The name "piodermity" comes from the Greek words (ruon - pus, and tar - the skin) is purulent-inflammatory diseases of the skin caused by a variety of pathogens: pathogenic staphylococcus, streptococcus, pneumococcus, Proteus vulgaris, B-negnoynoy and E. coli, but more often pyococcus - streptococci and staphylococci, manifesting the formation of the skin of the primary elements - the pustules (pustules).
Piodermity may be primary independent disease, or arise secondarily as a complication of itching dermatoses - scabies, lice and allergic (eczema, atopic dermatitis), as well as fungal diseases that affect the smooth skin, scalp and feet.
The share piodermitov accounted for 50% of temporary disability, ill all, but most people are those occupations where there is increased trauma and contamination of the skin: builders, steelworkers, miners.
Features of the modern course of pyoderma
1.U adults more often multiple boils, hydradenitis (hot processes).
2.Uchastilis impetiginoznye processes, especially as a complication of scabies, lice, allergic - eczema, atopic dermatitis because of the constant itching and skin injuries, as it has been an increase in allergic and enormous growth of scabies, pediculosis, which is important for the occurrence of migration, war, homeless, refugees, migrants, the rise in prices on detergents and rising unemployment.
3.Uchaschenie strepto-staphylococcal superinfection on the background of increasing secondary immunodeficiency population (many of pneumonia, acute respiratory viral infections, especially herpes infections), as well as the growth of HIV-infected people who have piodermity will be severe, chronic, with the presence of deep forms, with a strong demonstration effect primary acquired immunodeficiency does not respond to treatment, with some torpid throughout.
4.Uchaschenie piodermitov due to increased intestinal dysbiosis in children and even adults (after treatment with antibiotics, cytostatics, corticosteroids), as mikrotsinoz skin is in direct relation to intestinal dysbiosis.
5.Sleduet noted that in dermatology became rarer deep piodermity: chronic ulcerative-vegetative pyoderma, pioallergidy, deep infiltrative-ulcerative processes. Prevention piodermitov in children is extensive preventive work: sanitation pregnant sanprosvetrabota with pregnant and her parents, sanitation and hygiene activities in institutions and at home, isolation of sick children, crystal mode in the nursery, holding a wet cleaning with a detergent, regular medical monitoring over child care workers (Suspension patients with SARS, sore throat, piodermitami).
Etiology and pathogenesis piodermitov.
Most-pustular skin diseases caused by streptococci and staphylococci. Staphylococci are found in the mouths of hair follicles, sebaceous and sweat glands, respectively, causing inflammation. Streptococci inhabit the smooth skin and the folds (the skin). A major role in causing piodermitov played pathogenicity and virulence of the pathogen. Virulence of staphylococci and streptococci is due to their toxins and enzymes (enzymes). Healthy skin with its high immunity is a barrier for many organisms, even virulent, pathogens and their toxins. Inflammatory process in the outbreak of staphylococcal and streptococcal infections in response to infection occurs as follows. Root in the skin piokokki, depending on the properties they emit the toxin and its ability to affect living tissues in the body, on the one hand, violate the intracellular and intermediate exchange, on the other hand, affect numerous skin receptors. The consequence is an inflammatory process with a complex set of biochemical and immuno-biological reactions.
The main feature characterizing the inflammatory process caused by staphylococcal infection is festering while the process of streptococcal origin characterized by serous inflammation without suppuration. The inflammatory process caused by staphylococcus, is characterized by high activity, strong dilation of blood vessels, increasing their permeability. Through extended intervals between the endothelial cells begin to leave the masses from the bloodstream into the surrounding tissue polymorphonuclear neutrophils. They surround the source of infection massive leukocyte band, which performs active phagocytosis. White blood cells, digesting the staphylococci transformed into pus cells - purulent exudate. Clinical features of streptococcal inflammatory process is sluggish inflammatory process with a sharp tissue edema.
Clinical varieties piodermitov
Staph infection is ranked first in the pattern of morbidity in infants can cause neonatal mortality, and even children's early childhood. By stafilodermiyam include: ostiofollikulit, folliculitis, furuncle, carbuncle, hydradenitis and some other less common diseases. Ostiofollikulit - the first element of all forms of stafilodermy with the defeat of the follicle. At the mouth of the follicle appears pustule, pustules tight lid, the contents of purulent, and after opening the pustules exposed erosion. Folliculitis - is more profound defeat of the follicle has the form of bright red nodule, painful on palpation. Blotch - an acute purulent-necrotic follicles, sebaceous glands and the surrounding subcutaneous fat, the size of infiltration depend on the reactivity of the organism. Blotch is often accompanied by violation of the general conditions: fever, malaise, weakness.
Carbuncle - a conglomerate of boils, united by a common infiltration, the pain of carbuncle throbbing, tearing, lesion slate-blue color in the future it is melted, there are multiple holes, from which the gnoynokrovyanistaya liquid. Furunculosis - a chronic process. The development of furunculosis promotes change in the total and immunobiological reactivity, the presence of somatic diseases - diabetes, liver disease, stomach, colon, foci of chronic infection.
They are characterized by loss of surface layers of the skin and wrinkles (hair follicles, sweat, sebaceous glands are not affected).
Surface streptodermity in children: a strep impetigo - conflicts, angular stomatitis - slit impetigo (Zayed), bullous (impetigo gallbladder) turniol (surface felon) and certain other diseases.
Strep impetigo is characterized by a rash of surface bubbles of various sizes on hyperemic background with transparent content, the content of shrinking bubbles in the straw-yellow crust, possibly spreading process from one site to another resulting from the infection. Turniol - defeat cushion nail; disease contributes obkusyvanie nail avulsion burrs, leather cushion nail at first blush, then becomes edematous, painful, further untreated process may lead to rejection of the nail plate.
Mixed piodermity (streptostafilodermii) in this group include pyoderma, which originally arise defeat streptococcus, which soon joins aureus.
An example of surface streptostafilodermii is vulgar impetigo (contagious). After joining the initial element of staphylococcal destruction - conflicts, strep impetigo - is transformed into pustules covered with massive friable "honey" crusts of yellow-green color. Often difficult for scabies, lice, allergic, may be localized on the face with involvement of nasal mucosa, conjunctiva.
Treatment is carried out taking into account exogenous factors (hyperthermia, hypothermia, microtrauma, contamination of the skin) and endogenous factors, including disorders of protein, carbohydrate, fat, vitamins exchange and water balance. Therefore, clinical and laboratory conducted a full examination of the patient.
1.Principle treatment is to apply: etiopathogenetic treatment.
2.Individualnogo treatment in view of reactivity and background diseases, as well as the antibiotikogrammy - individual sensitivity of microflora to antibiotics.
5.Efferentnyh (non-medical) treatments.
Surface piodermity easy to topical therapy (at ostiofollikulitah, folliculitis, impetigo) aniline dyes (1-2% solution of methylene blue), magenta, fukartsina, paint Castellani, Baliz-2 (5% levomitsitinovogo, 2% boric alcohol, 2% boron- salicyl alcohol to clean the adjacent unaffected areas to prevent autoinokulyatsii piokokkami).
Recommended lubrication ointments containing antibiotics: gentamitsinovoy, linkomitsinovoy, polimiksinovoy, tetracycline, and 5-10% levomitsetinovym streptotsidnym liniments, levosinom, levomikolem, dioksikolem, sinpastoy ASD silver drug Argolife (0,05% solution of colloidal silver) with high antimicrobial effect ( production company ART LIFE).
Infants make common baths with disinfectants: a pale pink solution of potassium permanganate, etakridinlaktatom, or 5.0 g of zinc sulfate or copper sulfate at 5.8 liters, or bath with extract of fir ABITEL, as well as light RPMA bath salt as lemepa and the addition of ginseng, Rhodiola rosea (golden root). Treatment of children with staphylococcal skin lesions should be comprehensive, taking into account individual characteristics and Nutrition (correct breastfeeding, full, rich in vitamins and trace elements, with a sufficient amount of protein nutrition nursing mother).
General treatment. With deep piodermitah and common processes shown etiopathogenetic treatment, where the main etiotropic agents are antibiotics. With widespread severe forms with significant toxicity - a violation of general condition (fever, weight loss, weakness, refusal of the chest, regurgitation, vomiting), the presence of complications such as otitis, pneumonia, abscess especially with the development of pleurisy, staphylococcal enterocolitis - carried out a comprehensive therapy, as in sepsis. In addition to antibiotics, specific gamma-globulin, are shown detoxification tools: intravenous gemodeza, polioksidina, reopoliglyukina; effective methods such as plasmapheresis, hemosorbtion, intravenous laser therapy, the use of sorbents - polifepanovoy pasta for two weeks, medetopekta (containing apple pectin), biologically supplement FITOSORBOVIT firm ART LIFE until 10-12 days, karboktina as karbogelya on starch or karbomikstury on boiled water up to 5-7 days; enterodez and enterosorb within 10 days. Along with specific and nonspecific therapy, shows Vitamin A, B, C, D, E. For adults: autohemotherapy, lactotherapy, pyrotherapy, fermentoterapiya and physiotherapy. In the complex treatment of patients with pustular diseases have proven physical therapy techniques: phonophoresis with enzymes, antihistamines, electrophoresis, ultrasound, UHF, laser.
Prevention of pyoderma
Prevention of pyoderma newborns is screening pregnant, timely readjustment of chronic foci of infection, nutrition, hardening of children, the timely processing of the injured skin care institutions, maternity homes close to the sanitation twice a year.
Prophylaxis for adults - is to create optimal conditions in production, injury prevention, healthy summer (spa treatment with water treatments, hardening, Phytococtails).
It is also recommended the use of biologically active supplements (BAS) firms ART LIFE , boosts the immune defense, containing vitamins, trace elements, lacto-, bifidobacteria (ATSIDOBAK, BIFIDOBAK, cat's claw, Discovery CHARM, Discovery or force, or the Discovery Excellent, HEPAR FORMULA, RENSEPT, SKIN LINE SUPER Shield, Kaltsimaks, Green Star, TOKSFighTER, NEYROSTRONG company ART LIFE), the dosages prescribed by your doctor.
ARGOSEPT Occurrence piodermitov promote primary and secondary immunodeficiency states. In HIV-infected patients with primary acquired immunodeficiency piodermity occur chronically, getting deeper forms. In patients with congenital immunodeficiency piodermity always difficult for allergic diseases, so immunotherapy is a leader in the complex treatment of these patients. The drug ARGOSEPT offered by ART LIFE is designed for outdoor use in acute and chronic piodermitah (superficial and deep), as suppresses infection-inflammatory processes of the skin. The drug is an original set of silver with a broad spectrum of antimicrobial activity against pathogens piodermitov - staphylococci, streptococci, Proteus, Pseudomonas aeruginosa and other microbes, including resistant to antibiotics. The drug has potent anti-inflammatory effect, stimulates the regenerative processes in skin tissues.
-Ostiofollikulit, folliculitis, boils, carbuncles, hydradenitis;
- Vulgaris sycosis
- Rozatseopodobny folliculitis face Settona;
- Dekalviruyuschy folliculitis;
- Pyoderma gangrenosum;
- Strep impetigo;
- Vulgar ecthyma;
- Chronic ulcerative-vegetative pyoderma, shankriformnaya pyoderma, pyogenic granuloma (botryomycoma).
How to use: Apply a thin layer on affected areas of the body 2-3 times a day
Contraindications: drug intolerance silver.