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Erysipelas: causes, symptoms and methods of treatment

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

But sometimes the skin itself is the target of an attack of microorganisms - then dermatological diseases develop, among which is erysipelas.

Content

Erysipelas (face) - what is it?

Erysipelas of the lower leg, photo 1

Erysipelas of the lower leg, photo 1

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

Erysipelas causes Beta-hemolytic streptococcus of group A with its penetration into the thickness of the skin through minor abrasions, cuts, insect bites, scrapes, rubs.

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

The prevalence of the disease is great - the fourth place after ARI, gastrointestinal and hepatitis infections.

Beta-hemolytic streptococcus group A

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

Angina, pharyngitis, laryngitis, scarlet fever, rheumatism, severe damage to kidney tissue is far from a complete list of pathological conditions caused by BHSA. The Ministry of Health states: the damage to the economy from β-hemolytic streptococcus is 10 times higher than the damage from all viral hepatitis.

It belongs to a conditionally pathogenic microflora, because practically all people in the oral cavity, respiratory tract, on the skin and external genital organs are present. Good immunity limits his virulence (degree of contagiousness).

BGSA very quickly spreads through the air, through the digestive tract and objects, so it usually shows up in rooms where children's and work collectives are for a long time, 57.6% of angina and 30.3% of ARI are caused by it.

Streptococci survive by freezing and heating to 70 ° for 2 hours, in the dead biomaterial (blood, pus) they retain high infectiousness for several months. Toxins cause severe heart and kidney disease.

For children, the carrier of the pathogen in the upper respiratory tract is more typical. When examining schoolchildren BGA is allocated in the nasopharynx 20-25% of children.

Causes of erysipelas

Manifestations of erypsipelas, photo 2

Manifestations of erypsipelas, photo 2

The cause of erysipelas can be small abscesses, furuncles and carbuncles, purulent wounds. Frequent hypothermia of the feet or excessive inflammation that cause microtraumas of the skin can contribute to the spread of dangerous streptococci in the skin.

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

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

Stressful situations, sharply reducing immunity, can give a push to attack streptococcus on its carrier.

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

Symptoms of erysipelatous foot inflammation, photo

Rozhaya in children, photo 3

Rozhaya in children, photo 3

After a week (on average), after introduction into the skin of the pathogen, there is an acute onset of the disease.

Suddenly, there are signs of intoxication:

  • sharp weakness,
  • temperature up to 40 ° C with chill,
  • painful headache,
  • aches in bones and muscles,
  • sometimes - nausea and vomiting.

During the day, there are symptoms of erysipelas on the shin: the affected area swells drastically, glossy from tension and turns red. The name "mug" also occurs as a derivative of the word "red" in some European languages.

photo 4

photo 4

photo 5

photo 5

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

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

Pain and burning cause severe suffering to the patient. Inflamed popliteal and inguinal lymph nodes. In the direction to them from the lesion zone under the skin, dense reddish stripes are visible - lymphatic vessels, lymphangitis develops.

Diagnosis of erysipelas

Often, the diagnosis is made without tests, for a combination of general and local symptoms.

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

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

Forms of erysipelas

Based on the nature of local changes, there are:

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

2. The erythematous hemorrhagic form - on the affected area, against the background of general reddening (erythema), there are multiple point bleedings - a sign of damage to the blood capillaries.

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

The liquid in them contains a large mass of streptococci with a high degree of virulence, therefore, when the blisters are opened, antiseptic treatment must be carefully performed. Healed with the formation of a crust, under which is formed a smooth skin.

4. Bull-hemorrhagic form - in the blisters is an opaque bloody liquid.

5. Gangrenous form with areas of skin necrosis.

A wandering form is allocated when, within a few days, the lesion is shifted to a neighboring site, and the primary focus is scaly and heals.

This form is characteristic of newborn children, with the rapid spread of erysipelas, children can die.

The severity of the disease is distinguished:

  • light form (the lesion is small, the temperature is not higher than 38.5 ° C),
  • moderate (several small lesions, the temperature to 40 ° C is not more than 5 days)
  • heavy form, when bullous-hemorrhagic elements cover almost the whole body, the temperature is critical for several days, loss of consciousness, delirium and signs of meningitis.

The inflamed part of the skin remains after healing, sensitive to streptococcal infection, which gives grounds for the diagnosis of "repeated" and "relapsing" erysipelas.

Treatment of erysipelatous foot inflammation

Treatment of erysipelatous foot inflammation

Treatment of erysipelatous foot inflammation

Light forms of erysipelas can be treated on an outpatient basis. Severe and neglected cases require hospital treatment.

Первое и главное назначение — антибиотики в виде внутримышечных инъекций или перорально. 1) The first and main purpose is antibiotics in the form of intramuscular injections or orally. Penicillin antibiotics have remained effective in the fight against hemolytic streptococcus.

