas:

1. Development of a fever(convulsions, delirium).
2. Manifestation of symptoms of intoxication(including headache, chills).
3. On limited areas of the skin burning sensation, itching. There are painful sensations when interacting with this area. Over time, the skin becomes redder and stronger. After a few days, swelling sets in and the pain intensifies.
4. Insomnia.
5. Elevated temperature.
6. Nausea and vomiting.
7. Weakness in the muscles.

Erysipelas in a child - the first signs

Erysipelas in children occurs almost always in the spring and autumn. The initial phase in babies is faster and more acute than in adults. However, the first signs and symptoms of the disease are the same. A distinctive feature is only heartburn, which is experienced by 99% of infected children.

Important! Girls get sick twice as often as boys.

Diagnostic measures

Diagnosis of erysipelas disease is carried out on the basis of clinical symptoms and the results of laboratory tests that indicate the presence of a bacterial infection. After that, the dermatologist draws up a treatment plan.

Treatment

How to treat erysipelas? There are several treatments for erysipelas. All of them are divided into 3 types:

• Medical treatment. It has been scientifically proven that hemolytic streptococci, which provoke the disease, are highly sensitive to nitrofurans, penicillin antibiotics and sulfonamides. This means that drugs containing penicillins, erythromycin, oleandomycin, clindamycin will be useful in the fight against the disease. They can be taken either orally or by injection. Treatment lasts 5-7 days. After 1-3 days from the moment of its onset, the temperature returns to normal, the inflamed areas gradually turn pale. After 10 days, an antibacterial agent biseptol is prescribed. For topical application, that is, directly for use on the affected areas of the skin, the doctor prescribes erythromycin ointment and powder in the form of crushed tablets, which contain enteroseptol. Drug treatment is often supplemented with biostimulants and vitamins.
• Physiotherapy. In this case, we are talking about ultraviolet irradiation, which has a bacteriostatic effect on active bacteria. It is often given to patients with erythematous erysipelas. In the treatment of relapses of the disease, ultra-high frequency and laser therapy are sometimes used. But short-term freezing of the surface layers of the skin with a stream of chloroethyl until whitening, in combination with antibacterial therapy, is practiced in cases where the disease is particularly acute.
• Surgery. It should be noted that the need for this method of treatment arises when the patient has a bullous form of erysipelas or purulent-necrotic complications. During the operation, the bullae are opened and the pathological fluid is evacuated. Only antiseptic agents are applied locally.

Prevention

First of all, it is necessary to monitor the cleanliness of the skin, treat various wounds and cracks, and treat pustular diseases in a timely manner. And also, during medical manipulations, observe asepsis and use only sterile instruments. Then the risk that a person will undergo erysipelas is minimized.

Consequences of erysipelas

In addition to the typical residual effects of erysipelas, which include peeling of the skin and its pigmentation, lymphedema, that is, the accumulation of protein-rich fluid in the interstitial space, can become a more severe consequence. In this case, surgical intervention is necessary in combination with physical anti-edematous therapy.

Restoration of the skin after the disease

To restore the skin after erysipelas, both cosmetology and an independent fight against the consequences of the disease can help. Before using any medication, it is better to consult a specialist.

Treatment of erysipelas at home - folk recipes

To combat the disease at home, they often use:

• pork fat. They smear the affected skin 2 times a day.
• Kalanchoe juice. It is preserved with alcohol to a strength of no more than 20%, then a napkin is dipped in it and in a five percent solution of novocaine, after which it is applied to the inflamed area.
• Plantain. The plant is crushed and mixed with honey. After that, boil and apply a bandage with a cooled ointment to the skin, changing it every 4 hours.

Important! Some of the remedies that people have been trying to treat erysipelas at home for several centuries not only do not contribute to recovery, but can also cause even more harm to human health. These include, for example, chipping the affected area of ​​the skin with mercury salts.

Video: erysipelas in adults - causes and treatment.

The skin is the outer cover of the human body with an area of ​​about 1.6 m2, which performs several important tasks: mechanical protection of tissues and organs, tactile sensitivity (touch), thermoregulation, gas exchange and metabolism, protection of the body from the penetration of microbes.

But sometimes the skin itself becomes the object of attack by microorganisms - then dermatological diseases develop, among which is erysipelas.

Erysipelas (erysipelas) - what is it?

Erysipelas is an acute diffuse inflammation of the skin (less often mucous membranes) of infectious origin, usually affecting the face or lower legs.

Erysipelas is caused by group beta-hemolytic streptococcus BUT when it penetrates into the thickness of the skin through minor abrasions, cuts, insect bites, scratches, abrasions.

Erysipelas is more common in men of working age and in women over 45 years of age. For children under the age of one year, it is a mortal danger (photo 3).

The prevalence of the disease is high - the fourth place after acute respiratory infections, gastrointestinal infections and hepatitis.

Group A beta-hemolytic streptococcus

Group A β-hemolytic streptococcus itself (GABHS) was discovered relatively recently (150 years ago), but mankind has been familiar with the diseases it causes for a long time.

Angina, pharyngitis, laryngitis, scarlet fever, rheumatism, severe damage to kidney tissue - this is not a complete list of pathological conditions caused by GABHS. The Ministry of Health states that the damage to the economy from β-hemolytic streptococcus is 10 times greater than the damage from all viral hepatitis.

It belongs to the conditionally pathogenic microflora, because it is present in almost all people in the oral cavity, respiratory tract, skin and external genitalia. Good immunity limits its virulence (degree of infectivity).

GABHS very quickly spreads through the air, through the digestive tract and objects, so it is usually detected in rooms where children and labor groups stay for a long time, 57.6% of sore throats and 30.3% of acute respiratory infections are caused by it.

Streptococci survive when frozen and heated to 70°C for 2 hours; in dried biomaterial (blood, pus), they remain highly infectious for several months. Toxins cause severe heart and kidney disease.

For children, the carriage of the pathogen in the upper respiratory tract is more characteristic. When examining schoolchildren, BHSA is isolated in the nasopharynx by 20-25% of children.

Causes of erysipelas of the legs

The cause of erysipelas of the legs can be small abscesses, boils and carbuncles, purulent wounds. The spread of dangerous streptococcus in the skin can be facilitated by frequent hypothermia of the legs or excessive sunbathing, causing microtrauma of the skin.

Erysipelas on the leg is very often the result of other serious diseases:

• diabetes;
• varicose veins;
• thrombophlebitis;
• trophic ulcers;
• fungal infection;
• alcoholism;
• obesity.

Stressful situations that sharply reduce immunity can give impetus to the attack of streptococcus on its carrier.

Chronic foci of infection in the form of destroyed teeth, enlarged tonsils 5-6 times increase the risk of erysipelas in any part of the body.

Symptoms of erysipelas of the leg, photo

A week later (on average) after the introduction of the pathogen into the skin, an acute onset of the disease occurs.

Suddenly there are signs of intoxication:

• severe weakness,
• temperature up to 40°C with chills,
• excruciating headache,
• aches in bones and muscles,
• sometimes - nausea and vomiting.

During the day, symptoms of erysipelas appear on the lower leg: the affected area swells sharply, shines from tension and turns red. The name "erysipelas" comes from the word "red" in some European languages.

The inflamed area is separated from healthy skin by a demarcation roller. Its uneven scalloped outlines along the perimeter of the lesion are characteristic. Severe reddening of the skin is caused by hemolysis - the process of destruction of red blood cells (erythrocytes) by streptococcus.

When pressed with a finger, the redness disappears for a few seconds. The lesion is warmer to the touch than the surrounding tissue.

Pain and burning cause great suffering to the patient. The popliteal and inguinal lymph nodes become inflamed. In the direction of them from the affected area under the skin, dense reddish stripes are visible - lymphatic vessels, lymphangitis develops.

Diagnosis of erysipelas

Often the diagnosis is made without tests, according to the totality of general and local symptoms.

In other diseases, local symptoms often appear first, and only after them does intoxication appear.

Laboratory tests may confirm the presence of β-hemolytic streptococcus.

Forms of erysipelas of the leg

Based on the nature of local changes, there are:

1. Erythematous form- the site has a bright uniform color and clear boundaries.

2. Erythematous-hemorrhagic form- on the affected area, against the background of general redness (erythema), there are multiple pinpoint hemorrhages - a sign of damage to the blood capillaries.

3. Erythematous bullous(bulla, lat. - bubble) form - with it, on the third day, the upper layers of the skin are stratified with the formation of blisters.

The liquid in them contains a large mass of streptococci with a high degree of virulence, therefore, when opening the blisters, it is necessary to carefully carry out antiseptic treatment. Heal with the formation of a crust, under which smooth skin is formed.

4. Bullous-hemorrhagic form - in the blisters is an opaque bloody fluid.

5. Gangrenous form with areas of skin necrosis.

stands out wandering form when, within a few days, the lesion shifts to a neighboring area, and the primary focus flakes off and heals.

This form is typical for newborn children, with the rapid spread of erysipelas, children may die.

According to the severity of the disease are distinguished:

• mild form (the affected area is small, the temperature is not higher than 38.5 ° C),
• moderate (several small lesions, temperature up to 40 ° C for no more than 5 days)
• a severe form, when bullous-hemorrhagic elements cover almost the entire body, the temperature is critical for several days, loss of consciousness, delirium and signs of meningitis.

The inflamed area of ​​the skin remains sensitive to streptococcal infection even after healing, which gives grounds for the diagnosis of “repeated” and “recurrent” erysipelas.

Mild forms of erysipelas can be treated on an outpatient basis. Severe and advanced cases require inpatient treatment.

1) The first and main appointment is antibiotics in the form of intramuscular injections or orally. Penicillin antibiotics have retained their effectiveness in the fight against hemolytic streptococcus.

They are combined with taking oleandomycin, furazolidone, erythromycin for one to two weeks.

2) Their action is enhanced by sulfanilamide preparations (biseptol).

3) Be sure to prescribe vitamins and biostimulants (levamisole, pentoxyl, methyluracil) to restore immunity and the fastest healing of the focus.

4) Non-steroidal drugs are prescribed as anti-inflammatory and antipyretic drugs: aspirin, diclofenac, ibuprofen, baralgin, reopirin.

5) In case of severe intoxication, glucose solution or reopyrin is repeatedly injected.

6) To relieve intoxication, plenty of fluids and diuretics are prescribed.

7) Physiotherapeutic procedures:

1. ultraviolet irradiation in the acute period has a bacteriostatic effect;
2. lidase electrophoresis,
3. ozokerite,
4. magnetotherapy.

The last three procedures improve lymph flow, preventing the development of elephantiasis.

8) Antihistamines prevent sensitization of the body.

9) Sclerotherapy - the introduction into the affected veins of a substance that causes narrowing and resorption of the vessel - promotes the rapid healing of blisters and the healing of the inflamed skin area.

10) Endovasal laser coagulation - leads to the disappearance of the lumen in diseased veins, preventing the development of lymphostasis.

11) Surgical treatment of the lesion:

1. opening the blisters, treating them with a solution of furacillin, enteroseptol in the form of powder, erythromycin ointment;
2. excision of inflamed veins and necrotic areas.

12) In severe cases, a blood or plasma transfusion is performed.

Treatment of erysipelas of the leg is carried out by a doctor. In order to avoid complications, the patient must strictly comply with all medical prescriptions, even with outpatient treatment.

In the treatment of erysipelas at home it's important to know:

1) You can not tightly bandage the affected area, only light bandages are allowed, which are changed several times a day after antiseptic treatment of the skin.

2) You can not use and - they increase the influx of interstitial fluid and slow down the healing process;
excessive softening of the skin with ointments will lead to additional infection of the wounds.

3) After opening the blisters, you can treat the erosion with hydrogen peroxide and dry the skin under them with powder, which includes:

• boric acid (3 g),
• xeroform (12 g),
• streptocide (8 g).

From above, cover the wound surface with a two-layer gauze.

Complications of erysipelas

Erysipelatous inflammation can go away on its own: after two weeks from the onset of the disease, the redness subsides, but the swelling and pigmentation of the skin remains for a long time. There is a high chance of a repeat process.

With insufficiently active treatment, erysipelas causes general and local complications. It is especially dangerous for patients with diabetes mellitus, allergies, varicose veins and thrombophlebitis, with heart failure and HIV infection.

There is a danger of developing pneumonia, sepsis and meningitis.

Streptococcus toxins cause rheumatism, myocarditis and glomerulonephritis.

Local complications are phlegmons and abscesses, trophic ulcers and lymphostasis (elephantiasis), in which the volume of limb tissues increases sharply due to the accumulation of interstitial fluid and thickening of the skin.

Elephantiasis develops in 15% of all cases of erysipelas. It is accompanied by such phenomena as papillomas, eczema, lymphorrhea (lymph effusion from thickened pigmented skin). All this greatly complicates the life of the patient.

The prognosis after erysipelas on the legs depends on the severity of the disease and the body's immunity.

Recurrent forms often develop when staphylococcal flora is also attached to GABHS.

Due to acquired lymphostasis, working capacity may be reduced.

In general, the prognosis for the patient's life is favorable if complications have been avoided.

Prevention of erysipelas

There is no specific prevention. To prevent erysipelas, some general and local measures must be observed.

• limit contact with patients with erysipelas, after contact, carry out antiseptic treatment of their skin;
• take care of strengthening immunity by establishing a daily routine, physical education, avoiding stressful situations;
• eliminate foci of chronic streptococcal infection in time, monitor the state of health;
• establish proper healthy nutrition - hemolytic streptococcus multiplies rapidly in stale food, giving particular preference to meat broths;
• in order to avoid relapses after erysipelas, year-round carry out prophylactic injections of bicillin.

Local Measures:

• pay more attention to your feet - wash them regularly, avoid blisters and scuffs, minor cuts, hypothermia and overheating;
• monitor the condition of the venous system and contact a specialist in time.

Erysipelatous inflammation mkb 10

In the international classifier of diseases ICD 10, erysipelas is:

Class I
- A30 - A49 Other bacterial diseases

• A46 Erysipelas