Streptoderma in children signs. Children's slit-like impetigo. Useful tips for parents

What is streptoderma? Streptoderma in children is a bacterial infection caused by streptococci. Children are most susceptible to this disease, since they have not yet fully developed the protective function of the skin, and the rules of personal hygiene are not always observed.

streptococci- bacteria that are always in contact with humans. For habitat, they choose the skin, respiratory tract, mucous membranes, gastrointestinal tract. These microorganisms are resistant to drying, dust. They die on contact with disinfectants and at temperatures above 60°C.

As long as there is no damage to the skin and mucous membranes, streptococci are not dangerous. However, any skin injury(, scratch, cut, insect bite,, scratching with, microtrauma) can give rise to the development of streptoderma. On the damaged area of ​​​​the skin, streptococci multiply rapidly, thereby causing inflammation.

How can children get streptoderma?

• May be on the skin of the baby;
• With toys, dishes, bed linen and towels;
• From a carrier of streptococci, who himself may be healthy;
• From someone who is already sick with diseases caused by streptococcus.

Most often, streptoderma affects children who are weak, with chronic, or. Streptoderma can also occur with frostbite. The likelihood of this disease is also high if the baby is poorly cared for.

Videos streptoderma in children

Symptoms of streptoderma in a child

• Body temperature above 38°C;
• The child complains of headaches and muscle pain;
• may appear;
• You should pay attention to the lymph nodes, whether they are inflamed.

The disease, depending on the form and severity of the lesion, can last from 3 to 14 days.

There are many forms of streptoderma, consider the most common

1. Streptococcal impetigo. It develops mainly in the nasal passages, less often the face, hands, feet and open areas of the child's skin are susceptible to infection. As a rule, with this form of skin superficial.

A dense bubble up to 3 mm with a clear or cloudy liquid forms on the skin. This is conflict. There is redness around this vesicle. Then it opens or falls.

The affected area is covered with a light yellow crust. After separation of the crust, spots of a dark pink or pinkish-bluish color remain, which soon disappear. It takes 5-7 days from the onset of conflict to cure. It is important to start treatment as soon as the first blisters appear to prevent them from spreading.

1. Slit impetigo. This form occurs in the corners of the lips, in the lateral folds of the eyelids, the wings of the nose. It looks like a narrow strip of inflamed skin, causes pain. With good immunity, it can pass on its own. However, there is a risk of this form becoming chronic.
2. Nail panaritium. It occurs if there are burrs or the cuticle is injured. You should pay attention if swelling, redness, and pain appear around the nail. Lack of treatment can lead to loss of the nail plate and more serious consequences.
3. Streptococcal diaper rash. This form is manifested in babies.
4. Dry form of streptoderma. Appears on the face, limbs and torso. During this form, rounded pink or reddish spots appear. On the surface exfoliating whitish particles.

All forms of streptoderma must be treated to prevent the development of complications. Only a doctor can determine the form of streptoderma and prescribe the correct treatment. The inspection can be done as therapist, and dermatologist.

Treatment of streptoderma in a child

During treatment, it is very important to observe the rules of personal hygiene:

• Do not wet areas of the skin that are infected. You need to limit yourself to washing parts of the body where there is no inflammation. You can use wet towels, napkins;
• Do not comb, touch the affected areas of the skin;
• The patient must have an individual towel, dishes, bedding, which must be washed and laundered frequently;
• Treat all minor injuries and scratches;
• Regularly clean the premises. In contact with the child no soft toys.

To treat the infection, the doctor usually prescribes antiseptic solutions and ointments. Infected skin areas must be treated 2 to 4 times a day. It can be "brilliant green", a solution of hydrogen peroxide. Zinc ointment is used for drying. In some cases, an appointment is possible.

A disease such as streptoderma cannot be prevented. The prevalence of streptococci is very high. But you can reduce the likelihood of illness by strengthening the child's immunity. And here the observance of the daily regimen, a balanced diet, and physical activity are very important. Good help and. The child must follow the rules of hygiene.

Attention! The use of any medicines and dietary supplements, as well as the use of any medical methods, is possible only with the permission of a doctor.

Streptoderma is a human skin disease of inflammatory etiology caused by streptococcus bacteria. Depending on the localization and depth of penetration of pathogenic microflora into the layers of the skin, various types and varieties of streptoderma are distinguished.

Children are most susceptible to the disease: streptoderma in children occurs more often than in adults, due to the emerging skin immunity, an increased number of minor skin lesions and the inability to comply with all hygiene rules that prevent the onset of streptoderma. How to treat streptoderma in children depends on the age of the child and the characteristics of the clinical picture of the disease.

Streptococcus: the microorganism that causes streptoderma

Streptococci are opportunistic bacteria present on the skin of every person. They are detected in the analysis of intestinal microflora, scrapings from mucous surfaces, samples from the inner surface of the respiratory tract. The sizes of microorganisms are so small that they can only be seen in photographs of streptococci created with multiple magnification through microscopes. However, the prevalence of bacteria and statistical data allow us to assert that every person is familiar with streptococcal infection, and some people may be permanent latent carriers that spread pathogenic organisms.

Streptococci are bacteria that survive well outside the human body: the viability period lasts for months, and infection is possible through contact with household items. During disinfection, these microorganisms die within 7-15 minutes, depending on the concentration of the solution, at a temperature of 60 ° C, neutralization begins after 15 minutes, at boiling temperatures and above - instantly.

Streptococci are almost universal microorganisms that can cause not only streptoderma of various types, but also responsible for the development of scarlet fever, streptococcal angina, tonsillitis, pharyngitis, inflammation of the lungs of bacterial etiology, bronchitis, meningitis, myocarditis, glomerulonephritis, erysipelas of the skin, lymphadenitis, contribute to the development of abscesses, etc.

Often, with streptoderma and abscesses, treatment is complicated by the addition of an additional microorganism - staphylococcus, also present on the skin and in the human body.

Injuries of the skin as a factor in the development of streptoderma

Normally, streptococci live on the surface of the skin without harming a person. Local skin immunity allows you to maintain a balance between beneficial and conditionally pathogenic microflora, preventing microorganisms from destroying the layers of the epithelium. However, to start rapid reproduction and the inflammatory process, it is enough for them to penetrate into the layers of the skin through a scratch, crack, cut, scratching the site of an insect bite. In this case, the injury of the epithelium can be microscopic and imperceptible to the eye. Such a phenomenon as streptoderma in the nose is one of the frequent manifestations of streptoderma disease in children prone to studying the nasal passages with their fingers. Streptococci that inhabit the skin or mucous membranes are activated in the slightest scratches of the mucous membranes left by children's nails.

