Pustular skin diseases: causes, symptoms, treatment. Pustular skin diseases

Pustular diseases skin (pyoderma) are a group of infectious diseases caused by streptococci and staphylococci. On healthy body these microorganisms exist in limited quantities, without showing themselves in any way. But for any “entry gate” - skin damage caused by microtraumas, dermatoses with itchy skin, contaminated skin, decreased immunity, chronic illnesses, changes in the composition of sweat and increased sweating - begin to actively develop.

Sometimes pyoderma can be triggered by other infections - Pseudomonas aeruginosa and Escherichia coli, Proteus vulgaris, pneumococci. Pustular skin problems are quite common diseases.

Causes and conditions of skin diseases

Pustular skin diseases are caused by streptococci and staphylococci

Among the causative agents of pyoderma, staphylococci and streptococci are in first place. Staphylococci often colonize the upper layers of the skin: the mouth of the follicle, sweat and sebaceous glands.

Streptococci colonize the epidermis: the face, areas of natural folds.

With normal homeostasis and moderate sweat production, microorganisms living on the skin serve as a kind of “brake” that displaces pathogenic microflora. Endocrine and immune disorders change chemical composition sweat and sebum, provoking the activity of foreign microflora.

Mechanism of development of skin diseases

There are external (exogenous) and internal (endogenous) causes that influence the activity of pyococci and the occurrence of pyodermatitis. The first group includes:

• Skin injuries of various nature(cuts, irritations, mosquito bites, scratching).
• Maceration (overmoistening) of the skin due to increased sweating or the constant presence of moisture on the stratum corneum.
• Skin contamination: at the domestic level (ignoring hygiene standards) or professional (constant irritation of the skin with fuels and lubricants, coal dust particles, etc.).
• General or local overheating or cooling.

Internal factors:

• Chronic infections (pathologies genitourinary system, consequences of untreated caries, ENT diseases).
• Endocrine problems associated with diabetes mellitus, hyperandrogenism, hypercortisolism.
• Chronic alcohol or drug poisoning.
• Unbalanced diet (protein deficiency, vitamin deficiency).
• Immune disorders provoked by the use of glucocorticoid drugs and immunosuppressants in HIV and after radiation.

Both of these reasons reduce all types of immunity and skin capabilities. Gradually the composition of the microflora deteriorates.

Classification of pyoderma

The types of diseases depend on the cause that causes them, therefore they are divided into staphylococcal, streptococcal and mixed pathologies. Each type of disease can be superficial and deep, acute and chronic. In the superficial form, the infection affects the epidermis and dermis, in the deep form – the dermis and hypodermis.

Staphylococcal species

Among pyodermas with acute course diseases are distinguished:

• Superficial form: ostiofolliculitis, folliculitis, bullous impetigo (in children), pemphigoid in infants.
• A deep variety, found with boils, folliculitis, carbuncles, hidradenitis.

The chronic stage of staphylococcal skin diseases is:

• Superficial, as in vulgar sycosis.
• Deep – with furunculosis, folliculitis decalvans.

Pyoderma is a fairly common disease.

Streptococcal infections

The acute form is characteristic:

• For superficial types of impetigo and diaper rash.
• For deep erysipelas and ecthyma.

The chronic stage occurs with diffuse streptoderma.

Mixed type

Streptostaphylococcal pyoderma in acute form is:

• Superficial, like impetigo vulgaris.
• Deep – vulgar ecthyma.

Chronic forms of mixed pyoderma are distinguished:

• Ulcerative pustular disease.
• Ulcerative-vegetative pyoderma.
• Abscessing pyoderma.

Pustular skin diseases occur on completely clean skin or on the basis of previous skin problems - scabies, eczema, lice, dermatitis.

Clinical features

Rash when pustular infections polymorphic. The type of primary rash will depend on the degree of tissue damage.

Staphylococcal pathogens multiply on hair follicles and sweat glands oh and provoke inflammation.

Rashes with pyoderma polyphora

Different types of skin lesions can look the same, for example, follicular pustules occur with ostiofolliculitis, folliculitis and sycosis, and an inflammatory nodule can be a sign of folliculitis or just a boil. Streptococcal infections prefer smooth skin.

The main external symptom of superficial streptoderma is a bubble. With a thin stratum corneum, it has a flabby appearance (phlytena); with hyperkeratosis (on the palms, soles), the surface blisters are harder, filled with serous fluid.

If the infection is deep, the rash will be in the form of ecthyma - an epidermal pustule with local necrosis, edematous erythema with a growing focus of inflammation (for example, erysipelas).