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

Их действие усиливают сульфаниламидными препаратами (бисептол). 2) Their action is enhanced by sulfanilamide preparations (biseptol).

Обязательно назначаются витамины и биостимуляторы (левамизол, пентоксил, метилурацил) для восстановления иммунитета и быстрейшего заживления очага. 3) Vitamins and biostimulants (levamisole, pentoxil, methyluracil ) must be prescribed for the restoration of immunity and the fastest healing of the focus.

В качестве противовоспалительных и жаропонижающих препаратов назначают нестероидные средства: аспирин, диклофенак, ибупрофен, баралгин, реопирин. 4) As non-inflammatory and antipyretic drugs, non-steroid agents are prescribed: aspirin, diclofenac, ibuprofen, baralgin, reopyrin.

При выраженной интоксикации неоднократно вводят раствор глюкозы или реопирин. 5) With severe intoxication repeatedly injected with a solution of glucose or rheopyrin.

Для снятия интоксикации назначаются обильное питьё и мочегонные средства. 6) For the removal of intoxication, abundant drinking and diuretics are prescribed.

Физиотерапевтические процедуры: 7) Physiotherapeutic procedures:

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

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

Surgical treatment of erysipelas, photo 7

Surgical treatment of erysipelas, photo 7

Сенсибилизацию организма предотвращает приём антигистаминных препаратов. 8) Sensitization of the body prevents the intake of antihistamines.

Склеротерапия — введение в поражённые вены вещества, вызывающего сужение и рассасывание сосуда — способствует быстрому заживлению пузырей и оздоровлению воспалённого участка кожи. 9) Sclerotherapy - the introduction of a substance into the veins that causes narrowing and resorption of the vessel - promotes rapid healing of blisters and healing of the inflamed skin area.

Эндовазальная лазерная коагуляция — приводит к исчезновению просвета в больных венах, предупреждая развитие лимфостаза. 10) Endovasal laser coagulation - leads to the disappearance of lumen in diseased veins, preventing the development of lymphostasis.

Хирургическая обработка очага поражения: 11) Surgical treatment of the lesion:

  1. opening of blisters, treatment with furicillin solution, enterosepthol in powder form, erythromycin ointment;
  2. excision of inflamed veins and necrotic areas.

В тяжёлых случаях проводят переливание крови или плазмы. 12) In severe cases, a blood or plasma transfusion is performed.

Treatment of erysipelas is performed by a doctor. To avoid complications, the patient must strictly perform all medical appointments, even with outpatient treatment.

When treating erysipelas in the home, it is important to know:

Нельзя туго бинтовать поражённый участок, допускаются только лёгкие повязки, которые за день несколько раз меняют после антисептической обработки кожи. 1) You can not tightly bandage the affected area, only light bandages that are changed several times after antiseptic treatment of the skin are allowed.

Нельзя применять ихтиоловую мазь и бальзам Вишневского — они усиливают приток внутритканевой жидкости и замедляют процесс заживления; 2) You can not use ichthyol ointment and Vishnevsky's balm - they increase the inflow of interstitial fluid and slow the healing process;
excessive softening of the skin with ointments will lead to additional infection of the wound.

После вскрытия пузырей можно обрабатывать эрозии перекисью водорода и присушивать кожу под ними присыпкой, в которую входят: 3) After opening the bubbles, it is possible to treat erosion with hydrogen peroxide and put the skin beneath them with a powder, which includes:

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

Top cover the wound surface with two-layer gauze.

Complications of erysipelas

Erysipelas can pass by itself: two weeks after the onset of the disease redness decreases, but swelling and skin pigmentation remains for a long time. The probability of a repeat process is great.

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

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

Streptococcus toxins cause rheumatism, myocarditis and glomerulonephritis.

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

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

Forecast

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

Recurrent forms often develop with the addition of the Staphylococcal Flora to the BHSS.

Due to acquired lymphostasis, work capacity may be reduced.

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

Prevention of erysipelas

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

Are common:

  • limit contact with patients with erysipelas, after contact, perform antiseptic treatment of their skin;
  • to take care of strengthening immunity by adjusting the regime of the day, exercise, avoidance of stressful situations;
  • in time to eliminate the foci of chronic streptococcal infection, to monitor the state of health;
  • to establish a proper healthy diet - hemolytic streptococcus rapidly multiplies in stale food, giving particular preference to meat broths;
  • in order to avoid relapse after the transferred erysipelas to conduct preventive injections of bicillin all the year round.

Local measures:

  • pay more attention to your feet - regularly wash them, avoid calluses and rubs, small cuts, hypothermia and overheating;
  • Monitor the condition of the venous system and consult a specialist in time.

Erysipelas of microbes 10

In the International Classification of Diseases ICD 10 erysipelas is found:

Class I
- A30 - A49 Other bacterial diseases

  • A46 erysipelas (erysipelas)
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