One of the many skin diseases that affect its deepest layers is ectyma. The lesion, which affects the deeper layers of the epidermis, is provoked by infection with streptococcus / staphylococcus.
Features of the disease
Ecthyma usually begins in the sick as a sore. Rankes can be single / multiple. This disease is characterized by the manifestation of pigmentation, small scars on the epithelium after the sores heal. This pathology affects 2 layers of skin:
- epidermis;
- dermis.
In young children, in very weak newborn babies, the disease looks like deep penetrating ulcers.
Next we'll talk about contagious, vulgar, common, streptococcal, gangrenous, syphilitic ecthim in humans, we'll take a look at the patients' photos, give useful advice.
The expert in this video will tell about the eclipse and similar diseases:
Classification of
The defeat of the skin can act as a primary illness( due to a microtrauma), and also as a secondary one( in the background of dermatoses like eczema, scabies).
Specialists distinguish such types of ecthymas:
- vulgar .This form of the disease refers to the ulcerative lesions of the dermis, which developed due to the penetration of streptococcus. In the beginning vulgar ectima appears under the influence of streptococcus, then streptococcus joins it. The disease develops in the body, whose protective system is reduced due to malnutrition, chronic diseases, disruption of the nervous system;
- gangrenous .It is referred to as primary skin infections. The disease provokes Pseudomonas aeruginosa. A painful ulcer occurs in the place where the infection has penetrated. Due to injury of the vessels, rapid necrosis of the sore is noted. This form of the pathology in question provokes the development of sepsis.
Ecthyma stages
Disease is observed in patients in two stages:
- Pestule .Skin covers cover pustules.
- Ulcerative .After combing the pustules, ulcers appear.
Causes of
The specialists noted that ecthyma occurs more often in people with weak immunity due to the following pathologies:
- tuberculosis;
- HIV;
- dermatoses;
- circulatory disturbance;
- vitamin deficiency;
- impaired lymphatic circulation;
- diabetes mellitus.
Symptoms of
This lesion of the epithelium is more often formed on the legs. In other parts of the body, traces of the disease may also appear. The main symptom of developing pathology is ulcers.
- At the beginning of the disease dermal nodes are formed, which are characterized by a dense structure. Such formations are very painful. At the top of the node, a small bubble forms, which then turns into a flat blister. Inside such a blister is a bloody liquid. Blisters can be of small size or very large with a diameter like that of a hazelnut. The bottom of the node has a cyanotic, bright red color.
- The bloody liquid inside the vesicle shrinks with time. A brownish crust forms on the bladder, which will disappear in a couple of weeks. On the site of the sore there will be a scar, which in most cases is pigmented.
- With violent rejection of the crust of the blister, you will see a deep ulcer, at the bottom of which there is a purulent coating. The edges of such ulcers are soft, inflamed, slightly elevated above the healthy skin.
- With a light form of ecthyma, the skin is covered from 1 to 5 ulcers. In more severe cases, multiple eruptions occur on the epithelium. The pathology considered can disturb a patient for several months. If the ecthyma is very difficult, new pustules appear against the background of healing ulcers.
- In some cases, the lymph nodes may be enlarged, which are located close to the affected area. The patient may also be troubled by such signs of ecthymia as weakness, fever.
The following methods of investigation of the contagious and other forms of ecthyma are examined.
Diagnosis
To accurately establish the diagnosis, a specialist studies the clinic of the disease. He offers the patient a surrender tank, which is necessary for the establishment of an infectious agent that provoked infection of the epithelium. The purulent discharge from the ulcer is taken for analysis. Also, the sensitivity of the infection to different antibiotics is established. Such a study is required to select the most effective therapy.
By conducting a histological examination of a biopsy specimen taken from an infected area, specialists discover the following components:
- horny masses;
- crusts of fibrin;
- epithelial cells;
- microorganisms;
- leukocytes.
The doctor recommends conducting comparative diagnostics with such diseases:
- trophic ulcer;
- late cutaneous periphery;
- herpes;
- scrofuloderm;
- syphilitic ecthima;Impersonation
- ;
- ischemic leg ulcers;
- sporotrichosis.
To exclude these diseases, the patient is sent for blood donation:
- to RW;
- for sugar;
- for syphilis.
A patient with suspected ecstema will need to be examined by the following specialists:
- phthisiatrician;
- dermatologist;
- endocrinologist;
- Surgeon;
- therapist.
On whether vulgar, streptococcal and other types of ecthymia are curable in children and adults, read below.
Treatment of
For the treatment of ectyme, various methods are suitable: medication, physiotherapy, therapeutic. In the process of treatment, the bubbles are opened to be treated with a special medicine( aniline dye, disinfectant ointment). Most often used such disinfectant ointments:
- "Ichthyol ointment"( 10%).
- "White mercury ointment"( 5%).
If the patient has a chronic form of the disease, it is treated with the following drugs and procedures:
- "Tetracycline".
- Multivitamins.
- Biomycin.
- "Sulfadimezin".
- Autohemotherapy.
Therapeutic method
- Treatment of the disease with the therapeutic method involves the use of vitamin preparations, antibacterial ointments( "Erythromycin", "Tetracycline").
- The patient is shown to follow a special diet, which excludes sugar from the diet, as a nutritious among microorganisms, alcoholic beverages.
- Ulcers can be cauterized with lapis( 10 - 20%), with a solution of tannin( 10%).If the sores do not heal well, they are sealed with a sticky band-aid, they put a glue bandage on them.
- Of the numerous physiotherapeutic procedures, UHF, laser therapy, stamping with silver nitrate, UFO are recommended.
Rash that occurs on the skin, it is forbidden to wet. In addition to the basic treatment, you can also use folk remedies( tinctures from elecampane, walnut leaves, fennel seeds).
Drug medication
For any form of the disease, it is recommended to inject penicillin. Initially, 200,000 units are administered twice / three times per day. Over time, the dose is increased, bringing it up to 3 000 000 units. The dosage of the drug depends on the result of the therapy.
A noticeable effect is the use of Shestakovsky's balm, an ointment with white sedimentary mercury. To clear the ulcer from pus, it is applied to "Himopsin", "Trypsin".After these ointments, they use "Solcoseryl" together with antibiotics, as well as "Ihtiol ointment", "Vinilin", "Ihtiolo-camphor ointment".
From antibiotics the patient is recommended to take:
- "Dicloxacillin".
- "Lincomycin".
- "Cephalexin".
If a patient has a gangrenous form of the disease, angioprotectants, corticosteroids, are prescribed.
To wash ulcers use such solutions:
- "Rivanol"( 1: 1,000);
- "Furacilin"( 1: 5,000).
Ointments with colimycin, tetracycline, penicillin, neomycin, as well as ointment "Dioxol", "Dioxydin Ointment"( 5%) are also very effective.
In patients with ecstema, it is recommended to use:
- Preparations for intramuscular administration( Polymyxin B sulfate, Amikacin, Carbenicillin disodium salt, Polymyxin M sulfate, and Tobramycin).
- "Cefoid".
- "Gentamycin sulfate".
- Fortum.
- "Sodium salt of cefoperazone".
- "Cefazidim".
Operation
In the case of gangrenous form, the ecthims are initially given antibacterial therapy. If it does not help, surgical treatment is required. Initially, they eliminate bacteremia, then perform necrectomy.
Prevention of
The main preventive method, as with many other skin diseases, is:
- compliance with hygiene standards;
- treatment of dermatoses immediately after their detection;
- microtrauma treatment with antiseptics( iodine solution, hydrogen peroxide).
Complications of
Ectymus is dangerous for the following complications:
- development of erysipelas;
- lymphadenitis, lymphangitis;
- blood poisoning.
Non-dangerous complications of the disease are cosmetic defects( scars formed on the site of healed ulcers).
Forecast
With a disease such as ecthyma, the forecast specialists establish a favorable. The only unpleasant consequence of skin disease is the formation of scars.