Streptococcal impetigo is characterized by the appearance of pustules, blisters on the skin, transmitted during a contact with a sick person. The name comes from the Latin word impetigo, which means "scab".
Types of streptococcal impetigo
The forms of the disease are classified according to external manifestations. Common to all species, with the exception of dry impetigo, is the formation of fliesen surrounded by a strip of inflamed skin.
Flikten( phlyctaena - vesicle, blister) almost does not rise above the surface of the skin. The diameter fliken reaches 0.5-1 cm, the bubble is filled with a transparent exudate containing leukocytes, bacteria. They become infected with streptococci when injuring the skin - wounds, cuts, scratches.
More detailed information about different types of streptococcal impetigo and some similar diseases will be told by a specialist in the video below:
Bullous
Mostly adults are ill. With bullous impetigo, bullae are formed - bulging bubbles that appear in the lesion, the site of infection, with crusts more dense than other types of impetigo.
Bullas reach a diameter of 2 cm, are localized more often on the back of the hands, sometimes occur on the skin of the feet, shins. Exudate filling flikenu contains pus, because of which, when it is opened on the skin, there is ulceration, which does not heal for a long time, and requires the use of antibiotics.
Bullous impetigo( photo)
Slit
Slit-like impetigo is characterized by localization at the site of the skin fold - in the corners of the lips, the wings of the nose, the outer corner of the eye. The corners of the mouth are most injured during dental surgery, the wings of the nose are macerated in the rhinitis, the corners of the eyes - with a violation of hygiene.
Most often, pustules appear in the corners of the mouth, which is accompanied by drooling, long-term ulcers, or "zaedami."Streptococcal congestion is local in nature, does not spread to other areas of the skin, is not accompanied by itching, soreness arises from cracks in the corners of the mouth.
Next we will tell you about post-erosive syphilliform impetigo.
Post-erosive syphil-like
Flicks spread over a large area of the skin, marked on the buttocks, external genitalia, and the posterior surface of the thigh. This type of streptococcal infection is more common in infants. It differs from other types of streptococcal impetigo by the appearance of a bluish-blue color leaving spots of erosion after opening.
Next, let's talk about ring-shaped impetigo.
Tournament
Impetigo of nail rollers or tournamentol is more common in adults. Fliktena occurs on the spot burr, the injured area of the skin, the wound, when it receives streptococci. Contribute to the penetration of infection in the tissues surrounding the nail, combing the itchy skin.
A bubble appears around the nail roller, surrounds it in the form of a ring. The content changes rapidly from serous to serous-purulent. Inflammation causes discomfort with constant itching, pain, fever, deterioration of well-being, swelling of the affected phalanx, impaired ability to work.
The nail roller swells, becomes inflamed, the cuticle disappears. Sometimes inflammation causes rejection of the nail plate.
Tournament( photo)
Ring-shaped
The disease begins with the appearance of several flat large flies. Bubbles rapidly increase in size due to expansion in diameter. On the periphery, new fictionens are eliminated, which in turn are screened out.
As a result, circular, garlandlike foci of lesions are formed on the skin. The center of the fiction disappears, forming a brown crust on the surface.
Impetigo of the mucous membranes
Fluctuations of almost flat shape arise in the oral cavity on the mucous tongue, the inner side of the cheeks, gums, firm palate, affects the mucous lining, the cornea. Impetigo of the mucous membranes usually does not arise as an independent disease, more often accompanies streptococcal lesions of the skin.
Streptococcal intertrigo
This type of impetigo is quite common in adults who do not comply with hygiene, who are overweight. Flickety are located in groups, prefer large skin folds - glutes, under the mammary glands, armpits, in the folds of the groin, abdomen.
Fusing, the fictioners form damp erosive areas with a scalloped edge. The erosion spot gradually increases in size, gives screenings, and in the center a painful crack that is difficult to treat is formed.
Simple lichen
Streptococcal dry impetigo or simple lichen occurs without the formation of a flicten. Symptoms of the disease are manifested in the form of bright spots of rounded shape, appearing on the skin. Usually this disease ill children.
Light spots appear on the face, limbs, trunk.