The “entrance gate” for infection can also be damage to the skin that is not associated with mechanical trauma: manifestations of an allergic reaction, atopic dermatitis, urticaria, skin rash with chickenpox, etc.

How does streptoderma begin?

The causative agent of streptoderma can be present everywhere, and the likelihood of developing the disease depends to a large extent on the immunity of the child and the number of pathogenic organisms that exist on his skin or get on it by contact.
Sources of streptococcal bacteria:

• the skin of the child himself, the carrier of streptococci;
• household items: dishes, furniture, toys, bed linen, towels, etc.;
• another child or adult who is a healthy carrier of the bacteria;
• a patient with diseases caused by streptococci: streptoderma, tonsillitis, bronchitis, pneumonia of streptococcal etiology, and scarlet fever. In this case, the development of streptoderma is more likely, since contact occurs with aggressive bacteria that multiply under favorable conditions, requiring less time to activate.

Streptoderma in children's institutions can proceed as an epidemic outbreak, when a sick child is a source of infection and spreads pathogens. The latent incubation period for this disease is from 2 to 10 days.

How is the transmission of infection with streptoderma and other diseases caused by streptococci? The infection can be transmitted in the following ways:

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

Causes of relapses and complications in the treatment of streptoderma

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

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

Ctreptoderma in children: forms and symptoms

Depending on the form of the disease, streptoderma in children can cause temporary discomfort or occur with severe symptoms. In severe forms, the following clinical picture of streptoderma is observed:

• the child's body temperature rises to febrile levels;
• there are symptoms of general intoxication of the body: headache, muscle, joint pain, nausea, vomiting, lethargy, loss of appetite;
• local lymph nodes increase, may be painful on palpation;
• in blood tests, a characteristic picture of the inflammatory process is revealed.

The disease normally with appropriate therapy lasts from 3 days to two weeks, ending in recovery. Symptoms of streptoderma, the period of the acute stage depends on the form of streptoderma, the location of inflammation, its depth and severity, as well as on the individual characteristics of the body to resist infection.
Depending on the place of development of the inflammatory process, the depth of penetration of the pathogen into the skin and the severity of the disease, several forms of streptoderma are distinguished. All of them belong to streptoderma, but have different names.

Streptococcal impetigo

Among all forms of streptoderma, this is the most common. It includes streptoderma, which develops in the nasal passages, as well as small local skin lesions located on the front of the head, hands, feet and other open areas of the child's skin.

This form of streptoderma is a superficial skin lesion, in which the initial development of the disease is opposed by the mechanism of local immunity, which limits the inflammatory process. It proceeds in accordance with the following stages of the disease:

• on an outwardly calm area of ​​\u200b\u200bthe skin, a conflict is formed - a dense bubble with a transparent or unclear content up to 3 mm in diameter, redness occurs around;
• at the next stage, the conflict bubble spontaneously opens or falls off, a light yellow crust forms at the site of the lesion (drying or weeping “sores” on the face);
• the crust separates, leaving patches of a dark pink or pinkish-bluish color, which subsequently disappear.

Each individual site of inflammation from the onset to the cure exists for 5-7 days. If therapy is started at the first stage of the appearance of a bubble, in most cases the infection affects the skin singly. However, if you do not pay attention to the manifestation of streptoderma, the pathogen spreads throughout the body during touching, bathing, toweling or sleeping, which causes multiple lesions. Such a disease can last from a month or more, causing a decrease in general immunity in a child and contributing to the spread of infection in the family and children's groups.

slit-like impetigo

This form of streptoderma is better known under the popular name "zaedy": a narrow strip of inflamed skin in the form of a gap, which occurs most often in the corners of the lips, less often in the lateral folds of the eyelids, wings of the nose.

At the beginning of the disease, a conflict is formed, as a rule, a single one. The disease in most cases is limited to one area of ​​the skin, causing itching, soreness, discomfort, and goes away on its own or with little local therapy.

However, with reduced immunity or the presence of inflammatory processes near the site of development of streptoderma (oral candidiasis, caries, gingivitis, conjunctivitis, rhinitis, etc.), the disease can pass into a chronic, sluggish stage, difficult to cure.

Nail panaritium

Streptococcal inflammation of the skin around the nails develops when the pathogen enters the wound, most often with burrs or cuticle injury. Streptococcus can penetrate both from the surface of the skin around, and when the injured area comes into contact with the environment or in the process of combing already existing streptoderma-impetigo.

Panaritium is expressed in redness, swelling, soreness of the skin area around the nail fold, the formation of phlegmon, and erosive changes. Without treatment, it can lead to the loss of the nail plate, the spread of the pathogen through the bloodstream to other organs, and cause meningitis.

Streptococcal diaper rash

They usually occur in young children. They develop when a streptococcal infection is attached to a skin lesion at the site of diaper rash, manifestations of dermatitis, and allergies. The manifestation of this form of streptoderma is observed with high frequency behind the auricles, in the inguinal skin folds, and axillary folds.

Secondary damage to damaged skin by streptococci leads to a fusion of erosions, soreness of the skin area, a long course that is difficult to treat. Treatment is carried out against the background of therapy of the underlying disease.

Dry form of streptoderma or erymatosquamous

Most often, erymatosquamous streptoderma occurs on the face, sometimes on the limbs or trunk. Weeping elements characteristic of other types of streptoderma are absent, the disease is expressed in the appearance of pink or reddish spots of uneven rounded shape with a surface of exfoliating whitish particles of the epidermis.
This is one of the least active form of all types of streptoderma in spreading through the body, which does not cause much discomfort during the course. However, a high level of contagiousness requires both treatment and isolation of sick children.

bullous impetigo

This form differs both in appearance and in the more severe course of the disease. Most often, the hands, feet and legs, at the initial stage, large serous purulent vesicles are formed, soft to the touch, with severe inflammation around. They tend to develop slowly. After spontaneous opening of purulent blisters, places of open erosion are formed.