Staphylococcal skin infections

1. Ostiofolliculitis is inflammation of the follicle. It looks like a small (2-3 cm) abscess in the shape of a hemisphere or cone with cream-colored pus, surrounded by a halo of hyperemia. An infection develops on an open part of the body (on the face, neck, head, bends of the arms and legs). These areas are often exposed to mechanical and chemical irritants (friction, shaving, household and industrial chemicals). After 2-3 days, the redness disappears, the brown crust dries out. After its rejection, the skin color changes slightly. With friction or maceration, the disease can progress and become more severe.
2. Folliculitis is a purulent inflammation that affects the hair follicle. The superficial process begins, like the previous pyoderma, with a small abscess deepening into the mouth. The surrounding skin turns red and thickens, the abscess increases to 5-7 mm in diameter. If the infection is primary, the papule is in the shape of a cone or hemisphere up to 5 mm in diameter. After 2-3 days, a dense pustule appears, disappearing after a week. After peeling off the dried crust, stagnant redness is observed. In the deep form, the entire hair follicle is affected. The painful process is accompanied by redness, swelling, infiltration
3. Impetigo develops in a child already in the maternity hospital (if hygienic standards of care are violated). Staphylococci that have penetrated into the dermis produce exfoliatin, which destroys the epidermis. Yellow ones are forming purulent blisters. The pathology is called infantile pemphigus. In children, the disease develops in the first week or month of life. Upon examination, you can see blisters the size of a hazelnut with a purulent filler. They appear on clean skin surrounded by an inflamed halo. When the bubble opens, wet erosion remains with the remains of the top layer without a crust. The rash can be seen on the chest, back, and in the folds of the limbs. The malignant form affects the entire body of the child. The illness begins with fever, increased erythema on the navel, around the mouth, in the folds. The skin peels off and hangs like petals on the damaged areas. Without timely treatment Impetigo in children can be fatal.
4. Vulgar sycosis is a chronic form of the disease. The main signs: periodically manifested ostiofolliculitis and superficial folliculitis with infiltration of the problem area. Adult men are more often affected; rashes can be observed near the mustache and beard, on the pubic area, under the arms, eyebrows, eyelids and head. Prerequisites for pustular diseases of the scalp can be frequent shaving and chronic infections hairy part. Inflammation begins with individual pustules that constantly recur in one area. Gradually, new follicles are involved, and the lesion grows. Skin in problem area turns blue and infiltrates. When pustules are opened, accumulations of crusts are observed; after their peeling, a wet spot remains. The hair is removed painlessly, and in its place you can see a glassy muff. The disease lasts a long time, with periodic relapses. The discomfort is minor: itching and burning. If left untreated, the condition will normalize spontaneously after 2-3 months.
5. Lupoid sycosis – rare view pathologies, when the skin atrophies, baldness is observed even without ulcers. The causative agent is Staphylococcus aureus, and other microflora are likely to be present. The prerequisites are a decrease in immunity in diabetics and chronic infections. Affects men over 40 years of age. Colonies populate around the mustache and beard, on the temples and crown of the head. With erythema with easily detachable crusts and gray scales, nodes and pustules develop in groups, forming a dark red plaque Ǿ 2-3 cm. Over time, it turns pale in the center, becomes thin and smooth and seems to be drawn inward. All signs of its atrophy are observed, new follicles no longer appear, individual hairs remain. The radius of the inflammation (up to 1 cm) is filled with follicular papules, its size gradually increases, the spot takes on an asymmetrical shape, apple jelly syndrome is not observed during diascopy. The process takes several years. Discomfort occurs only on the head due to the proximity of the aponeurosis.
6. A furuncle is a deep inflammation of the follicle and tissues. The node develops around the affected follicle, where pus accumulates. Gradually, the disease covers the tissues and sebaceous gland, turning into a painful node. Swelling is noticeable on the face. After 3-4 days, a fistula is formed; after its opening, an ulcer with a green necrotic core at the base is obtained. After 2-3 days it is rejected with bloody discharge. Pulsation and pain decrease. At the site of the ulcer there will be a retracted scar. The furuncle settles anywhere with hair follicles. On the face they are most traumatic and, if irritated, can provoke thrombophlebitis of the face with swelling, high fever, and confusion. Injured boils of the extremities are dangerous due to complications in the form of acute glomerulonephritis.
7. Furunculosis is boils with periodic repetitions in the acute form and isolated manifestations in the chronic form. It can be local or widespread. Acute form provoke exogenous factors, chronic stage – diabetes, infections, vitamin deficiency, dietary errors, poisoning, decreased immunity.
8. Carbuncle is a severe pyoderma that involves deep layers of skin and many follicles. In pathogenesis special meaning have diabetes mellitus and an immunosuppressive state. Localized on the lower back, neck, arms and legs. The formation of a node is accompanied by headache, fever, and blackening of the inflammatory zone. The carbuncle opens after 5-7 days. The ulcer gradually heals and the condition returns to normal. Without medical assistance, the process drags on for 2-3 weeks. A carbuncle on the face can cause complications in the form of venous thrombophlebitis, embolism, sepsis, and brain thrombosis.
9. Hidradenitis is an inflammation of the apocrine glands in adulthood as a result of skin trauma or improper use of deodorants. It is localized under the armpits, but it may affect the area of ​​the nipples, genitals, and navel. At first, the node under the skin can only be determined by touch. Gradually the area turns red and blue, and pain appears. The fistulas are opened and a yellow-green exudate is released. The scar at the site of the fistula is retracted. If treatment is prompt, an abscess can be avoided.

