Erysipelas on the arm. Erysipelas: symptoms of infection. Statistics and facts

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

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

What kind of disease is erysipelas on the arm?

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

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

Causes of the disease

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

The occurrence of pathology is possible as a result of:

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

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

Provoking factors

Inflammation in the hand can be triggered by:

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

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

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

Cream unambiguously effective remedy to combat all types of fungal infections both on the skin and on the nails.

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

Typical symptoms of erysipelas on the arm

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

Otherwise, primary and characteristics development of erysipelas are as follows:

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

Sometimes the first symptoms are similar to ordinary dermatitis. That is why, when the first dangerous signs You can't put off going to the doctor. If similar symptoms suddenly appear, you should not hesitate to call an ambulance or go to the nearest clinic. By the way, the disease is observed in older people during horticultural work so you have to be vigilant.

IT'S IMPORTANT TO KNOW!

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

The inflammation begins with:

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

At first, the face has acute course and the symptoms are not specific. Through 1-2 days there is a strong intoxication of the body, some even have hallucinations and delusions. Could happen toxic injury kidneys, heart. The patient is nauseated, shivering, sleepy. On the initial stage erysipelas is similar to the flu.

Features of erysipelas on the arm

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

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

In children, the disease usually occurs in mild form, but the elderly are more difficult to tolerate. The feverish condition can last about 2 months, often worsening all chronic diseases in the body. Erysipelas tend to recur and are poorly treated. Those who are ill with suspected illness should not delay contacting a dermatologist, immunologist or infectious disease specialist.

Features of erysipelas on the leg

It has the following properties:

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

Complications

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

New erysipelas can subsequently lead to:

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

All this indicates untimely treatment and progression of the disease.

Complications usually result from untimely appeal to doctors, self-treatment, joining secondary infection. The risk group includes people with diabetes mellitus, HIV-infected people who have had meningitis, pneumonia.

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

Treatment

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

For the treatment of erysipelas appoint:

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

Lack of treatment can lead to serious complications and lethal outcome. Self-medication with erysipelas is excluded. Only qualified specialist will be able to direct the treatment in the right direction.

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

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

Patients with erysipelas are not contagious. Women get sick more often than men. More than 60% of cases of erysipelas are carried by people aged 40 and older. The disease is characterized by a distinct summer-autumn seasonality.

Erysipelas symptoms

The incubation period of erysipelas is from several hours to 3-5 days. In patients with a recurrent course, the development of the next attack of the disease is often preceded by hypothermia, stress. In the vast majority of cases, the onset is acute.

The initial period of erysipelas is characterized rapid development general toxic effects, which in more than half of the patients for a period of several hours to 1-2 days ahead of the occurrence local manifestations illness. Are celebrated

headache, general weakness chills, muscle pain
25-30% of patients develop nausea and vomiting
already in the first hours of the disease, the temperature rises to 38-40 ° C.
on areas of the skin in the area of future manifestations, a number of patients develop a feeling of fullness or burning, mild pain.

The height of the disease occurs within a period of several hours to 1-2 days after the first manifestations of the disease. General toxic manifestations and fever reach their maximum. There are characteristic local manifestations.

Most often, erysipelas are localized on lower limbs, less often on the face and upper limbs, very rarely only on the trunk, in the area of the mammary gland, perineum, in the area of the external genital organs.

Skin manifestations

First, a slight red or pink spot, which within a few hours turns into a characteristic erysipelatous redness. Redness is a clearly delimited area of the skin with uneven boundaries in the form of teeth, "tongues". The skin in the area of redness is tense, hot to the touch, moderately painful to the touch. In some cases, you can find a "marginal roller" in the form of raised edges of redness. Along with reddening of the skin, its edema develops, spreading beyond the redness.

The development of blisters is associated with increased effusion at the site of inflammation. If the blisters are damaged or spontaneously rupture, fluid flows out, superficial wounds appear in place of the blisters. While maintaining the integrity of the blisters, they gradually shrink with the formation of yellow or brown crusts.

The residual effects of erysipelas, which persist for several weeks and months, include swelling and pigmentation of the skin, dense dry crusts in place of the blisters.

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

Diagnosis of erysipelas

Diagnosis of erysipelas is carried out by a general practitioner or infectious disease specialist.

certain diagnostic value have elevated titers of antistreptolysin-O and other antistreptococcal antibodies, detection of streptococcus in the blood of patients (using PCR)
Inflammatory changes in the general blood test
Violations of hemostasis and fibrinolysis (increased blood levels of fibrinogen, PDF, RKMF, increase or decrease in the amount of plasminogen, plasmin, antithrombin III, increase in the level of platelet factor 4, decrease in their number)

Diagnostic criteria for erysipelas in typical cases are:

acute onset of illness severe symptoms intoxication, an increase in body temperature to 38-39 ° C and above;
predominant localization of the local inflammatory process on the lower extremities and face;
development of typical local manifestations with characteristic redness;
increase lymph nodes in the area of inflammation;
absence of severe pain in the focus of inflammation at rest

Erysipelas treatment

Treatment of erysipelas should be carried out taking into account the form of the disease, the nature of the lesions, the presence of complications and consequences. Currently, most patients with mild erysipelas and many patients with moderate forms are treated in a polyclinic. Indications for mandatory hospitalization in infectious diseases hospitals (departments) are:

severe course;
frequent relapses of erysipelas;
the presence of severe general concomitant diseases;
old age or childhood.

The most important place in the complex treatment of patients with erysipelas is occupied by antimicrobial therapy. When treating patients in a polyclinic and at home, it is advisable to prescribe antibiotics in tablets:

erythromycin,
oletethrin,
doxycycline,
spiramycin (course of treatment 7-10 days),
azithromycin,
ciprofloxacin (5-7 days),
rifampicin (7-10 days).

In case of intolerance to antibiotics, furazolidone (10 days) is indicated; delagil (10 days).

It is advisable to treat erysipelas in a hospital with benzylpenicillin, a course of 7-10 days. At severe course diseases, the development of complications (abscess, phlegmon, etc.), a combination of benzylpenicillin and gentamicin, the appointment of cephalosporins are possible.

With severe inflammation of the skin, anti-inflammatory drugs are indicated: chlotazol or butadione for 10-15 days.

Patients with erysipelas need to prescribe a complex of vitamins for 2-4 weeks. In severe erysipelas, intravenous detoxification therapy is performed (hemodez, reopoliglyukin, 5% glucose solution, saline) with the addition of 5-10 ml of a 5% solution ascorbic acid, prednisone. Cardiovascular, diuretic, antipyretic drugs are prescribed.

Treatment of patients with recurrent erysipelas

Treatment of recurrent erysipelas should be carried out in a hospital setting. It is mandatory to prescribe reserve antibiotics that were not used in the treatment of previous relapses. Cephalosporins are prescribed intramuscularly or lincomycin intramuscularly, rifampicin intramuscularly. The course of antibiotic therapy - 8-10 days. When especially persistent relapses two-course treatment is advisable. Consistently prescribe antibiotics that optimally act on streptococcus. The first course of antibiotic therapy is carried out with cephalosporins (7-8 days). After a 5-7-day break, a second course of treatment with lincomycin is performed (6-7 days). With recurrent erysipelas, immunity correction is indicated (methyluracil, sodium nucleinate, prodigiosan, T-activin).

Local therapy for erysipelas

Treatment of local manifestations of erysipelas is carried out only with its cystic forms with localization of the process on the limbs. The erythematous form of erysipelas does not require application local funds treatment, and many of them ( ichthyol ointment, Vishnevsky balm, antibiotic ointments) are generally contraindicated. AT acute period in the presence of intact blisters, they are carefully incised at one of the edges, and after the release of fluid, bandages are applied to the inflammation site with a 0.1% solution of rivanol or a 0.02% solution of furacilin, changing them several times during the day. Tight bandaging is unacceptable.

In the presence of extensive weeping wound surfaces at the site of the opened blisters, local treatment begins with manganese baths for the extremities, followed by the application of the bandages listed above. For the treatment of bleeding, 5-10% dibunol liniment is used in the form of applications in the area of the inflammation focus 2 times a day for 5-7 days.

Traditionally, in the acute period of erysipelas, it is prescribed ultraviolet irradiation on the area of the focus of inflammation, on the area of the lymph nodes. Appoint applications of ozokerite or dressings with heated naftalan ointment (on the lower limbs), paraffin applications (on the face), electrophoresis of lidase, calcium chloride, radon baths. Shown high efficiency low-intensity laser therapy of a local focus of inflammation. Applied dose laser radiation varies depending on the state of the focus, the presence of concomitant diseases.

Complications

Complications of erysipelas, mainly local character, are observed in a small amount sick. Local complications include abscesses, cellulitis, skin necrosis, suppuration of blisters, inflammation of the veins, thrombophlebitis, inflammation of the lymphatic vessels. To common complications, developing in patients with erysipelas quite rarely, include sepsis, toxic-infectious shock, acute cardiovascular insufficiency, pulmonary embolism, etc. The consequences of erysipelas include persistent lymph stagnation. By modern ideas, lymph stagnation in most cases develops in patients with erysipelas against the background of already existing functional insufficiency of the lymphatic circulation of the skin (congenital, post-traumatic, etc.).

Prevention of recurrence of erysipelas

Prevention of recurrence of erysipelas is integral part complex dispensary treatment of patients suffering from a recurrent form of the disease. Preventive intramuscular injection bicillin (5-1.5 million units) or retarpen (2.4 million units) prevents relapse of the disease associated with reinfection with streptococcus.

With frequent relapses (at least 3 in the last year), continuous (year-round) bicillin prophylaxis is advisable for 2-3 years with an interval of 3-4 weeks for bicillin administration (in the first months, the interval can be reduced to 2 weeks). In case of seasonal relapses, the drug is started to be administered a month before the start of the morbidity season in this patient with an interval of 4 weeks for 3-4 months annually. In the presence of significant residual effects after suffering erysipelas, bicillin is administered at intervals of 4 weeks for 4-6 months.

Forecast and course

With adequate treatment of the lungs and moderate forms- full recovery.
Chronic lymphedema (elephantiasis) or scarring in a chronic relapsing course.
In the elderly and debilitated, there is a high incidence of complications and a tendency to frequent recurrence.

Erysipelas (or simply erysipelas) is one of the bacterial infections skin, which can affect any part of it and leads to the development of severe intoxication. The disease flows in stages, which is why mild form, which does not violate the quality of life, can turn into a severe one. Protracted erysipelas without proper treatment, ultimately, will lead to the death of the affected skin and the suffering of the whole organism.

It is important that in the presence of characteristic symptoms of erysipelas, the patient should consult a doctor, and not be treated on his own, waiting for the progression of the disease and the development of complications.

Causes of erysipelas

For erysipelas to occur, three conditions must be met:

The presence of a wound - in order for the bacteria to penetrate the skin, it is not necessary to have extensive damage to the soft tissues. A scratch, “cracking” of the skin of the legs or a small cut is enough;
If a certain microbe enters the wound - it is believed that only hemolytic streptococcus A can cause erysipelas. In addition to local damage to the skin, it produces strong toxins and disrupts the immune system. This is manifested by intoxication of the body and the possibility of erysipelas to recur (appear again, through certain time);
Weakened immunity - this factor has great importance to develop skin infections. Erysipelas practically does not occur in healthy people whose immunity is not weakened by another disease or harmful conditions life (stress, physical / mental overload, smoking, drug addiction, alcohol, etc.).

Despite the fact that the disease can occur in every person, under the above conditions, mainly people of senile age suffer. Also at risk are infants with diabetes mellitus, HIV, any oncological pathology, or taking glucocorticosteroids / cytostatics.

What is erysipelas

There are several forms of erysipelas, which differ in the severity of symptoms, severity and treatment tactics. It should be noted that they can sequentially pass one into another, so it is important to start treatment in a timely manner.

In principle, the following forms of the disease should be distinguished:

Erythematous erysipelas - manifested classic symptoms, without any additional skin changes;
Bullous form - characterized by the formation of blisters on the skin with serous contents;
Hemorrhagic (bullous-hemorrhagic) - a feature of this type of erysipelas is that the infection damages small blood vessels. Because of this, blood sweats through their wall and forms blisters with hemorrhagic contents;
Necrotic - the most severe form, in which necrosis of the affected skin occurs.

Depending on the location, the face can be on the face, leg, arm. Much less often, the infection is formed in the perineum or other parts of the body.

The beginning of erysipelas

From the moment of infection of the wound to the appearance of the first symptoms, on average, 3-5 days pass. Symptoms of erysipelas of the skin of the face, arms, legs and any other localization begin with a rise in temperature and soreness of the affected area. As a rule, on the first day of illness, a fever of no more than 38 ° C is observed. In the future, body temperature can rise to 40 ° C. Due to the action of streptococcus, the patient has all the characteristic signs of intoxication of the body:

Severe weakness;
Decreased/loss of appetite;
increased sweating;
Hypersensitivity to bright light and annoying noise.

A few hours after the temperature rise (up to 12 hours), symptoms of damage to the skin and lymphatic structures appear. They differ somewhat, depending on the location, but they are united by one sign - this is a pronounced redness of the skin. Erysipelas may spread beyond the affected area, or remain in only one area. It depends on the aggressiveness of the microbe, the body's resistance to infection and the time of initiation of therapy.

Local symptoms of erysipelas

Common signs of erysipelas on the skin are:

Severe redness of the affected area (erythema), which rises slightly above the surface of the skin. From healthy tissues, erythema is delimited by a dense roller, however, with widespread erysipelas, it may not be;
Pain when probing the area of redness;
Swelling of the affected area (feet, lower leg, face, forearm, etc.);
Soreness of the lymph nodes, next to the focus of infection (lymphadenitis);
In the bullous form, the appearance of transparent bubbles on the skin filled with blood or serous fluid (plasma).

Apart from common features, erysipelas has its own characteristics when localized in different parts body. They must be taken into account in order to suspect an infection in time and start treatment in a timely manner.

Features of erysipelas of the skin of the face

The face is the most unfavorable localization of infection. This part of the body is very well supplied with blood, which contributes to the development of pronounced edema. Lymphatic and blood vessels connect surface and deep structures, which is likely to develop purulent meningitis. The skin of the face is quite delicate, therefore it is damaged by the infection somewhat more strongly than with other localizations.

Given these factors, it is possible to determine the features of the symptoms of erysipelas on the face:

The soreness of the infected area is aggravated by chewing (if the erysipelas is located in the area mandible or on the surface of the cheeks);
Severe swelling of not only the reddened area, but also the surrounding tissues of the face;
Soreness when probing the lateral surfaces of the neck and under the chin is a sign of inflammation of the lymph nodes;

Symptoms of intoxication during infection of the skin of the face are more pronounced than with other localizations. On the first day, body temperature may rise to 39-40 ° C, severe weakness, nausea, severe headache and sweating may appear. Erysipelas on the face is a reason to immediately consult a doctor or go to the emergency room of a surgical hospital.

Features of erysipelas on the leg

There is a belief among doctors that erysipelas of the lower limb is closely related to the violation of the rules of personal hygiene. Lack of regular foot washing creates excellent conditions for the reproduction of streptococci. In this case, for their penetration into the skin, one microtrauma is enough (cracks on the feet, a small scratch or puncture).

Features of the clinical picture of erysipelas in the legs are as follows:

The infection is located on the foot or lower leg. The hip is rarely affected;
Typically in the area inguinal folds(on the front surface of the body, where the thigh passes into the trunk) can be found painful formations round shape - these are inflamed inguinal lymph nodes, which inhibit the spread of streptococcal infection;
With severe lymphostasis, swelling of the leg can be quite strong and spread to the foot, area ankle joint and shin. It is quite easy to detect it - for this you need to press the skin against the bones of the lower leg with your finger. If there is swelling, then after removing the finger, a hole will remain for 5-10 seconds.

In most cases, erysipelas of the lower extremities is much easier than with a different location of the infection. The exception is necrotic and complicated forms.

Features of the face on the hand

Streptococcal infection affects the skin of the hands quite rarely, since it is quite difficult to create a large concentration of microbes around the wound. Erysipelas on upper limb may be the result of a puncture or cut by a contaminated object. The risk group is made up of children of preschool and school age, intravenous drug addicts.

Erysipelas on the arm is most often common - it captures several segments (hand and forearm, shoulder and forearm, etc.). Since the lymphatic pathways are well developed on the upper limb, especially in the axillary region, edema can spread from the fingers to the pectoral muscles.

If you feel the inner surface of the shoulder or armpits regional lymphadenitis can be detected. Lymph nodes will be enlarged, smooth, painful.

Diagnostics

The doctor can establish the presence of erysipelas after an initial examination and palpation of the affected area. If the patient has no comorbidities, additional methods diagnostics, it is enough to use only general analysis blood. The following indicators will indicate the presence of infection:

The erythrocyte sedimentation rate (ESR) is more than 20 mm/hour. During the height of the disease, it can accelerate to 30-40 mm / h. It normalizes by the 2nd-3rd week of treatment (the norm is up to 15 mm / hour);
Leukocytes (WBC) - more than 10.1 * 10 9 / l. An unfavorable sign is a decrease in the level of leukocytes less than 4 * 10 9 /l. This indicates the inability of the body to adequately resist the infection. It is observed in various immunodeficiencies (HIV, AIDS, blood cancer, consequences radiotherapy) and with generalized infection (sepsis);
Erythrocytes (RBC) - a decrease in the level below the norm (less than 3.8 * 10 12 / l in women and 4.4 * 10 12 / l in men) can be observed when hemorrhagic erysipelas. In other forms, as a rule, it remains within the normal range;
Hemoglobin (HGB) - can also decrease, with a hemorrhagic form of the disease. The rate of the indicator is from 120 g / l to 180 g / l. A decrease in the indicator below the norm is a reason to start taking iron supplements (when prescribed by a doctor). Decreased hemoglobin level below 75 g/l - indication for transfusion whole blood or erythromass.

Instrumental diagnostics is used in violation of blood flow to the limb (ischemia) or the presence of concomitant diseases, such as atherosclerosis obliterans, thrombophlebitis, thromboangiitis, etc. In this case, the patient may be prescribed Doppler of the lower extremities, rheovasography or angiography. These methods will determine the patency of the vessels and the cause of ischemia.

Complications of erysipelas

Any erysipelas infection, with untimely treatment or a significantly weakened patient's body, can lead to the following complications:

An abscess is a purulent cavity, which is limited by a capsule of connective tissue. Is the least dangerous complication;
Phlegmon - a diffuse purulent focus in soft tissues (subcutaneous tissue or muscles). Leads to damage to surrounding structures and a significant increase in the symptoms of intoxication;
Purulent phlebitis - inflammation of the vein wall on the affected limb, which leads to its thickening and narrowing. Phlebitis is manifested by swelling of the surrounding tissues, reddening of the skin over the vein and an increase in local temperature;
Necrotic erysipelas - necrosis of the skin in the area affected by streptococcus;
Purulent meningitis - may occur when located erysipelas on the face. it serious disease, which develops due to inflammation of the membranes of the brain. Manifested by cerebral symptoms (unbearable headache, clouding of consciousness, dizziness, etc.) and involuntary tension of certain muscle groups;
Sepsis is the most dangerous complication of erysipelas, which in 40% of cases ends in the death of the patient. It's a generalized infection affecting organs and leading to the formation of purulent foci throughout the body.

You can prevent the formation of complications if you apply for medical care and do not carry out self-treatment. Only a doctor can determine the optimal tactics and prescribe therapy for erysipelas.

Treatment of erysipelas

Uncomplicated forms of erysipelas do not require surgery - they are treated conservatively. Depending on the condition of the patient, the question of the need for his hospitalization is decided. There are unequivocal recommendations only for erysipelas on the face - such patients should be treated only in a hospital.

The classic treatment regimen includes:

Antibiotic - the combination of protected penicillins (Amoxiclav) and sulfonamides (Sulfalen, Sulfadiazine, Sulfanilamide) has an optimal effect. As alternative drug you can use ceftriaxone. The recommended term of antibacterial treatment is 10-14 days;
Antihistamine - since streptococcus can compromise the body's immunity and cause allergic-like reactions, this group of drugs should be used. Currently, the best (but expensive) drugs are Loratadine and Desloratadine. If the patient does not have the opportunity to purchase them, the doctor may recommend Suprastin, Diphenhydramine, Clemastine, etc. as an alternative;
Pain reliever - for erysipelas, non-hormonal anti-inflammatory drugs (NSAIDs) are used. Preference should be given to Nimesulide (Nise) or Meloxicam, as they have the least amount adverse reactions. Alternative - Ketorol, Ibuprofen, Diclofenac. Their use should be combined with taking Omeprazole (or Rabeprazole, Lansoprazole, etc.), which will help reduce Negative influence NSAIDs on the gastric mucosa;
Antiseptic dressings with 0.005% Chlorhexidine - important component therapy. When applied, the dressing should be drenched in the solution and kept wet for several hours. A sterile bandage is applied over the bandage.

How to treat erysipelas of the skin, if any local complications or developed bullous erysipelas? In this case, there is only one way out - hospitalization in a surgical hospital and the operation.

Surgery

As already mentioned, the indications for surgery are the formation of abscesses (phlegmon, abscesses), necrosis of the skin or a bullous form of erysipelas. One should not be afraid of surgical treatment, in most cases it takes no more than 30-40 minutes and is carried out under general anesthesia(narcosis).

During the operation, the surgeon opens the cavity of the abscess and removes its contents. The wound, as a rule, is not sutured - it is left open and a rubber graduate is installed to drain the fluid. If dead tissues are found, they are completely removed, after which conservative therapy is continued.

Surgical treatment of the bullous form of erysipelas occurs as follows: the doctor opens the existing blisters, treats their surfaces with an antiseptic and applies bandages with a 0.005% Chlorhexidine solution. Thus, the addition of an extraneous infection is prevented.

Skin after erysipelas

On average, the treatment of an erysipelas infection takes 2-3 weeks. As the local inflammatory response decreases and the amount of streptococcus decreases, the skin begins to renew itself. The redness decreases and a kind of film appears on the site of the damaged area - this is the “old” skin that is separated. As soon as it is finally rejected, it should be removed by yourself. Under it should be unchanged epithelium.