There may be a sharp deterioration in well-being, febrile temperature (from 38 ° C), an increase in local lymph nodes, signs of intoxication of the body.

Ecthyma vulgaris

Refers to the most severe forms of streptoderma. Streptococci infect the deep layers of the epidermis. The tissue becomes necrotic and ulcers form. Typical localization - buttocks, lower limbs with possible exceptions.

Factors contributing to the development of ecthyma vulgaris are a decrease in the body's resistance after SARS, influenza, chickenpox, measles, intestinal infections, as well as hypovitaminosis, systemic diseases (diabetes mellitus of all types, diseases of the hematopoietic system, endocrinological pathologies).
It proceeds severely, requires complex therapy.

Diagnosis of streptoderma

Diagnostic measures for streptoderma may be limited to anamnesis and visual examination by a pediatrician or dermatologist. In some cases, to clarify the diagnosis, the presence of a primary disease and the composition of pathogenic microflora, additional examinations may be prescribed:

• laboratory analysis of blood parameters (general, biochemical);
• general indicators of urine analysis;
• analysis of feces for helminth eggs;
• sometimes they can prescribe an analysis for the Wasserman reaction, the presence of immunodeficiency states of viral etiology.

streptodermain children: types of treatment

All forms of streptoderma, even mild ones, must be accompanied by treatment, since the disease is highly contagious to others, without therapy it can affect large areas of the skin and lead to the development of severe complications.

The importance of hygiene in the treatment of streptoderma

Streptoderma is a disease in the therapy of which the hygienic factor plays an important role both in preventing its development and in spreading the pathogen to others. Treatment of streptoderma without observing hygiene rules may not have a therapeutic effect and lead to a protracted form of the disease.
Hygiene rules for all forms of streptoderma:

• avoid wetting the affected area of ​​the skin, do not bathe the child for 3-5 days, limiting yourself to washing certain parts of the body (legs, genitals), if they do not have inflamed areas. Use wet wipes, towels, etc.;
• in the presence of itching, try to avoid scratching, touching the affected area, it is possible to use antihistamines;
• use an individual towel, dishes for the patient, often wash and wash;
• treat all minor injuries and scratches on the skin regularly with antiseptic preparations;
• carry out regular hygienic cleaning of the premises, remove soft toys, often wash and iron bedding.

streptoderma: home treatment with antiseptic preparations

For local treatment of streptoderma in children at home, antiseptic solutions and ointments are used. They need to wipe the areas of inflammation. But in some cases, it is necessary to open the bladder with the treatment of the affected area with an antibacterial agent. This should only be done by a medical professional.

Streptoderma can be treated with the following antiseptics:

• hydrogen peroxide solution;
• fucorcin;
• salicyl alcohol;
• furatsilin;
• brilliant green ("brilliant green").

Means are used to treat the affected area and the skin around it from 2 to 4 times a day. Zinc ointment can be used as a drying and disinfecting agent. To enhance the effect, it is possible to apply decoctions chamomile, oak bark, succession flowers.

Antibiotics for streptoderma

Preparations of antibiotic groups are used in the treatment of the disease in forms that have local and systemic effects. How to treat streptoderma in children with antibacterial drugs, the specialist determines.

Medicines from the group of antibiotics used for streptoderma can be either monocomponent, with one active ingredient, or combined. Combined drugs used in the treatment of various forms of streptoderma include local drugs (creams, ointments) with a combination of antibacterial and hormonal therapy.

Systemic antibiotic therapy for streptoderma

Penicillins are recognized as a group of antibiotics of the first choice in the treatment of various forms of streptoderma. In some cases, it is possible and appropriate to replace penicillin drugs with a cephalosporin group or macrolides.
When is penicillin not prescribed to children for the treatment of streptoderma?

• if the child has an individual intolerance to drugs of this group, allergic reactions to previously taken penicillins or cross-allergens to it;
• if there is a disease in the immediate anamnesis, in the treatment of which antibiotics of the penicillin series were used;
• if the analysis for the resistance of microflora revealed a high resistance of pathogenic microorganisms to penicillin.

streptodermaand similar diseases

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

pyoderma

Pyoderma is a group of all purulent inflammations of the skin, and all forms of streptoderma are included in this group. However, unlike other pyodermas, with streptoderma, the primary stage is more similar to the manifestation of a viral rather than a bacterial infection. Thus, other pyodermas of bacterial etiology differ from streptoderma in the turbidity of the secreted and distinctive forms of the inflammatory process.

Herpetic eruptions

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

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

Thrush or candidiasis

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

Allergy manifestations

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

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

Chickenpox

Sometimes the onset of chickenpox can be mistaken for the first stage of streptococcal inflammation of the skin: chickenpox, as a rule, begins to appear first on the skin of the face, a characteristic place for banal impetigo. The rapid development of infection in chickenpox contributes to a fairly short-term differentiation from skin inflammation. If necessary, in both cases, you can use a local antiseptic, zinc ointment until an accurate diagnosis is established.

Prevention of pyoderma caused by streptococcus

Streptococcal infections cannot be prevented, the prevalence of this pathogen is too high. However, it is possible to increase the body's resistance to contact with streptococci and reduce the likelihood of contact with active agents.

To strengthen the child's immune defense, it is necessary first of all to pay attention to the observance of sleep, rest and games, walks, study, as well as to the usefulness of the diet rich in vitamins and minerals. From an early age, it is necessary to instill hygiene rules, wash hands, use personal dishes, towels, etc. Sports activities, physical education, swimming, hardening and sunbathing also have a beneficial effect on both the general and local skin immunity of the child, increasing it resistance to streptococci.

After diagnosing the disease, it is necessary to take measures to reduce the likelihood of streptoderma in family members in contact with the child. General hygiene measures and rules (cleaning, frequent change of clothes, bed linen, removal of soft toys, blankets from the patient's room, individual dishes and towels) will help not only maintain the health of relatives, but also avoid a long course and recurrence of pyoderma.

In order to prevent an epidemic outbreak of streptococcal infection in preschool and educational institutions, sick children are isolated from the team for the duration of treatment, all children who have been in contact with the patient are quarantined for 10 days (the maximum incubation period of the disease).

Any skin purulent-inflammatory diseases that are caused are classified in medicine as streptoderma . In order for the disease to begin its development, only two factors are needed - the presence of streptococci and damage to skin areas in which there is a decrease in the protective function. Most often, the disease in question is diagnosed in childhood - this is due to frequent skin lesions at this age, and the impossibility of constant monitoring of personal hygiene.

streptococci

These are conditionally pathogenic microorganisms with which a person is constantly in contact - they "live" in the human gastrointestinal tract, and on the skin, and in the respiratory tract, and on all mucous membranes. Each person periodically becomes a carrier of streptococci, there are people who belong to the group of permanent carriers of these pathogenic microorganisms. But it is interesting that staphylococcus always joins streptococcus, which is the causative agent of streptoderma.

Streptococci have amazing "survivability" - they instantly die only when boiled, but at a temperature of 60 degrees Celsius, streptococcus continues to live for another 30 minutes, in chemical agents these microorganisms die only after 15 minutes.

The considered pathogenic microorganism can cause a person to develop not only streptoderma, but also myocarditis and other diseases.

How does streptoderma begin in children?

If the skin performs its protective functions at 100%, then streptococci do not cause any problems to a person at all. But even a slight damage to the skin disrupts the protective functions, the wound becomes a "gateway" for infection - streptoderma develops. As a rule, the disease in question originates in places of scratches and rashes, insect bites (they are combed), cuts and abrasions. Even if streptoderma arose without visible damage to the skin, this means that the injuries are simply invisible to the eye - they are microscopic, but sufficient for infection.

As soon as streptococci enter the damaged area of ​​the skin, they begin to actively multiply and provoke the development of an inflammatory process that is not so easily treatable.

Streptococcus can get to the area of ​​damaged skin from a variety of places:

• toys, dishes, towels and any household items;
• from a patient with streptoderma, tonsillitis, scarlet fever,;
• from the child's own skin;
• from a carrier who is healthy and has no disease.

If the development of streptoderma is associated with infection with an infection from an already sick person, then in this case the course of the disease will be more rapid, aggressive and prolonged. Often streptoderma proceeds as an epidemic - this usually happens in places where there are a lot of children (kindergartens, schools, public organizations). The incubation period of the disease in question is 2-10 days, it all depends on how strong the child's immune system is.

In medicine, there are only three types of ways of infection with streptoderma:

• contact household - toys, dishes, towels, bed linen, shoes, clothes;
• contact - hugging a sick child, kissing, close contact during the game;
• airborne - streptococcus gets on the skin of a child when an already sick baby sneezes or coughs.

Note: the airborne route of infection is so rare that doctors most often do not note it.

What is the reason for the long course of streptoderma

In the case of strong immunity and general health of the child, streptococci simply do not develop on the skin - the body copes with these pathogenic microorganisms on its own. But there are factors that contribute to the fact that the course of streptoderma will be long, severe and with frequent relapses. These provoking factors include:

• diagnosed helminthiases, anemia, hypotriphy, general intoxication of the body;
• chronic skin diseases - allergic reactions;
• and - discharge from the ears and nose is irritating to the skin;
• and/or frostbite;
• violation of personal hygiene rules, insufficient child care;
• prolonged contact of damaged areas of the skin with water;
• lack of treatment for skin wounds.

Forms and symptoms of streptoderma

Doctors clearly distinguish the symptoms of streptoderma - they are of a general nature and are inherent in all forms of the disease in question. Signs of streptoderma in childhood:

The duration of the disease is too variable - from 3 to 14 days, it all depends on the individual characteristics of a particular child's body.

Doctors also define several forms of the disease in question:

Streptococcal impetigo

This is the most common form of the disease, which is characterized by the appearance of specific rashes on the face, hands, feet and other open areas of the body. Often diagnosed in childhood streptoderma of the nose - it also applies to the form in question.

Streptococcal is often found because in this case the infection does not penetrate into the deep layers of the skin, since its protective functions are still preserved, and the local mechanisms of inhibition of the inflammatory process are switched on almost instantly in childhood.

Symptoms of streptococcal impetigo:

• the skin does not change externally, it can only turn slightly red. At this point, a bubble appears with a clear or cloudy liquid inside, bordered by a reddish line;
• the liquid inside the bubble gradually becomes cloudy, then it all bursts, and a light yellow crust forms in place of the bubble;
• after the crust comes off, a pink or bluish spot remains, which eventually disappears without a trace.

Note:the maturation period of each bubble is 5-7 days.

If streptococcal impetigo is noticed at the initial stage of development, then the treatment started can stop the development of the disease. But as a rule, such a change in the skin is either simply not noticed, or not touched in the hope that everything will “pass by itself”. But the child begins to comb the formed crusts (itching is present during healing), a liquid flows out of them, literally “stuffed” with streptococci. This liquid gets on healthy areas of the skin, remains on bed linen and clothes - infection continues, the spread of the disease is rapid.

If treatment and hygiene are not carried out correctly, then streptococcal impetigo lasts more than 4 weeks, and in some cases the infection can even give serious complications.

This form of the disease is considered more severe and requires professional medical attention. Distinctive characteristics of the considered form of streptoderma:

slit-like impetigo

This is what people call zaedami - streptoderma appears in the corners of the mouth, it can rarely appear in the folds of the wings of the nose or the corners of the eyes. As a rule, a single bubble appears, even when opened, the slit-like impetigo does not spread.

It is noteworthy that it is this form of the disease in question that proceeds rapidly, does not manifest itself with any additional symptoms, and simply causes some discomfort to the patient. Only in extremely rare cases, slit-like impetigo becomes chronic with frequent relapses.

Erythematosquamous streptoderma

This is a dry type of the disease in question, which is most often present on the skin of the face - there are no weeping vesicles and red or bluish spots, only pink scaly spots are present at the lesions.

Erythematous-squamous streptoderma does not cause critical discomfort, is not prone to widespread distribution, but is contagious - treatment should be complete.

Superficial panaritium

occurs against the background of streptococcal impetigo, but only on the skin around the nail. The site of infection becomes inflamed, becomes red and swollen, characteristic vesicles appear, and then crusts.

A prolonged course of superficial panaritium can lead to complete rejection of the nail plate. Doctors insist that with this form of the disease in question, intensive treatment is necessary.

Streptococcal diaper rash

The peculiarity of this form of streptoderma is a secondary lesion against the background of classic diaper rash. Most often, streptococcal diaper rash occurs in the behind the ear and armpits, folds and groin.

The considered form of streptoderma is quite difficult to treat, because when crusts form on the skin, cracks appear, a streptococcal infection can once again join.

Ecthyma vulgaris

This is a very severe form of streptoderma, which is characterized by the formation of ulcers and deep erosions. Distinctive characteristics of vulgar ecthyma:

How is streptoderma diagnosed?

An experienced pediatrician or dermatologist will be able to diagnose the disease in question only by external signs. But often doctors conduct scraping tests from the affected areas of the skin - this will reveal the sensitivity of the pathogen to antibacterial drugs and quickly begin competent treatment.

In some cases, the specialist may prescribe an additional examination of the patient:

How to treat streptoderma in children

Even if streptoderma occurs in a child in a mild form, a full course of treatment is required. There are several activities that form a complex of therapeutic measures.

Personal hygiene

Many parents are sincerely amazed that the child does not get rid of streptoderma even when using specific medications. This may be due to improper personal hygiene procedures.

Things to remember:

A lot of prescriptions for local treatment of streptoderma in children are already “invalid” - many substances are simply discontinued, many are sold in pharmacies strictly according to the prescription. But you can also use modern, very effective means:

Apply antiseptics correctly:

• first, the vial is opened - extremely carefully;
• then, with a cotton swab or cotton pad, an antiseptic is applied to the area of ​​\u200b\u200bthe opened vial and 1-2 mm around this place;
• you need to wait until the antiseptic is completely dry.

If we talk about folk remedies, then decoctions of chamomile, string and / or oak bark are approved even by official medicine - they are used as lotions and for washing the resulting wounds.

Note:it is impossible to treat streptoderma in a child with folk remedies - there is an inflammatory process on the skin, there is a pathogenic microorganism, so you can’t do without drugs.

Antibiotics for streptoderma

With streptoderma in children, they are taken orally and externally. But no doctor will prescribe such aggressive medications for single manifestations of streptoderma, a mild form of the disease. Antibiotics are prescribed only in extreme cases, when conventional means fail to stop the process, and the child's condition worsens.

In some cases, doctors even prescribe drugs from the hormonal group, but this is already an extreme measure.

For local treatment, the following antibiotic ointments are used:

Ointments with hormones prescribed in extreme cases:

• Lorinden S;
• Kanizon plus;
• Belogent;
• Triderm;
• Betaderm and others.

If we talk about systemic antibiotic treatment, then most often doctors use antibiotics of the penicillin group, cephalosporins or macrolides for this. Penicillins may not be prescribed if in the recent past the child has already received such treatment for any other disease, or if there is a history of individual intolerance and hypersensitivity to such drugs.

Comparison of streptoderma with other diseases

Even experienced doctors admit that streptoderma is quite easy to confuse with some other skin diseases - at a certain stage of its development, it simply takes on other forms. But there are some differences - they will help you quickly navigate, make an accurate diagnosis and conduct effective treatment.

pyoderma

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

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

Herpes

The main difference between and seizures is that with the disease in question, the course of the disease is rapid, the affected area falls precisely on the corner of the mouth, and there is no spread to healthy tissues.

Interestingly, older children may pay attention to the itching that appears on clean skin - this is a harbinger of herpes. But when seizing, itching appears only after the external manifestation of the disease.

Candidiasis of the corners of the mouth

In principle, this disease is easy to differentiate - the cracks in the lesions are deep, there is a plaque characteristic of thrush.

Chicken pox

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

allergic rash

Even some experienced pediatricians may confuse the disease in question with a banal allergy. No, when the streptoderma vesicles are already fully formed and begin to burst, it is not difficult to make a diagnosis at all, but you can also conduct a short test earlier: when you press on an allergic rash, the skin turns white, with streptoderma, such changes in the color of the skin are not observed.

Note:is also very similar to streptoderma, therefore, to differentiate the diagnosis, the doctor may refer the child for analysis for syphilis.

Preventive measures

Since the disease in question is contagious, the sick child is quarantined for 10 days. It is very important to introduce such a quarantine in a preschool institution, in a school or circles and sports palaces - during these very 10 days, symptoms of streptoderma may appear in other children.

As for the family, here it is also necessary to carry out prevention with an already sick child - it all comes down to observing the rules of personal hygiene.

If we talk about general prevention, then we can single out the intake of vitamin-mineral complexes, strict adherence to the rules of personal hygiene and strengthening the immune system.

Streptoderma is an unpleasant disease that causes discomfort to the child. But there are a lot of modern medicines that greatly alleviate the condition of the child and contribute to a speedy recovery.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

Often, slight redness and single blisters on the skin of the child are ignored by the mother. However, this often indicates the onset of an infectious skin disease - parents simply do not know how streptoderma begins in children. In this case, the disease is prone to spread on the skin and is very contagious to others.

It is quite possible to get rid of streptoderma in a child and avoid negative consequences at home. A speedy recovery is facilitated by the timely determination of streptococcal lesions and the start of treatment with fairly simple means from the first days of the disease.

What is this disease?

Streptoderma is an inflammatory and infectious skin lesion caused by the rapid development of β-hemolytic streptococcus. Most often, streptoderma is diagnosed in children from the neonatal period to school age. The disease proceeds with varying degrees of severity, sometimes provokes an increase in temperature and a deterioration in the general condition of the child. In most cases, the skin lesion heals in 5-15 days, leaving red-bluish spots. Only if the deep layers of the skin are damaged (streptococcal ecthyma), scars can form.

The "culprit" of the disease is streptococcus. The opportunistic bacterium is present in all people: on the skin, mucous membranes of the respiratory tract and intestines. The rapid growth of the microorganism on the skin restrains local immunity, which is not sufficiently developed in childhood. This fact explains the widespread streptoderma in young children. Streptococcus is quite stable - the bacterium perfectly tolerates drying, it remains in the dust for a long time. Disinfectant solutions inactivate the microbe after 15 minutes. When washing at 60ºС, streptococcus dies after 30 minutes, and when boiled, instantly.

Reasons for the development of streptoderma

The presence of streptococcus on the skin does not always provoke the development of the disease. Streptoderma in a child occurs under the following conditions:

Against the background of concomitant diseases - diabetes mellitus, chronic tonsillitis - streptoderma takes a long time, and its treatment should be combined with the therapy of the underlying disease.

Important! The contagiousness of streptoderma for others is 90-100%. That is why outbreaks of the disease are often recorded in kindergartens and schools.

Children become infected with the active form of streptococcus from a sick person or a carrier with no outward signs of infection. Infection occurs through toys, dishes or linen (bedding, shared towels), with bodily contact. Rarely, infection of the skin of a healthy baby occurs when a patient coughs / sneezes with a streptococcal lesion of the respiratory system.

Forms of streptoderma and characteristic symptoms

External manifestations of streptococcal infection appear after 2-15 days from the entry of microorganisms on the injured skin surface. Streptoderma can develop on any part of the child's body. However, most often the inflammatory process begins on the face: the child often touches the face with unwashed hands, the flow of saliva from the mouth and a runny nose are also provoking factors.

Depending on the nature of the lesion and localization of the streptococcal focus, the following forms of the disease are distinguished:

Streptococcal impetigo

The most common form of streptoderma affects the superficial layers of the skin of the face (under the nose, on the cheeks and chin) and extremities. The initial stage of streptoderma in children proceeds quite easily and does not affect the general condition, however, without treatment, the skin lesion is prone to spread. Characteristic signs of streptococcal impetigo:

• On reddened areas of irregular shape, single bubbles (conflicts) appear, filled with a clear or yellowish liquid. The diameter of the elements usually does not exceed 3 mm.
• The surface of the bubble becomes soft, the liquid inside it becomes cloudy. After 3-5 days, conflicts spontaneously open. At this stage, itching appears.
• The affected areas are covered with yellow crusts. Increasing itching causes the child to scratch the lesions, which leads to the spread of infection and delays healing.
• Healing usually occurs in 5-7 days. The crusts dry up and fall off, leaving a pink or bluish spot in their place.

The tactics “do not touch and it will pass by itself” in the case of classical streptoderma is not justified. Without elementary antiseptic treatment, the disease drags on for 3-4 weeks. Combing the face, the child not only spreads the infection to other parts of the body, but also contributes to the infection of others.

The disease can occur in the scalp. The crusts from the opened bubbles are constantly torn off when combing the hair or by the child themselves due to itching. In addition to increased sweating, streptoderma spots on the child's head grow and merge, often forming large foci covered with yellow crusts.

slit-like impetigo

It is characterized by skin lesions in the corners of the mouth (jaw), eyes or at the wings of the nose. This is the mildest form of streptoderma, not prone to spread. However, it often takes a long time due to the inattention of adults to minimal manifestations and the absence of complaints in a child. The course of slit-like impetigo:

• in these areas, a single conflict appears, which quickly becomes cloudy and opens;
• in its place, a crack is formed, surrounded by a small area of ​​redness;
• if the child has salivation, the crack constantly gets wet and deepens;
• when crying and eating, deep cracks can bleed, causing pain to the child.

Tourniol

Otherwise called streptococcal panaritium, tourniole is the result of combing the main focus of streptoderma. An infection introduced into the skin around the nail plate - into hangnails and periungual wounds - causes severe hyperemia, swelling and pain.

Appeared conflicts burst and become covered with crusts. Their frequent picking leads to the formation of erosion. Often, the tourniole leads to rejection of the nail.

Streptococcal diaper rash

It is more often diagnosed in babies and is associated with prolonged non-compliance with hygiene (wet diapers, rare washing in the bathroom). A streptococcal infection joins the initially occurring banal diaper rash (contact dermatitis) on the ass, in the inguinal and axillary folds, behind the ears.

Multiple conflicts merge and, after opening, form cracks on the delicate skin. The pain makes the child act up. At the same time, urine that has fallen on inflamed wounds, or profuse sweating of the child provokes a sharp cry.

Important! Compliance with the careful hygiene of the baby with streptococcal diaper rash should be combined with antiseptics or local antibiotics.

Erythematous-squamous form

The dry form often occurs on the face, but watery bubbles do not form. Dry streptoderma in children is characterized by the appearance on the skin of pink or reddish spots without a clear outline, covered with white, easily peeling scales.

The lesions grow slowly and practically do not disturb the child. However, this form of the disease is also contagious, so the baby should be isolated and fully treated.

bullous impetigo

This form of streptoderma has more pronounced symptoms - large flaccid blisters (bulls) with a diameter of 5 mm or more form on the hands, feet and legs. Around the rash there is diffuse hyperemia and swelling. The fluid accumulated in the blisters is first transparent, then suppurates.

Regional lymph nodes increase, body temperature can rise to 40ºС, the child is naughty, vomiting often occurs. Having burst, the bullae form long non-healing, painful erosions.

Ecthyma vulgaris

The most severe form, due to infection of the deep layers of the skin. Most often, large inflammatory foci of streptoderma are localized on the buttocks and legs of the child. After opening, ulcers are formed with a rim of necrotic white tissues and an inflammatory reaction around.

Common symptoms: high fever, nausea/vomiting, moodiness and crying. Only serious antibiotic therapy leads to healing of ulcers and scar formation.

Important! Streptococcal ecthyma in 90% of cases indicates an increase in blood sugar in a child.

How to distinguish streptoderma from other skin diseases?

Redness, vesicles and crusts form with many skin diseases. Similar symptoms can be observed with herpes, chickenpox, an allergic reaction, and even with skin tuberculosis. Comparative symptoms of streptoderma and other diseases:

• Herpes - begins with severe itching and burning against the background of unchanged skin, while with streptoderma, itching occurs later. Herpetic vesicles are very painful, increase in size and do not become cloudy for a long time.
• Chickenpox - watery elements appear without red spots on the skin, starting from the head. The difference is the rapid spread of bubbles.
• Fungal infection - a yeast infection of the corners of the mouth is characterized by a white coating in the crack. At the same time, thrush in the mouth is often found in a child - small, painful sores with a white bottom.
• Skin allergy - when pressed, the rash turns pale. With streptoderma, the inflammatory reaction persists.
• Staphylococcal pyoderma - vesicles filled with purulent yellow-green contents. However, this difference does not always indicate the absence of streptococcal lesions.

Initially transparent streptococcal conflicts often suppurate due to the addition of staphylococcus aureus. In both cases of infection, broad-spectrum antibiotics are used, the lack of a therapeutic effect indicates the need for bacteriological culture to determine the type of microorganisms and select the most effective drug.

Although every mother should know how streptoderma begins in children and how to treat it, only a qualified doctor can make an accurate diagnosis. In mild cases, the treatment course is prescribed by a pediatrician, with common forms and severe cases, you should contact a dermatologist.

Possible Complications

Complications occur with improper / absent treatment and severe forms of the disease. The risk of negative consequences is especially high in premature and weakened children, patients with diabetes mellitus and other serious diseases. The most common complications of skin streptoderma include:

• strepto-staphylococcal pyoderma - the addition of a staphylococcal infection that complicates treatment;
• scarlet fever and streptococcal tonsillitis;
• glomerulonephritis (kidney damage), meningitis, endocarditis and rheumatism;
• sepsis is the most dangerous complication, leading to cerebral edema and toxic shock, and the risk of death is high.

If the condition of a sick child worsens, it is necessary to call an ambulance, since many of the listed conditions require urgent medical measures.

Streptoderma treatment - antibiotics and skin treatment rules

Treatment of streptococcal skin infections includes the following areas: hygiene, antiseptic treatment and antibiotics.

Hygiene measures

Hygiene is a fundamental part of a child's speedy recovery. Even treatment with medications without observing certain hygiene rules will not lead to a quick recovery. What to do and not to do with streptoderma:

• The first days (before the appearance of crusts) it is strictly forbidden to wash the affected areas. Water procedures are reduced to frequent washing of hands, wiping the body (especially important at high temperatures), separate washing of the legs and genitals.
• Try to avoid scratching the blisters. With severe itching, the child can be given conventional antihistamines (Suprastin, Tavegil).
• A sick child is not taken to kindergarten, school and various children's groups (pool, sports, etc.).
• At home, they allocate a separate towel (you can’t wipe the foci of infection with them) and dishes. After each use, the dishes are carefully processed and the towels are washed in hot water (at least 60ºС). Bed linen is changed daily, ironed as a last resort (pillowcases are especially carefully).
• Rubber and plastic toys are daily treated with disinfectants with thorough rinsing in the future or doused with boiling water. Soft toys should be washed and put away when sick.
• If a child has lesions on healthy skin, they are treated with any antiseptic three times a day.

Treatment of lesions

Lubrication with antiseptic solutions is necessary to prevent the spread of infection. Treatment of streptoderma in children at home is carried out with the following drugs:

• 2% solution of salicylic alcohol - perfectly dries wetting;
• 1% hydrogen peroxide solution - it is worth remembering that in vials there is a 3% solution;
• fukortsin - the best for newborns;
• brilliant green - used exclusively in the post-Soviet space.

The treatment of inflammatory foci is carried out with a cotton swab, while sluggish conflicts spontaneously open. Movements should start from the periphery and end in the center of the pathological focus in order to avoid infection on the surrounding healthy tissues. The child may complain of a burning sensation, but the treatment should be repeated 2-4 times a day, and the ointment should be applied only after the antiseptic has completely dried.

Home treatment exclusively with antiseptics will bring results only with minimal rashes. The use of decoction of chamomile, oak bark and other folk remedies for lotions is not recommended due to weak antiseptic properties and a high risk of spreading infection with an aqueous solution. Their use is justified only for rinsing healthy skin for the purpose of prevention.

Antibiotic therapy

With a mild form of streptoderma, antibacterial drugs are prescribed in ointments. For this, the following means are used:

• Tetracycline or erythromycin ointment;
• Levomekol (destroys bacteria and accelerates healing);
• Gentamycin and lincomycin ointments;
• Synthomycin liniment or Levomycetin tablets crushed into powder;
• Ointments containing a hormonal component (triderm, lorinden, akriderm) are used only in severe cases.

Treatment with antibacterial ointments is carried out until the wounds are completely healed and the crusts fall off. With the growth of pathological spots and the absence of even a minimal result of local treatment during the first 3 days of treatment, the doctor prescribes antibiotic tablets. It is also advisable to prescribe antibacterial tablets from the first days of illness to children with weakened immune systems.

• Penicillins are the drugs of choice Amoxicillin, Amoxiclav, Augmentin (for babies in syrup from 9 months).
• Macrolides - Erythromycin, Clarithromycin, Sumamed (allowed from 6 months) are prescribed only if penicillins are ineffective or sensitized to them.
• Cephalosporins - Ciprofloxacin (from 5 years old), Cefuroxime have high antibacterial efficacy, but are prescribed to children only as a last resort, because they have a negative effect on the bone apparatus.

Important! It is forbidden to give a child with streptoderma an antibacterial drug on its own. Only the doctor determines the drug, dose and duration of use. V / m and / in the introduction of antibiotics is carried out in debilitated children in cases of common and severe forms of the disease exclusively in hospitals.

Prevention

• Instilling in children the rules of personal hygiene and timely treatment of wounds and abrasions.
• Maintaining immunity - treatment of foci of infection, good nutrition, walks, rational daily routine.
• Cleanliness of the child's underwear and bed linen.
• If a case of streptoderma is detected in the children's team - isolation of the patient for at least 10 days, daily examination of those in contact.
• Compliance with hygiene recommendations in the focus of the disease.

In newborns and infants, streptoderma is most widespread, so the disease is a big problem in neonatology. According to statistics, pyoderma occupies the first place in the structure of dermatological pathology. A variety of clinical forms of infection and a large number of pathogenic strains of microorganisms that can cause disease make it difficult to diagnose and can mislead an inexperienced doctor. From this it can be seen that streptoderma in children is a disease that needs to be given close attention.

THE REASONS

The main causes of streptoderma are various strains of streptococci. Group D organisms are most commonly cultured in children.

Characteristics of pathogenic bacteria:

• turn blue on Gram stain;
• can receive the necessary energy in an oxygen-free environment;
• depending on the severity of enzymatic reactions, they are able to hemolyze erythrocytes;
• motionless;
• arranged either in pairs or form chains;
• under unfavorable conditions, they can go into encapsulated form;
• sensitive to the action of standard antiseptic drugs;
• resistance to antibiotics develops slowly.

Under normal conditions, the skin in children is able to protect the body from the penetration of pathogenic flora. However, under the influence of a number of environmental or endogenous factors, the barrier function is impaired and streptoderma develops in children.

Predisposing factors:

• ignoring the rules of personal hygiene;
• the presence of microtraumas on the surface of the baby's skin;
• prematurity;
• immaturity or acquired defects of the immune system;
• local overheating or hypothermia;
• improper timing or products introduction of complementary foods;
• unbalanced diet with vitamin deficiency;
• violation of the feeding regimen of the newborn;
• chronic somatic pathology.

The transmission mechanism of the causative agent of streptoderma is contact. At the same time, the pathogenic flora inoculates the skin, household items, personal belongings of the patient and, upon contact with a susceptible baby, is transmitted to him, which, in combination with predisposing factors, manifests itself as symptoms of streptoderma in children.

CLASSIFICATION

Streptoderma is divided depending on the nature of the lesion of the skin.

The main clinical forms of the disease:

• Impetigo is a lesion of the epidermis and hair follicles.
• Intertrigo - the appearance of weeping erosions in the skin folds.
• Ecthyma is a pathological process affecting the dermis, ending in the formation of ulcerative defects.

The above forms have limited localization. With the progression of infectious inflammation, the development of generalized streptoderma in a child is possible, which is characterized by skin lesions of various depths.

Involvement of internal organs in the pathological process indicates the onset of bacterial toxic shock, in which the symptoms and treatment of streptoderma in children will differ significantly from local forms of the disease.

SYMPTOMS

The clinical picture of an infectious lesion of the skin in children differs depending on the form of streptoderma in a child. Consider the patient's complaints for each of them.

Impetigo

With this form of streptoderma, the main complaints in children are associated with rashes on the skin and mucous membranes, while the general condition of the child remains satisfactory. There is a subfebrile rise in body temperature, a decrease in appetite, a decrease in the dynamics of weight gain. There are practically no pronounced signs of intoxication.

The main symptom of streptoderma in children, manifested in the form of impetigo, is the appearance of conflict. Their features:

• the element of the rash resembles a bubble with purulent contents, which is located on a hyperemic base;
• blisters quickly open, yellow crusts form in their place;
• the rash may be accompanied by slight itching;
• blisters cover the skin of the face, neck, limbs;
• the mucous membrane of the mouth or nose may be involved in the process;
• in the corners of the mouth, in place of the conflict, transverse cracks are formed - jamming;
• rashes may recur.

It is worth remembering that streptoderma appears on the pope of a child with the progression of the infectious process. This should alert parents and pediatricians.

Intertrigo

This form of streptoderma also debuts with the appearance of blisters in a child, however, they are localized in the folds of the skin, quickly turning into weeping erosions. The patient is concerned about:

Diaper rash in children is localized in places of large skin folds, behind the auricles, in the interdigital spaces.

Ectima

When the deep layers of the skin are affected by streptococcal flora, ecthyma occurs. During streptoderma in children, ulcerative defects are formed from the primary elements of the rash in a child, which are accompanied by:

• pain and itching;
• purulent discharge.

Healing of ulcerative defects occurs within a month. During this period, the bottom of the ulcer is cleared of purulent-necrotic contents, and the synthesis of connective tissue is enhanced. At the site of the defect after the disease, scars can be found.

Generalized streptoderma

The lack of adequate therapy and a significant decrease in the protective properties of the child's body contributes to the spread of infection involving all layers of the skin in the pathological process. In such patients, conflicts are combined with diaper rash and ulcers. More often, the disease affects the lower limbs and areas of the skin with traumatic injuries.

Bacterial toxic shock

The course of streptoderma in children is extremely severe. This is due to the action of toxins and waste products of pathogenic microflora on the internal organs. The most sensitive to them are:

• Cells of the nervous system, the defeat of which leads to disruption of the vital centers in the medulla oblongata. As a result, the patient has a drop in blood pressure, respiratory failure, and a disorder of consciousness.
• The organs of the genitourinary system, which is accompanied by a drop in diuresis.
• Hepatocytes, massive damage to which leads to liver failure.
• The intestines are a violation of the normal microflora with a violation of the stool.

In addition to multiple organ failure, children have hyperthermia and massive skin rashes.

DIAGNOSTICS

Diagnosis of streptoderma in a child is based on physical and laboratory research methods.

During the inspection, pay attention to:

• typical localization of skin lesions;
• the presence of characteristic elements of the rash.

In a general blood test in children, the following changes are detected:

• an increase in the number of white blood cells with the appearance of immature forms in the general circulation;
• eosinophilia;
• increased erythrocyte sedimentation rate.

During a biochemical blood test, you can find:

• increased markers of the inflammatory process;
• the appearance in the plasma of factors indicating pathological changes in the internal organs;
• violation of blood clotting activity.

In a severe protracted infectious process, it is necessary to check the immune state of the body. Confirm the diagnosis of "streptoderma" allows a serological study, during which it is possible to detect antibodies to streptococcal antigens.

In the analyzes of urine and feces, characteristic changes are not observed.

TREATMENT

It is necessary to treat streptoderma in children in an infectious diseases hospital. Therapy is divided into two areas:

• local;
• general.

Local therapy includes:

For general therapy use:

• broad-spectrum antibiotics;
• antihistamine drugs;
• multivitamin complexes;
• immunostimulants.

With bacterial-toxic shock, the volume of therapy is significantly expanded. Treatment of streptoderma in children with such symptoms, in addition to fighting the pathogen, is aimed at maintaining the functioning of internal organs.

COMPLICATIONS

Streptoderma in a child can be complicated by various conditions, the most formidable of which are:

• the spread of pathogenic microflora with blood flow to internal organs with the development of septic lesions in the brain, heart, kidneys, lungs, etc.;
• non-healing ulcerative defects;
• microbial eczema.

In severe cases, with generalized streptoderma, death is possible.

PREVENTION

To prevent the development of streptococcal infection, the following recommendations should be observed:

• strictly follow the rules of personal hygiene;
• optimize the nature of nutrition;
• timely treat somatic pathology;
• properly care for the skin of the child;
• avoid overheating or hypothermia;
• at the first symptoms of the disease, immediately consult a specialist.

PROGNOSIS FOR RECOVERY

Rational drug therapy allows you to completely get rid of pathogenic microflora. However, the bacterial-toxic form has an unfavorable prognosis. In a child, such streptoderma is extremely difficult and often ends in death.

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