Differences and similarities between them
With streptococcal impetigo, there are common symptoms characteristic of all types of diseases, as well as differences distinguishing them from each other. General deterioration of well-being with streptococcal superficial skin infection is rarely seen, only when a large area is affected or in children.
General symptoms:
- increase in regional lymph nodes located in the inflammation zone;
- temperature increase;
- lack of appetite;
- signs of intoxication - lethargy, weakness.
Differences between types of impetigo are noted in external manifestations.
- So, the syphil-like post-erosive impetigo should be distinguished from the syphilitic pemphigus, which causes pale treponema.
- Streptococcal infection from microbial eczema should also be distinguished, which is accompanied by marked reddening of the skin, multiple screenings of small vesicles along the periphery.
Symptoms of
A common form of streptococcal impetigo is a simple form, usually found in children under 12 years of age. The disease develops in stages. From the first fliken, the appearance of which remains, as a rule, unnoticed, until the appearance of severe symptoms of the disease takes 5-7 days.
This is the time it takes, on average, to maturity one bubble, after which:
- ripened flicten burst;
- fluid with streptococci enters the skin, spreading to the skin, a yellowish scab remains on the site of the fiction;
- after the fall of the scab remains red, which goes through a few days.
Bullous impetigo is difficult. Unlike other types of this disease, the bullous form of inflammation is accompanied by swelling, deterioration of the general condition, a change in the blood formula.
Diagnostics
Diagnostic examination reveals the nature of the disease, determine whether it originated primarily as a result of the penetration of streptococci, or again - due to scratching with itching dermatoses.
In primary impetigo, the disease is differentiated from fungal infection, syphilitic damage by laboratory testing. Streptococcal impetigo is distinguished:
- with herpes;
- with pemphigus neonates;
- by staphylococcus, vulgar impetigo;
- with impetigo syphilis;
- with eczema.
Also:
- With streptococcal impetigo, there are no bubbles associated with the hair follicle, which distinguishes this type of disease from staphylococcal impetigo. There are no pustules perforated in the center of the hair.
- The color of the crusts also differs. With staphylococcal infection, the scabs are dirty-green, brownish, unlike yellowish scabs when infected with streptococci.
- The color of crusts can be distinguished from streptococcal infection from vulgar impetigo, in which the crusts are crumbly, yellowish-greenish in color.
In terms of appearance, one can distinguish streptococcal impetigo:
- from impetigious syphilis - there are no freckles filled with clear liquid, but large red papules;
- from pemphigus of newborns - flickens appear, but they have an unusually large size, reach 2 cm in diameter, are localized on the trunk, and not on the face and extremities, as with streptococcal infection.
Differences in the treatment of impetigo nail roller, tournamentol, bullous, slit and other types of streptococcal impetigo, including tests, we will tell below.
Treatment of
Antibiotics are used in common impetigo, bullous form of the disease, prescribe:
- penicillin intramuscularly;
- sulfonamides;
- vitamins.
Locally used:
- ointments with antibiotic - biomycin, colimycin, polymyxin;
- solutions of antiseptic - green, a solution of pioktanin;
- mercurial ointment, boron-dyagtern ointment.
Also:
- The bullous form has its own particular treatment. Bulls filled with pus are opened.
- The protracted character is a slit-like impetigo. Frequent injury to the corners of the mouth with dental prosthesis in the elderly, the habit of licking the lips in children does not allow the opened pustule to heal, supports the focus of inflammation.
- In the treatment of pemphigus of newborns, a synthomycin emulsion, ichthyol paste, ointment based on mercury is used.
Vitamin A, B, C are prescribed to strengthen immunity. The lack of B vitamins is one of the causes of frequent streptococcal galloping, the appearance of painful cracks in the corners of the mouth.
The treatment of streptococcal impetigo in children will be described by Elena Malysheva in this video:
Complications of
Possible complications of any impetigo:
- lymphadenitis;
- boils;
- kidney disease glomerulonephritis.
Prevention
For all types of streptococcal impetigo, the following is the prophylaxis:
- patient isolation;
- hygiene compliance;
- timely treatment of skin lesions with disinfectants;
- an appeal to a dermatologist or infectious disease specialist when symptoms of infection appear.
Forecast
The prognosis for all types of streptococcal impetigo is favorable.
More information about bullous dermatitis can be found in the video below: