Streptoderma

General information

Streptoderma is a disease caused by streptococci.
Damage to the skin is characterized by the appearance of a rash. Blisters and ulcers form on the surface of the skin, which itch and cause discomfort. Streptoderma in children can be acute or chronic. The first is characterized by an aggressive course with severe symptoms. Chronic is characterized by periodic exacerbations and periods of subsidence of the inflammatory process.

Based on the depth of the lesion, streptoderma is divided into superficial, deep and intertriginous (the rash develops in the skin folds). Each of the forms has its own characteristics.

Streptoderma in pregnant women

In the process of bearing a child, a woman undergoes a significant restructuring of her hormonal levels and a decrease in immunity. The body uses all resources for the development of the fetus. It is at this moment that the expectant mother is most vulnerable to the possibility of streptoderma.

The disease does not harm the health of the unborn baby; infection can only occur when streptococcus enters the bloodstream. Infection can get on the baby's skin during childbirth if there are infectious rashes on the woman's body. In this case, the disease can cause serious complications and threaten the child’s health.

Timely treatment will reduce all risks of infection during childbirth. Doctors will select the most gentle therapeutic course. All prescribed medications will not be dangerous for the baby. Most often, special creams and ointments are prescribed.

Symptoms of streptoderma

Streptoderma in children occurs with severe symptoms:

temperature rise to 39°C;
intoxication;
enlarged lymph nodes.

The condition of the skin differs depending on the form of the disease:

Superficial. First, red spots appear on the skin. After 2-3 days they transform into blisters with a cloudy liquid inside. The blisters increase to 2 cm in diameter, then burst. In their place, yellow crusts form. Subsequently, the skin in this place heals, and the disease spreads further.
Dry. This form is more common in boys. White and pink spots up to 5 cm in diameter form on the skin. They are located on the face, neck, ears, arms and legs, and are gradually covered with a scab. After healing, scars may remain. These areas remain lightened and do not tan under the sun.
Streptococcal infection. The disease affects the corners of the mouth and occurs when there is a lack of vitamin B. Microcracks appear on the skin, which hurt and bleed. Then they transform into pustules that become crusty. It hurts the child to open his mouth, eating becomes difficult. Less commonly, streptococcal seizures occur in the corners of the nose or eyes.
Felon. If streptococcus affects the periungual ridges, panaritium occurs. It is more common in children who are accustomed to biting their nails. Over time, the ulcers open up.
Streptococcal diaper rash. This form of the disease is typical for infants. Blisters form in the folds of the skin. They gradually merge. If they are opened, pink, weeping surfaces are exposed.

Knowing how streptoderma begins in children, parents will be able to contact a dermatologist in time and begin treatment. If you delay going to the doctor, the disease becomes chronic, and achieving a complete cure becomes very difficult.

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23177 November 26

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Streptoderma: causes, symptoms, diagnosis and treatment methods.

Definition

Streptoderma (impetigo) is an infectious skin disease that is more common in childhood. Belongs to the group of pyoderma, which is based on purulent lesions of the skin, its appendages, as well as subcutaneous fatty tissue.

Causes of streptoderma

As the name of the disease suggests, the causative agents of streptoderma are usually streptococci.

Exogenous factors contributing to the development of the inflammatory process and its relapses include:

violation of the integrity of the epidermis (microtraumas, maceration of the skin);
In adult patients, infection can enter the skin as a result of non-compliance with the rules of asepsis and antisepsis when performing cosmetic procedures (mesotherapy, peelings, etc.) or when using contaminated cosmetic instruments.
increased sweating (hyperhidrosis);
shift of skin pH to the alkaline side, the effect of high and low temperatures;
skin contamination.

Endogenous risk factors include:

various endocrinopathies (for example, diabetes mellitus);
insufficient intake of proteins into the body;
presence of severe somatic diseases;
chronic intoxication;
the presence of foci of infection in various organs and tissues.

Streptoderma is a contagious disease and can be transmitted by contact (through a handshake, contact with a surface on which a streptococcal infection is present, etc.) and by airborne droplets.
Classification of streptoderma
Streptoderma can be superficial and deep.

Superficial streptoderma:

streptococcal impetigo,
crevice impetigo,
paronychia,
papulo-erosive streptoderma,
intertriginous streptoderma,
erysipelas,
Streptococcal toxic shock syndrome (STSS),
acute diffuse streptoderma.

Deep streptoderma:

cellulite,
ecthyma vulgar.

There are three stages of streptoderma:

initial, when there are small purulent rashes resembling blisters;
non-bullous, which develops after the opening of the vesicles and is characterized by the formation of streptococcal ecthyma (ulcerative streptoderma);
chronic, which develops either due to improper treatment of the disease or as a result of decreased immunity and is characterized by regular rashes.

Symptoms of streptoderma
Impetigo streptococcal

observed in children of different age groups. It is characterized by the formation of conflicts (rash elements) with serous or serous-purulent contents, mainly on the skin of the face. As a result of the opening of the blisters, ulcers are formed, which are covered with dry crusts that fall off after 3–4 days. Scars form after the disease extremely rarely.

For bullous impetigo

characteristic rashes with serous-purulent contents and surrounded by a pink halo. After opening, erosions, covered with a thin crust, form in their place. The rashes are localized mainly on the lower extremities and the back of the hands.

Slit impetigo (jamming)

represents shallow cracks and erosions that tend to macerate (wet). Localized in the corners of the mouth, at the outer corners of the eyes, at the base of the wings of the nose.

Paronychia (superficial panaritium) is a phlyctena on an inflamed base, localized around the nail plate.
Papulo-erosive streptoderma
is observed in infants and is localized on the skin of the buttocks, back and inner thighs, in the perineum, and scrotum. The disease is characterized by dense bluish-red papules surrounded by inflamed skin. Phlyctens form on the surface of the papules, which quickly open with the formation of erosions and crusts.

Intertriginous streptoderma

localized on the contacting surfaces of large folds (inguinal, axillary, cervical, buttock, behind the ears). The bubbles quickly open with the formation of weeping erosions that have clear boundaries. This form of streptoderma often occurs in children and adults with excess body weight, diabetes mellitus, and hyperhidrosis.

Erysipelas

, as a rule, is localized on the legs, arms, torso (in areas of surgical wounds), on the face (as a complication of rhinitis or conjunctivitis), in children - on the cheeks, in the periorbital region, on the neck and limbs. Inflammation is represented by erythema with raised edges, clear boundaries of irregular outline. The source of inflammation is swollen, shiny, hot to the touch, painful on palpation. Sometimes blisters, subcutaneous abscesses, and necrosis form on the surface of the lesion.

Streptococcal toxic shock syndrome (STSS)

characterized by the acute development of shock and organ failure. The patient quickly develops hypotensive shock with renal failure. Soft tissue infection is observed in 80% of patients and in most cases (70%) occurs as a severe subcutaneous infection (necrotizing fasciitis, myositis). Vesicles and blisters on the surface of the inflammatory focus do not appear immediately and not in all patients and are an unfavorable prognostic sign. Mortality reaches 30%.

Early signs of STSS may include hyperemia of the conjunctiva and oropharyngeal mucosa, and a crimson tongue.

Other skin signs include petechial, maculopapular, and diffuse scarlet-like rashes.

Acute diffuse streptoderma

characterized by the presence of conflicts, prone to peripheral growth and fusion with the formation of large erosions, bordered by a rim of exfoliated epidermis. There is pronounced swelling, hyperemia, profuse oozing, and serous crusts. The process is localized, as a rule, on the lower extremities, as well as around infected wounds, fistulas, and burns.

Cellulite

– infectious inflammation of the dermis and subcutaneous fat. The inflammatory focus has a bright red color, unclear contours, swollen, hot and painful on palpation. Within the focus of inflammation, vesicles, blisters, hemorrhages and even an abscess can be observed. Cellulite can appear on any part of the skin, but is more often localized on the skin of the lower extremities and face. Patients complain of malaise and body temperature rises.

Ecthyma vulgaris

– deep tissue damage with ulceration in a limited area. The disease manifests itself with the appearance of blisters with purulent contents, which within a few days become covered with crusts, under which deep ulcers form. Scars form at the site of the ulcers.

Diagnosis of streptoderma

Diagnosis of streptoderma is not difficult; the diagnosis is made based on the clinical picture and laboratory tests:

bacteriological examination of purulent discharge with determination of sensitivity to antibacterial drugs;

Causes of streptoderma

The causative agent of the disease is group A streptococcus. The bacterium affects the surface of the skin. But not every encounter with a microorganism leads to the development of a disease. Infection occurs if there are aggravating factors:

cuts, abrasions, cracks and other damage to the skin into which pathogens easily penetrate;
failure to comply with hygiene rules;
weak immunity;
endocrine pathologies;
concomitant dermatological diseases;
stress;
avitaminosis;
washing the skin too often, as a result of which the protective film is washed off;
intense exposure to low or high temperatures;
intoxication;
blood flow disturbance.

If at least one of the listed causes of streptoderma in children is present, the likelihood of developing pathology increases significantly.

Ways of infection of streptoderma

Regardless of the form in which the disease occurs, its infectious nature implies rapid transmission.

Infection can occur in one of the following ways:

close contact with an infected patient, such as shaking hands, kissing or hugging;
received injury to the skin in the form of an insect bite, burn or cut;
contact with a surface on which there is a trace of contact with a sick patient, this could be door handles in public places, handrails in transport, cutlery or bath accessories;
by airborne droplets from sneezing or coughing.

When a patient is in a large group, an outbreak of the disease can very quickly lead to a quarantine regime. Therefore, when primary signs of suspected streptoderma appear, the person must immediately be isolated from others. The incubation period can last up to two weeks. At the same time, people who were in direct contact with the sick patient are being monitored.

Treatment of streptoderma

Even if the initial examination was carried out by a pediatrician, a dermatologist should prescribe treatment for streptoderma in children.
A specialist in this profile is aware of narrow-spectrum drugs that will help to quickly cope with the disease. The first step is to transfer the child to a therapeutic diet with restrictions on sweets, fatty and salty foods. The course of therapy involves avoiding bathing: water procedures contribute to the spread of the disease. It is recommended to wash healthy areas with chamomile decoction, and never touch inflamed areas.

It is important to choose the right clothes for a sick child. Synthetic and wool items should be excluded from your wardrobe. These tissues cause discomfort and contribute to the spread of the disease.

Doctors recommend opening the blisters that form on the skin with a sterile needle, then treating the opening erosions with brilliant green 2 times a day. Areas of skin not infected with bacteria are wiped with a boron solution. Weeping erosions are lubricated with silver nitrate or resorcinol.

If crusts form on the skin, they are treated with antibacterial gels or ointments.

In severe cases, a number of other oral medications are prescribed:

antibiotics of the tetracycline or chloramphenicol series;
anti-allergy medications;
immunostimulants;
vitamin complexes;
antipyretic drugs.

The list of medications must be agreed upon with your doctor. Only a specialist knows how to treat streptoderma in children correctly. Self-medication can provoke the pathology to become chronic. With an adequate course of therapy, the symptoms disappear after 7 days, but after curing the deep form of the pathology, scars remain on the skin. Therefore, it is necessary to consult a doctor as early as possible.

Diagnosis of streptoderma

If characteristic signs of a skin disease appear, an immediate visit to our Your Health clinic in Moscow is required.

At an appointment with a dermatologist, an initial examination will be carried out followed by the appointment of the necessary diagnostic measures, the purpose of which is to confirm the preliminary diagnosis:

taking an anamnesis, during which the doctor will ask leading questions about the onset of symptoms, bad habits and other chronic pathologies;
a survey will be conducted about the place of work and social and living conditions will be clarified;
at the next stage, an examination of the affected areas of the skin is carried out, with an assessment of the localization, degree of prevalence and type of rash;
referral for bacteriological culture to collect the contents of papules and ulcers;
The test reveals the sensitivity of bacteria to various types of medications, which facilitates the correct selection of antibiotics for therapy.

Depending on the results of the study, additional tests may be prescribed in the form of biochemical blood sampling, determining the presence of syphilis and thyroid hormones. General analysis of urine and feces for worms.

Prevention of streptoderma

To reduce the likelihood of developing streptoderma in a child, follow the rules of prevention:

observe the rules of hygiene;
treat skin lesions with antiseptics;
strengthen your immune system with vitamin complexes and good nutrition;
do not wash your child with soap too often;
At the first symptoms of any disease, consult your doctor.

Streptoderma is a curable disease, but you need to see a doctor in time. The sooner treatment is started, the easier it is to avoid complications and transition to a chronic form. You can undergo a qualitative examination of your skin condition at the SM-Doctor clinic. Qualified pediatric dermatologists will make the correct diagnosis and prescribe the correct treatment.

Complications of streptoderma

The disease can cause serious harm to the health of patients suffering from immunodeficiency and people prone to frequent allergies. If, when the characteristic symptoms of streptoderma appear, the patient does not seek help in time, then the risk of developing complications increases significantly, which include:

when an infection enters the bloodstream, sepsis may form or blood poisoning may begin;
the appearance of deep wounds from non-healing ulcers;
damage to internal organs by staphylococci, rheumatism and nephritis may develop;
dangerous increase in body temperature;
intestinal dysbiosis;
damage to the fetus during childbirth if the mother has infectious rashes on her body;
the appearance of thrombophlebitis.

Quite often, after severe stages of skin damage, scars form that remain forever. A cosmetic defect subsequently requires additional expensive procedures to smooth out the outer layer of the skin.

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Bacterial infection of the deep layer of skin

Occurs when microbes enter deep into the dermis.

Furuncle

First, a painful node appears, then an abscess matures in its center. After 5–7 days it opens, a purulent-necrotic core is released, and the wound is scarred. When there is more than one lesion, they speak of furunculosis.

Carbuncle

These are several boils united into a common infiltrate. The place looks like a purple-bluish tumor. Pain increases, well-being suffers, body temperature rises. After opening the formation, a deep ulcer remains, healing with a scar.

Acne (blackheads)

- inflammation of the sebaceous gland ducts due to blockage. Pustules form on the face, chest, and shoulders. Their contents dry out to crusts, after which, when rejected, scars or bluish spots remain.

Hidradenitis

Purulent inflammation of the sweat glands. The process often recurs. Favorite localizations are armpits, inguinal folds, under the mammary glands. Deep painful nodes appear, bluish-red on the outside. They are opened with the separation of liquid pus.

Erysipelas

Occurs in people who are individually predisposed. Foci of inflammation are clearly limited. The affected area is swollen, hot, bright red, with bursting blisters. The disease is accompanied by fever, intoxication, and severe pain.

Deep pyoderma can be complicated by inflammation of the lymphatic vessels and nodes, abscess, and sepsis.

Stages of the disease

IT IS IMPORTANT TO KNOW!
There are three stages. At the initial, bullous stage of streptoderma, the appearance of purulent blisters is observed in the lesion. Further in the photo you can see deep skin lesions and ulcers, which dry out after some time. The third stage, and with it the chronic form of the disease, develops due to lack or improper treatment.

Streptoderma and similar diseases

Based on external manifestations and test results, not only a diagnosis of streptoderma, but other pathologies of the skin can be established.

In terms of external signs, the diseases are similar to each other, but the treatment regimen is completely different:

allergic dermatitis, characterized by severe itching not only in areas of the rash;
lichen and herpes, viral manifestations with rashes localized in the waist and abdomen, accompanied by elevated body temperature;
eczema, appears upon direct contact with an allergen or as a complication of chronic streptoderma;
staphylococcal pyoderma, destroys the sebaceous glands, and in severe form can cause furunculosis;
chickenpox, a viral pathology accompanied by rashes on various parts of the body;
pityriasis versicolor, characterized by the appearance of brown or reddish spots, the skin in the affected areas begins to peel off.

To accurately establish the disease, it is necessary to undergo a detailed examination and pass the necessary tests. Based on the results, the pathogen will be identified and an accurate diagnosis will be made.

Basic terminology

Under the influence of an infectious infection, round purulent and flaky elements can form on the body, which are painful and can increase in size and quantity. This is how diseases of the streptoderma group usually occur. The following photos and descriptions will tell you what these diseases look like, how they begin, and how they are treated.

Treatment of bacterial skin infections

It should start from the early stages and be carried out under the supervision of a specialist. In some cases, local treatment with antibacterial ointments and wiping with antiseptics is sufficient. Widespread rashes, deep pyoderma, require the prescription of systemic antibiotics. In chronic cases, the doctor may recommend autohemotherapy and immune drugs.

Surgical treatment is carried out if the abscess does not open on its own or if a rough scar must be avoided. Laser coagulation and physiotherapy are used to restore tissue.

It is important to identify and treat concomitant diseases, eliminate adverse external effects on the skin, and select nutrition.

Prevention

Observe the following rules:

After visiting the gym, wipe the areas that came into contact with the equipment with an antiseptic.
Treat cuts and wounds with antibacterial drugs (iodine, salicylic alcohol, hydrogen peroxide) immediately after they occur.
Do not share hygiene items or cosmetics with other people.
Places of abscesses and impetigo should not be washed with water, combed, or pressed.
Avoid spicy fatty foods and sweets.

Make an appointment with a dermatologist on time.
The doctor will help you identify the cause of the inflammation, do the necessary tests, and select a treatment that suits the type and stage of pyoderma. December 5, 2020
Author of the article: dermatologist Mak Vladimir Fedorovich

Symptoms

The causative agent of the disease determines the specific clinical picture. However, in general, the symptoms of streptoderma are more or less similar. The cause is often minor damage - for example, scratches in children or shaving in young men. Symptoms include:

Two to three days before the appearance of the rash, a person subjectively feels pain at the site of the future lesion. The inflammatory process still remains in the inner layers of the epidermis.
Next, blisters or redness appear. Zaeda or classic impetigo gives dry red crusts (“lichen”). The size of the rashes varies from 3-5 mm to large ones, more than 2 cm in severe forms of the disease.
The blisters inside are filled with purulent-serous contents.
In children, the symptoms of streptoderma in the form of skin manifestations are accompanied by manifestations of general intoxication - lethargy, low-grade fever, and perhaps poor appetite.
Subjectively, a person feels pain and sometimes itching in the affected areas.

Without treatment, the lesions tend to grow. If the course of the disease is unfavorable, complications are possible: the infection goes deeper, forming boils and abscesses up to general sepsis. Therefore, timely treatment of streptoderma plays an important role. The disease can also take a chronic form with the formation of permanent foci of proliferation of pathogenic microflora. Therapy against the disease will avoid this development.

Diet for streptoderma

During the acute form of the disease, in addition to treatment with antiseptic agents and antibacterial treatment, it is required to adhere to a diet. The following foods should be included in your daily diet:

legumes and nuts;
lean meat, fish, eggs and a small amount of fresh cottage cheese;
porridge;
soups cooked in low-fat broth;
fruits and vegetables;
unsweetened compotes, decoctions and other drinks with low sugar content.

There are no strict restrictions on foods for patients with streptoderma, but doctors advise to refrain from eating fried foods, sausages, butter and hot seasonings. It is advisable to temporarily exclude from the daily diet all products that contain dyes and flavor enhancers.