During next week, peeling of the skin may persist, which is normal reaction organism.

In some patients, erysipelas can take a relapsing course, that is, appear again in the same place after a certain time (several years or months). In this case, the skin will be prone to trophic disorders, chronic edema of the limb or replacement of the epithelium may form. connective tissue(fibrosis).

Frequently asked questions from patients

Question:
How dangerous is this infection?

Erysipelas is a serious disease that is dangerous due to severe intoxication and the development of complications. As a rule, with timely treatment, the prognosis is favorable. If the patient applied after a week or more from the onset of the infection, his body is weakened by concomitant diseases (diabetes mellitus, heart failure, HIV, etc.), erysipelas can lead to fatal consequences.

Question:
How to restore the skin after erysipelas?

In almost all forms of erysipelas, this process occurs independently, without the intervention of doctors. The main thing is to eliminate the source of infection and local inflammatory phenomena. The exception is necrotic erysipelas. In this case, the skin can only be restored surgical operation(plastic skin).

Question:
Why does erysipelas occur several times in the same place? How to prevent it?

AT this case, we are talking about a recurrent form of erysipelas. Group A streptococcus has the ability to disrupt the immune system, which leads to repeated inflammatory reactions in the affected skin. Unfortunately, adequate methods relapse prevention has not been developed.

Question:
Why is Tetracycline (Unidox, Doxycycline) not mentioned in the article for the treatment of erysipelas?

Currently, tetracycline antibiotics do not use for the treatment of erysipelas. Studies have shown that most hemolytic streptococci are resistant to this drug, so it is recommended to use the following antibiotics for erysipelas - a combination of synthetic penicillin + sulfanilamide or a 3rd generation cephalosporin (Ceftriaxone).

Question:
Should physical therapy be used in the treatment of erysipelas?

No. Physiotherapy during the acute period will lead to increased inflammation and the spread of infection. It should be postponed until recovery period. Once the infection has been suppressed, magnetic therapy or UVR may be used.

Question:
Is the treatment of erysipelas different for different locations of the infection (on the face, on the arm, etc.)?

Treatment of erysipelas of the arm, leg and any other part of the body is carried out according to the same principles.

Erysipelas is one of the most common infectious diseases of the skin and at the same time is on the list of the most dangerous diseases caused by infection. Complicating the situation is that erysipelas in some cases has various symptoms and intensity, which makes treatment difficult. Also, the disease can be caused by surgery, such as a mastectomy, and act as a complication.

Erysipelas can be contracted directly from the carrier of the infection, so even with minor damage skin is recommended to limit contact with the patient.

Symptoms of erysipelas of the hand

Symptoms of erysipelas of the hand depend on the intensity of the course of the disease. In most cases, the disease first manifests itself through chills, which quickly increase. It is also accompanied by lethargy, weakness and drowsiness. Despite the ambiguity of the signs of the disease, it is still worth worrying when they appear and go to the doctor for an appointment so that you have the disease detected in time.

Sometimes the patient, in the first hours after infection, may feel more obvious symptoms:

severe throbbing headache;
nausea;
gagging;
muscle spasms;
heat.

This condition of the patient cannot be ignored, so you should not wait until the condition worsens, you must immediately call an ambulance or go to the doctor, if possible.

In some cases, the symptoms of erysipelas of the hand can be even more unpleasant - convulsions, impaired speech and delirium. In this case, the bill goes for minutes, if you do not immediately seek help from medical workers, then there will be a threat to the lining of the brain, which may suffer from irritation.

If erysipelas of the arm occurs after a mastectomy (removal of the breast), then the affected arm begins to hurt very badly. In this case, erysipelas acts as a complication, and since the woman is under the supervision of a doctor, the disease is usually detected in the first stages.

Erysipelas with lymphostasis

The most dangerous complication of the hands is erysipelas. The disease develops due to ulcers, trophic disorders in venous and lymphatic insufficiency. The trigger for erysipelas is a decrease in immunity, during which an exacerbation occurs. In this case, when erysipelas is detected, the severity of the disease is determined and the question of the need for hospitalization is decided, since erysipelas can also have complications in the form of:

abscess;
septicemia;
deep veins.

How to treat erysipelas of the hand?

First of all, when erysipelas is detected, the patient is hospitalized. Next, the course of therapy begins. which can last from seven to ten days. The course of treatment for erysipelas of the hand is based on antibiotics and detoxification drugs. If the drugs are prescribed correctly and taken in accordance with the instructions, then the chills and fever disappear after a day, and the patient's condition improves significantly. Immediately after this, inflammation decreases and the level of pain decreases.

Erysipelatous inflammation of the hand and fingers is unpleasant because these parts of the body are always in motion - it is difficult for a person to do ordinary actions without their participation. It is recommended for the period of treatment and until complete recovery to move your hands less.

Three days after the start of taking antibiotics for erysipelas of the hand, the diagnosis is reviewed and the severity of the disease is determined, after which the course of treatment may change.

Erysipelas (erysipelas) is a common infectious disease characterized by streptococcal lesion soft tissues and prone to recurrence. The causative agent is group A beta-hemolytic streptococcus. Streptococci are very variable, so the antibodies that are produced by the body to protect against infection cannot “remember” them and develop immunity.

This explains the frequent relapses of streptococcal infections. In addition, pathogens are dangerous because they release toxins that weaken the immune system and destroy the walls of blood vessels. The inflammatory process on the skin is accompanied by fever and symptoms of intoxication of the body.

The concept of "Erysipelas" comes from the French word, in literal translation meaning "red". This definition most accurately reflects appearance a patient in the acute phase of the disease, when the skin becomes swollen and reddened. In recent years, doctors have noticed an alarming trend towards an increase in the incidence of severe forms of erysipelas associated with impaired lymph flow in the lower extremities and thrombophlebitis.

The prevalence of the disease reaches 20-25 cases per 10,000 population. Women and the elderly are more likely to be affected by this infection. The disease is characterized by a seasonal nature of the course, and most often occurs in summer or autumn.

A favorite place for localization of erysipelas is the legs (shins, calves) and hands, less often the face, trunk or groin area. Effective treatment of erysipelas is possible with timely seeking medical help. In this case, you can achieve a complete recovery and restoration of working capacity.

Streptococcus can live on the skin and mucous membranes without causing disease if a person has good immunity. But if it enters a weakened body, erysipelas occurs. Healthy man may be a carrier of infection, the presence of streptococcus in the body was detected in 15% of the population.

You can become infected through contact with a sick person or a carrier of the infection, since the pathogen is transmitted airborne by or through household items, handshake.

The main causes contributing to the development of the disease are considered damage skin and the presence of comorbidities.

In addition, the occurrence of erysipelas can contribute to colds, hypothermia of the body and intake medicines that suppress the immune system. The disease often occurs against the background of fungal skin lesions, obesity, varicose veins.

Thus, there are a lot of predisposing factors contributing to the development of streptococcal infection, and the treatment of erysipelas should begin with identifying the causes of the disease.

From infection to the appearance of the first symptoms, only a few hours pass, much less often - 2-3 days. The disease has an acute onset sharp increase temperatures up to 38-40 °C and is accompanied by strong weakness, chills, dizziness, headache, muscle and joint pain. AT severe cases convulsions, clouding of consciousness, the appearance of nausea and vomiting are possible.

There is an increase in lymph nodes, primarily those that are closest to the affected area. Symptoms of general intoxication occur in response to the first wave of toxins secreted by streptococci.

Within a day after the onset of the first symptoms, the skin at the site of the lesion turns red, there is a feeling of heat and itching. The bright red color of the skin is explained by the expansion blood capillaries under the influence of streptococcal toxin. The affected area has clear boundaries and rises slightly above the surface. healthy skin, resembling flames with their jagged edges.

In a few hours, the lesion can significantly increase in size, this area becomes swollen and painful, the pain increases with palpation. Patients note a burning sensation and skin tension in the periphery. Painful sensations are the result of pressure nerve endings as a result of edema. Toxins secreted by bacteria increase the permeability of the walls of blood vessels, as a result of which the liquid component of the blood seeps through them, provoking severe swelling.

When feeling the affected areas, it is noted that the skin becomes hot and painful. Heat and symptoms of intoxication may persist against the background therapeutic measures up to 10 days. Skin symptoms last longer - up to two weeks, then the redness disappears and in its place the skin begins to peel off. The pathological process is more often localized on the hands and lower extremities. Erysipelatous inflammation of the face appears in the area of the nose and cheeks in the form of a butterfly, can descend to the corners of the mouth and capture the area of the ear canal.

In the erythematous-hemorrhagic form of the disease, subcutaneous hemorrhages occur against the background of lesions, from small to extensive, prone to merging with each other. The fever lasts longer than in other forms of the disease, and the disappearance skin manifestations happens much more slowly.

bullous- hemorrhagic form accompanied by the appearance of blisters filled with purulent or bloody contents. After opening them, ulcerations and erosions remain on the skin, leading to the appearance of scars.

The erythematous-bullous form is characterized by the presence in the lesion of small vesicles filled with transparent serous contents. Through a short time they open on their own and do not leave scars behind.

Erysipelas of the leg most common in women and often in early stages does not cause any particular concern, since patients perceive swelling and redness of the skin as allergic reaction. If treatment is not started on time, it is possible to develop severe complications on the shins and calves ( purulent abscesses, elephantiasis).

can be recognized by severe itching, extensive swelling and rapid spread of painful redness. Lesions localized on the lower extremities are characterized by frequent relapses and a more severe course of the inflammatory process, which in some cases can lead to such a severe complication as gangrene.

The severity of erysipelas depends largely on the age of the patient. So, in old age, the acute form of the disease and repeated relapses are especially difficult and are accompanied by prolonged fever, symptoms of intoxication and exacerbation of concomitant diseases.

The course of streptococcal infection is often accompanied by severe complications. It can be suppuration (phlegmon, abscesses), tissue necrosis, thrombophlebitis. Violations of the lymph flow and stagnation of the lymph provoke the development of lymphedema and elephantiasis. With a significant weakening of the immune system, the development of toxic-infectious shock, cardiovascular insufficiency and sepsis is possible.

Diagnosis of erysipelas

Diagnosis of erysipelas is carried out by a therapist or infectious disease specialist. The doctor makes a diagnosis based on the clinical picture and laboratory tests blood showing signs of a bacterial infection.

In order to pick effective treatment, from the surface of the lesion, material can be taken for bacteriological research. This will clarify the type of pathogen and find out its sensitivity to antibiotics.

The basis of the treatment of this infectious disease is antibiotic therapy, designed to destroy the pathogen. Beyond antibiotics complex treatment includes application antihistamines, which help to eliminate itching and allow you to cope with intoxication of the body.

Medical treatment

For the treatment of erysipelas, the doctor will prescribe individual therapy with the selection of antibiotics in tablets. The course of antibiotic therapy averages from 5 to 10 days. The following drugs are prescribed:

Azithromycin
Erythromycin
Ciprofloxacin
Spiramycin

In case of intolerance to antibiotics, treatment with furazolidone or delagil is carried out. In severe cases of the disease, treatment is carried out in a hospital, where a course of benzylpenicillin is prescribed. When complications are attached, cephalosporins and gentamicin are additionally used. For the treatment of extensive lesions, the use of anti-inflammatory drugs is indicated. If erysipelas of the leg is complicated by a fungal infection, antimycotic drugs are prescribed.

In addition, patients with erysipelas are prescribed a maintenance course of vitamin therapy, antipyretics and diuretics. To eliminate the symptoms of intoxication, intravenous infusion of solutions is carried out.

In case of recurrence of the disease, consistently apply intramuscular injections antibiotics that most optimally affect streptococcus, and prescribe drugs to maintain immunity.

Local treatment

Treatment with drugs local action carried out only with cystic forms of the disease. The erythematous variety of Erysipelas does not need to be applied. similar drugs, and some of them (ichthyol ointment, ointments with antibacterial components, Vishnevsky liniment) can cause unwanted complications.

In the acute period, unopened blisters are carefully incised and after exiting serous fluid apply dressings with a solution of furacilin or rivanol to the lesion, changing them several times a day. If an extensive weeping appears at the site of the opened blisters wound surface the appointment of baths with a solution of potassium permanganate and the subsequent application of dressings with the above components is shown. With bleeding, applications of dibunol liniment are applied to the focus of inflammation.

Applications with dimexide solution are effective, which anesthetizes well, improves blood circulation, has antimicrobial and anti-inflammatory effects. For the treatment of weeping surfaces, powders with enteroseptol are used, with extensive lesions, oxycyclosol is used in the form of an aerosol, which allows treating areas of inflammation up to 20 square meters. cm.

Physiotherapy treatment

Physiotherapy procedures are used taking into account the stages of the disease and the severity of its symptoms:

At the stage of recovery good effect give applications with naftalan ointment and the use of ozokeritotherapy.

Treatment of erysipelas folk remedies at home

Treatment of Erysipelas with folk remedies with a developed lesion of the skin will not give a result. That's why folk recipes based homemade ointments, decoctions and infusions medicinal herbs can only be used in the initial stages as aid and after consultation with the attending physician. Here are a few recipes that are often used in the treatment of erysipelas at home. The most popular are compresses, which can quickly relieve inflammation and have an antiseptic and regenerating effect.