Streptococcal and mixed pyoderma

1. Streptococcal impetigo most often affects children and women, especially in the summer. The rashes are localized near the ears, nose, mouth, arms and legs. The infection is transmitted through contact, injury, and maceration. Surrounded by a red border, the yellow-green crusts gradually grow. After opening the phlyctene, the infection progresses quickly. With a positive course, erosion epithelializes without lasting traces. Complications are possible in the form of lymphangitis and imphadenitis, eczematization, and in children – glomerulonephritis. Vulgar impetigo is provoked by pathogenic streptococci, staphylococci gradually join, causing suppuration and drying yellow-green crusts. Most often it affects children, and outbreaks of the epidemic are possible.
2. Streptococcal diaper rash is a long-term, often recurring inflammation of contact tissues. With poor hygiene, the contact surface in the folds becomes irritated and sweat secretions decompose. Inflammation is often accompanied by yeast. Diabetes mellitus type 2, obesity, gout, seborrheic dermatitis. In the edematous folds the skin becomes wet, erosions and cracks appear. Complaints of pain and itching. With regression, pigmentation remains.
3. Streptoderma diffuse is a chronic skin disease of the skin of the legs after hypothermia, maceration, and problems with blood vessels. The lower legs are most often affected, especially in the presence of wounds and fistulas. The ulcers dry out, leaving erosions with serous pus under the crusts. When the lesion grows, complications are possible: lymphagitis and lymphadenitis. Without timely treatment, the disease becomes chronic.
4. Ecthyma vulgaris is a deep type of streptoderma that develops against the background of trauma, pollution, impaired blood flow in the legs, and intoxication. In addition to the legs, damage to the thighs, buttocks, and lumbar region is possible. It starts with a large bubble with a cloudy filling and a red border. After necrosis, an ulcer with a brown crust forms. It heals on its own within a month, leaving a hyperpigmented scar. Possible complications in the form of phlebitis, lymphangitis, lymphadenitis.
5. Erysipelas is a deep skin lesion, with symptoms of intoxication and fever. Sources of infection are any patients with streptococci (tonsillitis, rhinitis, tonsillitis, streptoderma). Frequent injuries, cracks, and scratching provoke relapses, leading to scarring and the formation of elephantiasis of the legs. The onset of inflammation is acute: swelling occurs with hot skin. Complaints of pain, burning, bloating, fever. There are the usual form (with erythema and edema), bullous-hemorrhagic, phlegmous (with suppuration) and gangrenous (with gangrene). Complications are severe: elephantiasis, phlegmon, abscesses, gangrene. On the face, sepsis and thrombosis of the sinuses of the brain are possible. It is advisable to hospitalize patients with erysipelas.

Diagnosis and principles of treatment of pustular diseases

For the treatment and prevention of complications of pustular skin diseases, Elon K, produced by the famous German pharmaceutical company Cesra Arzneimittel GmbH & Co, has proven itself well.

Ilon is produced in the form of an ointment, the basis of which is turpentine substances - oil and larch extract, which have a healing, antibacterial and tonic effect. How aid Elon K is widely used for the treatment of mild, localized pustular skin lesions of various etiologies, such as folliculitis, boils, abscesses, felons and inflammation of the sweat glands. Depending on the degree of suppuration, the ointment should be applied to the affected area of ​​the skin once or twice a day, and a sterile bandage or plaster should be applied on top.

Elon K ointment is not an antibiotic, and therefore has virtually no contraindications. Natural composition ointment allows it to be used not only for treatment, but also to prevent the appearance of purulent inflammation on the skin.

Now, widely known in many European, CIS and Baltic countries, Elon K ointment can also be bought in Russian pharmacies. Be sure to purchase it, and it will become a permanent “resident” of your home medicine cabinet.

Pustular skin diseases are treated by a dermatologist, mycologist, and surgeon

To influence the cause of the disease, it is necessary to carry out antimicrobial therapy, block provoking factors, adjust carbohydrate metabolism, prescribe vitamin complex, eliminate chronic infectious pathologies.

Etiotropic treatment should suppress the pyococcal flora. They practice both local and general treatment. Systemic therapy is carried out for:

• Multiple pyoderma and rapid spread of infection.
• Enlarged and painful lymph nodes.
• Fever, chills, malaise and other body reactions.
• Complicated and deep facial pyoderma with the threat of complications.

In weakened patients (after irradiation, with HIV syndrome, hematological pathologies), treatment should take into account all clinical data. General therapy involves the prescription of antibiotics and sulfonamides. The choice of drugs is based on the analysis of purulent exudate (culture, isolation of the pathogen, testing its sensitivity to drugs).

Medicines penicillin group can cause toxicoderma, so they are not prescribed to patients with purulent eczema. Exacerbations are also possible with psoriasis.

External treatment depends on the degree of damage and the form of the disease. In acute cases, the pustules are opened by treating the wounds with an antiseptic. For deep wounds, resolving therapy is indicated to accelerate the self-resolution of the infiltrate: dressings with ichthyol ointment, UHF, dry heat. Compresses, ozokerite, paraffin baths are contraindicated.

Treatment is selected based on analysis of purulent exudate

For deep abscesses, they are opened surgical methods, organizing drainage with turundas soaked in an antiseptic solution.

In the chronic stage, purulent crusts from the surface must be removed mechanically using tampons soaked in hydrogen peroxide. They are first softened with antiseptic ointment. After removing the crust, the wound is washed with an antiseptic.

From non-specific methods autohemotherapy, administration of protein blood substitutes, pyrogenal, prodigiosan, methyluracil and splenin are used. To strengthen the immune system in children and adults, herbalists recommend echinacea, ginseng, and Chinese lemongrass.

Prevention of pyoderma

Prevention of pustular skin diseases involves a temporary ban water procedures, compresses, local massage, the use of antiseptics for problem skin, which contribute to the spread of infection. If your scalp is damaged, you should not wash your hair. They are trimmed in the problem area, but not shaved. Healthy skin along the edges of the inflammation is treated with a 1-2% solution salicylic acid or potassium permanganate.

Nails should be cut short and treated with a 2% iodine solution before the procedures. You can’t squeeze out pustules!

Pyoderma can provoke epidemics in children's institutions, which is why it is so important to maintain a sanitary regime, promptly isolate patients and identify potential carriers of the infection.

Particular attention is paid to microtraumas: they are treated with a solution of aniline dyes, iodine, and Lifuzol film aerosol.

It is important to promptly identify and treat diseases that impair the protective properties of the skin.

Pustular skin diseases (pyodermitis). Pustular diseases occupy one of the first places in general morbidity population, and among skin diseases they are the most common.

Pustular skin diseases - pyodermatitis (from the Greek word "peony" - pus, "derma" - skin), are caused by pyogenic microbes - staphylococci and streptococci.

Staphylococci and streptococci are in the air along with tiny, invisible dust particles and are deposited on surrounding objects, on hands, hairdressing underwear, and on undisinfected hairdressing tools.

Common chemical agents for killing microbes (5% solution of carbolic acid, 0.1% solution of sublimate, 3% solution of formaldehyde) kill them within 15-30 minutes.

The most common cause of pustular diseases are minor injuries and minor damage to the skin. Very often they do not make themselves felt until purulent inflammation of the skin develops. Healthy, intact skin is reliable protection against the penetration of pyogenic microbes into it.

Skin pollution disrupts its functions and weakens the skin's protective reactions.

Varied chemical substances(acids, alkalis, etc.) can cause superficial burns and cracks, which also contributes to the development of pyodermatitis.

One of the causes of pustular diseases may be increased skin moisture (due to heavy sweating or the effect of moisture on the skin during work). It is known that the stratum corneum of the skin is durable, but it cannot withstand prolonged exposure to moisture and becomes permeable to microbes.

Staphylococci most often affect hair follicles, less often - sweat glands. They are distinguished by their tendency to penetrate deeper parts of the skin. Streptococci primarily affect the epidermis, and the process spreads over the surface of the skin.

There are also mixed forms of pustular skin disease caused by staphylococci and streptococci. Based on the depth of the abscess in the skin, superficial and deep pyodermatitis are distinguished.

Staphylococcal diseases. These diseases always affect either the hair follicles or the sweat glands.

Staphylococci cause the following diseases: folliculitis, staphylococcal sycosis, boil, carbuncle, hidradenitis.

Superficial staphylococcal skin diseases include folliculitis and sycosis.

Folliculitis - purulent inflammation hair follicle(hair follicle). Folliculitis can be superficial or deep (Fig. 7).

With superficial folliculitis, a small greenish-yellow abscess appears, the size of a millet or hemp grain. It is located at the mouth of the hair follicle, from the center of which a hair, usually a vellus, protrudes. The abscess is surrounded by a narrow belt of reddened skin. The appearance of an abscess is not accompanied by a feeling of pain. May be slight itching. Superficial folliculitis lasts 5-6 days, after which the contents of the pustules shrink into a crust. After the crust falls off, a bluish spot remains, which subsequently disappears without a trace.

Less often, instead of an abscess, there is a small red nodule that subsequently disappears without suppuration.

With deep folliculitis, the onset of the disease is the same as with superficial one, but then there are signs of purulent inflammation spreading deeper, which involves part of the follicle or even the entire follicle. First, a small red nodule appears on the skin at the mouth of the follicle, then an abscess around which redness increases and pain appears. When palpated, a thickening is felt around the circumference of the follicle. After a few days, the pus shrinks into a crust or the abscess opens, releasing pus.

Under favorable conditions, the disease goes away without treatment within 5-6 days. If the lesion covers the entire follicle, then after healing small scars may remain.

Folliculitis, especially superficial one, is a mild disease. However, we must remember that contaminated underwear and nails can transfer staphylococci from this abscess to other areas of the skin and cause new folliculitis or other more serious diseases there. Very often, in sick people, you can see whole “families” of folliculitis - this means that the skin has been inseminated with staphylococci from the primary source located here. This happens when a warming water compress is placed on the boil. On moisturized skin, staphylococci quickly multiply and spread, affecting numerous hair follicles.

Folliculitis can occur on any part of the skin. They are especially common on the bends of the arms and legs, where there is a lot of vellus hair. This disease is more often observed in men, since their pilosebaceous apparatus is more developed than in women.

Staphylococcal sycosis, a chronic pustular skin disease, occurs infrequently, mainly in men and less often in women.

Sycosis begins with the formation of small pustules (folliculitis) permeated with hair at the mouths of hair follicles. At first, the pustules are single, then they merge and form continuous areas of damage with inflammation in the surrounding tissues. It is characteristic that with sycosis the follicles dissolve, but new ones appear to replace the disappeared ones. Their number gradually increases, the lesion area expands. Due to the continuous rash of pustules, the skin at the site of the process becomes rough, takes on a red-purple color, becomes covered with crusts, and becomes somewhat thicker. Over time, crusts gradually accumulate on the area of ​​skin affected by sycosis, after which they fall off. minor abrasions and sores. Purulent fluid oozes from them, which shrinks into new crusts.

Most often, sycosis affects areas of the skin on the face in the area of ​​the beard, eyebrows, and armpits.

Shaving improperly sanitary rules may lead to the development of sycosis. The development of sycosis is also promoted by polluted long time skin on the face.

It must be said that the disease sycosis often begins with damage to the skin of the upper lip in people suffering from chronic runny nose. Nasal discharge irritates the skin and surrounding areas, causing new pustules to form.

With sycosis, patients sometimes complain of a feeling of tension in the area of ​​the pustules, mild itching and burning, and soreness.

To prevent the occurrence of sycosis in hairdressing salons, it is necessary to strictly follow sanitary rules during shaving.

Deep staphylococcal diseases include boils, carbuncles, and hidradenitis.

Furuncle (boil) is a disease of the hair follicles, sebaceous glands and surrounding tissue with a tendency to necrosis.

The disease begins with the appearance of a small abscess at the mouth of the hair follicle, i.e. from superficial folliculitis. The inflammatory process quickly intensifies. A painful nodule the size of a walnut is formed. The skin over it becomes purplish-red and swollen. The purulent crust that forms at the top of the boil soon disappears, and thick pus begins to ooze from the boil. The process of boil ripening lasts several days. After removing the pus, a deep ulcer is formed, at the bottom of which you can see the core of the boil - a thick mass greenish color, which is dead follicle tissue. After the rod is rejected, the ulcer begins to heal. A scar usually remains at the site of the boil. The duration of the disease is 10-14 days.

The entire process of development of a boil is accompanied by burning, pain, chilling, and sometimes an increase in body temperature, which subside after the rod is rejected.

Boils are located on any part of the skin, but more often in places of friction with clothing: on the neck, lower back, buttocks, thighs, as well as on the forearms and hands. Boils on the face, lips and forehead are accompanied by severe swelling of the skin.

It is impossible to squeeze out the purulent contents from a beginning or developing boil, since inside the rod there are staphylococci that are very dangerous to human health, like in a chamber. They are removed from the body only when the rod is rejected. Until this moment, it is necessary to protect the boil from pressure, friction, and any injuries. The rod must not be squeezed out, it must not be removed, otherwise the rod will rupture and staphylococci will penetrate into the surrounding tissues or directly into the blood, which can lead to general blood poisoning (sepsis).

A boil is especially dangerous when it is located on the face, on upper lip. It may be accompanied by large inflammatory edema, even tissue compaction. In these places there are large blood vessels, in particular the blood vessels of the brain, where staphylococci can enter. Such a boil must be especially protected from injury and bruises.

Furunculosis is multiple boils scattered throughout the body, appearing either repeatedly after healing, or continuously one after another for weeks, months, years, or with more or less long breaks. Very often, a patient can see several boils on the skin at the same time, which are in different stages of development: those that have just appeared, those that have reached full development, scars remaining in the place of former boils.

Boils in furunculosis have normal look, but their development proceeds more slowly, with less pain.

A carbuncle is a collection of many boils. In this case, the signs of the disease are more pronounced. Staphylococci penetrate deep into the skin and cause necrosis of not only the skin, but also the subcutaneous tissue over a large area. In the affected area, when the individual abscesses have not yet merged, several holes are noted. In this area, the skin first becomes bright red, then bluish-purple. Extensive painful swelling develops. Soon the swelling softens and breaks through several holes, from which pus is released. An extensive ulcer forms, in the depths of which shapeless dead tissue of a greenish color is visible - “ necrotic rod" Gradually, the rod separates and is pushed out along with a large amount of pus. After the dead tissue falls off, the ulcer gradually (over 5-6 weeks) heals. A rough scar remains in its place.

The process of carbuncle formation is accompanied by swelling, severe pain and very high temperature.

Most often, carbuncles are located on the neck and lower back. With facial carbuncles, blockages may develop. cerebral vessels, blood poisoning (sepsis). Foci of purulent lesions sometimes appear during internal organs, as a result of which the death of the patient may occur.

Everything that has been said about careful handling of a boil applies even more to a carbuncle.

Hidradenitis is a purulent inflammation of the sweat glands in the armpits. The disease begins with the formation of a small, dense, painful nodule, the size of a cherry pit. Over the course of several days, the nodule increases in volume. The skin on the affected areas turns red and swelling appears. Soon an abscess forms and opens.

Hidradenitis is more common in women.

The process of development and healing of hidradenitis lasts 2-3 weeks. Bilateral hidradenitis takes a particularly long time to develop. Increased sweating various kinds injuries and poor skin hygiene contribute to the occurrence of hidradenitis.

Streptococcal diseases. In contrast staphylococcal lesions they are not associated with hair follicles, with sebaceous and sweat glands; the initial manifestation with them is not an abscess, but a flaccid bladder filled with a clear, quickly cloudy liquid. Streptococcal impetigo is a superficial pustular disease that most often occurs in children. Impetigo usually affects exposed parts of the body - the skin of the face, behind the ears, around the openings of the mouth and nose, and on the hands. One or more small flat bubbles the size of a pea appear. Very fast clear liquid the bubble becomes cloudy. After 1-2 days, the bubble bursts, its contents dry out, forming a thin crust. At first thin, it then thickens, but remains loose and fragile. The color of the crust is straw-yellow, and in the case of blood admixture - brownish. Upon careful examination, along with the crusts, you can see one or two flat, inconspicuous bubbles, which also quickly turn into crusts.

After 5-7 days, the crust disappears, leaving a pinkish spot in its place, which soon disappears without a trace.

The suddenness and rapidity of the appearance of a pustular rash is one of the important signs of impetigo.

Impetigo is easily transmitted to other children. Therefore, children with this disease should not be allowed into nurseries, schools and other public places.

Zaeda is a streptococcal skin disease in the corners of the mouth. The emerging blister quickly turns into an abscess, the thin cover of which quickly bursts. Subsequently, a thin, tender crust is formed. When you open your mouth while eating or talking, bubbles and crusts constantly rupture and new ones form. Experiencing pain when opening the mouth, the patient involuntarily and often licks the affected corner of the mouth, repeating this every time it dries out.

If the disease is not treated, then after some time a superficial crack may form in the affected corner of the mouth, which, due to constant irritation of the skin by saliva and passing food, may not heal for a long time.

Zaeda is a very contagious disease, easily transmitted through kissing, through shared objects (plates, spoons, shared towels, etc.).

Superficial panaritium occurs exclusively in adults. The disease develops due to finger injuries, hangnails, when conditions arise for streptococci to penetrate into the thickness of the skin. For example, performing a manicure without following sanitary rules. First, flat blisters form, covering the skin surrounding the nail in a horseshoe shape. The blisters contain a light-colored liquid, which subsequently becomes purulent. Swelling, tenderness and redness are noted. After the blisters open, weeping lesions form, covering the nail folds and sometimes the nail bed. The affected areas bleed. Inflammation can spread around the circumference and involve the phalanx, and even the entire finger. When the nail bed is damaged, the nail plate falls off.

At modern methods treatment, superficial streptococcal panaritium is cured within 12-15 days.

Subcutaneous panaritium is a deep inflammatory purulent process of the fingers, involving the subcutaneous tissue. The disease is caused by streptococci, which enter deep into the skin through any damage - with a splinter, cuts, injections, etc.

An abscess forms deep in the skin, the finger increases significantly in volume, and severe pain appears.

Erysipelas (erysipelas) is a disease caused by a special type of streptococcus. Streptococcus penetrates the skin when its integrity is damaged. More often erysipelas skin lesions occur on the face, arms or legs.

Initially, a sharply demarcated redness of the skin appears, which quickly spreads over its surface. In the affected areas, the skin is swollen, tense, painful when pressed, and blisters may appear. This disease is accompanied by a significant increase in temperature, general malaise, as well as itching, burning and a feeling of tension in the affected areas of the skin.

Strepto-, staphylococcal diseases. When strepto- and staphylococci penetrate the skin, mixed strepto- and staphylococcal diseases can occur. There are several types of this disease.

Strepto-, staphylococcal impetigo is a very contagious disease, more common in children. First, a blister appears, which, due to the addition of staphylococci, after a few hours turns into an abscess; the contents of the abscess dry out and thick, yellowish-honey-colored crusts form, which fall off after 6-8 days. Strepto- and staphylococcal impetigo often occurs on the face and behind the ears. The duration of the disease is 8-15 days, after which pigmentation remains; Subsequently, the skin takes on a normal appearance.

An abscess is formed due to the entry of pyogenic microbes due to injury or contamination of the wound. In this case, the skin itself is involved in the process and subcutaneous fat. At the site of the lesion, there is redness, swelling, and painful compaction with further softening of the tissue. As a complication of the disease, blood poisoning (sepsis) can occur. Most often, an abscess is observed in miners, diggers, and fishery workers, i.e., in people of those professions in which there is severe skin contamination and the possibility of injury.

Cellulitis is a disease caused by pyogenic microbes. Compared to an abscess, phlegmon is a more extensive lesion. With it, purulent inflammation of the subcutaneous fatty tissue occurs, followed by gangrene (death). First, a dense, very painful elevation forms on the skin - a node, followed by maturation of the node, purulent melting of the deep tissues. Patients' temperature rises and their general condition worsens. Cellulitis can be accompanied by bleeding, and if urgent measures are not taken, the disease can result in death.

Prevention of pustular diseases at work and at home. Considering that pustular diseases are quite common, it is very important to be able to prevent them. The main causes of pustular diseases are: microtrauma, skin contamination, etc.

Prevention for microtraumas consists of providing first aid on the spot: it is necessary to treat the microtrauma as quickly as possible. To treat microtraumas, it is recommended to use BF-2 glue. It is applied to the damaged area of ​​the skin. After 1-2 minutes, the glue dries and forms an elastic film that lasts 4-5 days. After the film has formed, hands can be washed with soap and hot water; the film does not wash off.

Personal hygiene is of great importance in the prevention of pustular diseases. During the working day, the exposed parts of the body of hairdressing salon workers become contaminated with dust, particles of cut hair, nails, and skin flakes. All this is mixed with the secretion of sebaceous and sweat glands and leads to their blockage. Therefore, the most important point in preventing pustular skin diseases is systematic body washing. Hairdressing salons should be equipped with a shower that workers can take at the end of their shift.

Hair salon workers should pay special attention to hand care. This requirement arises from the specifics of the profession of a hairdresser, who constantly touches the hair or face of the visitor. If he does not follow basic hygiene rules, he may get sick, not only himself, but also suffer pathogenic microbes from one client to another. Therefore, the most important requirement for a hairdresser’s work is mandatory hand washing before serving each visitor.

Tuberculous skin diseases. These diseases are caused by the tuberculosis bacillus.

Not all patients with tuberculosis develop cutaneous tuberculosis. Infection can occur either as a result of the tuberculosis pathogen entering the skin from the affected organ through blood vessels, or as a result of the spread of the tuberculosis process from the diseased organ to the adjacent skin.

Patients with skin tuberculosis do not pose a danger to others if they do not have an active process in the lungs. However, such patients are not allowed to work.

Skin tuberculosis is very diverse. The most common are lupus and scrofuloderma.

Lupus is the most severe form of skin tuberculosis. More common in women and children. In almost 1/4 of cases, lupus affects the face. The tip and wings of the nose are mainly affected. From here the disease can spread to the lips, chin, eyelids. Lupus is characterized by small, soft, rust-colored bumps deep in the skin, about the size of a pinhead. More often they pour out in groups. The tubercles are prone to decay. In these cases, small superficial ulcers appear, healing with the formation of scars, on which fresh tubercles may reappear.

Lupus - chronic illness. If the patient does not see a doctor and is not treated, the disease drags on for decades. As a result, the patient's face is disfigured - the wings of the nose and the tip of the nose are destroyed, the resulting scars can cause eversion of the eyelids and a significant narrowing of the mouth.

Scrofuloderma is the most common form of skin tuberculosis after lupus. It is observed more often in children and adolescents. The lesions are usually located on the neck, in the armpits, and in the upper part of the sternum. The disease begins in subcutaneous tissue in the form of small nodules that do not bother the patient and are easily movable. Gradually, the nodules increase and protrude above the surface of the skin. Subsequently, the nodules fuse with the skin, which acquires a bluish-purple color, becomes thinner and opens with one or more holes, releasing purulent-bloody contents. Ulcers heal with the formation of uneven scars.

Anthrax. The disease caused by anthrax bacteria is called anthrax. Human infection occurs from sick animals: horses, sheep, pigs, cattle. In addition, the disease can occur in persons processing raw materials: slaughterhouse workers, skinning workers; workers involved in the manufacture of brushes and brushes; tannery workers, etc. The disease can be transmitted through soil and feed, if the latter are contaminated with anthrax bacteria.

The disease manifests itself as swelling of the skin with a vesicle or blister containing bloody fluid. This vesicle appears 1-3 days after infection and is most often located on the face or hands. After the blister bursts, deep tissue necrosis is visible, and new blisters develop around the skin. The disease is accompanied by high fever, severe headache and other severe symptoms. Sick people are taken to hospital for isolation and treatment. Animals found to have anthrax are immediately slaughtered, and their corpses are buried to a depth of at least 2 m. Eating meat from animals with anthrax is strictly prohibited.

Those working on dairy farms, slaughterhouses, tanneries, bristle and hair factories are required to carefully follow all measures personal prevention: immediate disinfection of abrasions, scratches, wearing special clothing and changing it regularly.

In hairdressing salons to prevent transmission anthrax It is prohibited to use razor brushes without prior disinfection, and not only used brushes are subject to disinfection, but also new ones (for more details, see the section “Disinfection of instruments”).

Pyoderma, as this group of skin diseases is commonly called, is caused by pyogenic microbes, namely staphylococci, streptococci, etc. These pathogens provoke the appearance of ulcers on the skin.

IN small quantity, they are always present on the skin and mucous membranes, but do not cause negative symptoms. However, if favorable conditions occur, microbes begin to actively and uncontrollably develop. As a result, pustular skin diseases appear, pimples, acne, and pustular rashes occur.

Violations of personal hygiene rules play an important role in the development of this disease. These include, among other things, dirty hands, the presence of cracks and microtraumas, insect bites and scratching of the skin. The development of the disease is influenced by hypothermia and overheating, increased sweating, regular overwork, impaired metabolism, decreased protective forces body.

The number of harmful microorganisms found on human skin is not constant and changes regularly. For example, it becomes significantly smaller after washing your hands with soap. After this, their number gradually increases again. There are especially many microbes and bacteria on moisturized areas of the skin and hair. But in the normal state, when their numbers do not increase rapidly, they do not cause any disturbances.

Symptoms

Symptoms of pustular diseases depend on the routes of entry of pathogens. They can begin to develop in the epidermis, dermis, hair follicles, sweat glands, and subcutaneous tissues.

In case of damage to the epidermis, superficial rashes usually occur. If the dermis is affected, the rash is more intense, and abscesses may be observed. In case of damage to the subcutaneous tissue, for example due to trauma, quite deep abscesses can form. Bacterial often develops.

In the case of a mild, uncomplicated course of the disease, the rash usually does not cause painful sensations and does not cause any significant discomfort.

However, in the case of severe cases, painful rashes appear, namely boils, carbuncles, and deep abscesses develop. After they heal, noticeable scars often remain.

In case of minor rashes, it is enough to carefully observe personal hygiene, wash, and keep the inflamed areas of the skin clean. With regular careful care, the disease often quickly disappears on its own, without special treatment.

For more serious manifestations of the disease, you should consult a doctor. The doctor will prescribe special antibiotic ointments, which should be applied pointwise, applied to the surface of the ulcers. Need to cotton swab clean the crust from the affected area and apply ointment.
In severe cases of pustular diseases, the doctor will prescribe antibiotics for oral administration. Independently such medicines cannot be used, since the choice of medicine depends on the type of pathogen, taking into account possible allergic reactions for medications.

The course of treatment must be completed to the end, even if the symptoms disappeared at the very beginning of treatment. This condition must be observed to prevent recurrent infections and to reduce the risk of developing antibiotic resistance.

Folk remedies

Since the disease is contagious, the spread of infection should be prevented. To this end ethnoscience recommends lubricating skin rashes with brilliant green or iodine. In addition, in order to prevent the spread of pathogens, it is recommended not to wash the affected areas with water, but to wipe them with camphor alcohol or vodka. It is not recommended to apply warm compresses, since heat, in cases of suppuration, can intensify the inflammatory process.

Can be used folk remedies treatments that speed up the healing process. Here are some of the herbal medicine remedies:

To prevent the development of pustular rashes, take 2 tsp daily before breakfast. spoons of brewer's yeast dissolved in 1 tbsp. clean water.

Place 4 tsp. young chopped asparagus shoots into a thermos and pour 1 glass of boiling water. Leave for at least 2-3 hours and then strain. The strained infusion should be drunk in a third of a glass, three times a day, before meals.

Grind dry dandelion roots, pour 1 tbsp. l. raw materials with 1 cup of boiling water and cook over very low heat, covered, for 15 minutes. Then strain, take a third of a glass three times a day, before meals.

Mix equal parts of dried walnut leaves, chopped burdock and elecampane roots. Add 1 tbsp. l. mixture into an enamel saucepan, pour 1 cup of boiling water and simmer over low heat for 10 minutes. Then cool the broth, strain, take 0.5 cups each time before meals.

Purulent diseases and their development depend on following conditions: penetration of pyogenic microbes into body tissues, body condition and conditions external environment. Therefore, all preventive measures are acutely purulent diseases must take into account listed reasons, on which the appearance and development of these diseases depends.

Causes of purulent diseases. One of the main reasons for the occurrence of purulent diseases is, as stated, the penetration of certain pyogenic microbes from the outside into the tissues or blood of the body through various damages skin or mucous membranes. Therefore, one of the important ways to prevent many purulent diseases is to prevent injuries both at work and at home.

In the presence of any open injury, the timely provision of rational first aid in compliance with general rules aseptics and antiseptics, as well as immediate processing minor damage by trained persons or in the form of self- and mutual assistance.

For any damage to tissues and organs, no matter what they arise from (wounds, operations), prevention is very important purulent complications. It consists of a number of measures aimed at preventing the entry of purulent microbes into wounds and further development infections. In this regard, the organization and quality of first and emergency care for all persons accidentally injured plays an exceptional role.

Purulent diseases prevention A. Prevention wound infection(and consequently, possible purulent complications) consists, first of all, in careful compliance with all modern rules of surgical asepsis when providing medical care (when applying dressings, injections, dressings, etc.).

To prevent the penetration of pyogenic microbes into the wound, many methods have been proposed. The simplest of them is to lubricate minor damage to the skin with iodine tincture or alcohol solution brilliant green. Even better results are obtained by using N. N. Novikov’s liquid, which has the following composition: tannin - 1.0, brilliant green - 0.2, 96° alcohol - 0.2, castor oil- 0.5 and collodion - 20.0. Using a pipette or glass rod, this liquid or BF-6 glue is applied directly to the damaged area of ​​​​the skin and the surrounding skin surface. After 1-2 minutes, a dense elastic film forms over the damaged area of ​​skin. For minor injuries, you can use another method: the wound and its circumference are wiped (washed) with a 3-5% soap solution or a 0.25 - 0.5% solution using gauze or cotton balls ammonia, dried, lubricated with iodine tincture, sprinkled with a mixture of penicillin and streptocide and carefully sealed with a sticky plaster. To prevent infection during microtrauma, a colloidal solution of furatsilin or brilliant green can also be used.

In the prevention of purulent diseases during wounds and operations, it is very important prophylactic use antibiotics or sulfa drugs. Paramedics and nurses should make extensive use of them when providing first aid for wounds. For this, they use, for example, sprinkling the wound with penicillin, streptocide, or even better - a mixture of them.

For large wounds, open fractures or burns, penicillin or bicillin should be administered intramuscularly. If injections are not possible, antibiotics are given orally in tablet form. After this, patients who have wounds that require primary surgical treatment are referred to a doctor. When a doctor treats fresh wounds, as well as during various operations (in the pre- and postoperative period), general and local application antibiotics.

The prophylactic use of antibiotics for various open injuries and operations contributes to better healing wounds, a significant reduction in purulent complications and their severity, and more quick recovery and restoration of patients’ ability to work.

In the prevention of further spread of acute purulent processes and the appearance various complications Timely and rational treatment of primary inflammatory diseases, especially in the initial stages of their development. Thus, timely use of antibiotics and surgical intervention for a limited abscess can prevent its transition to a more widespread and serious disease- phlegmon, as well as the appearance of complications such as lymphangitis, lymphadenitis. Timely and rational treatment of one boil can prevent its transition to furunculosis, timely surgery for acute appendicitis or other acute purulent process in the abdominal cavity prevents the development of general peritonitis, etc. The fight against pustular diseases (pyodermitis) at work and at home is also of great importance .

Speaking about the prevention of purulent diseases, it should be emphasized that all medical personnel must meticulously observe the rules of personal hygiene ( frequent washing hands, changing gloves and gowns), since dirty hands and dirty clothes contribute to the spread of pyogenic infection. In this regard, purulent diseases in individuals are of particular danger to surgical patients. medical personnel(boils, abscesses), as well as diseases such as sore throat, flu. The presence of these diseases among personnel can lead to infection of patients and their wounds and to the possible appearance of certain purulent diseases in them.

In addition to pyogenic infection, the occurrence and development of various purulent diseases largely depend on the body's defenses. Therefore, in the prevention of any, including purulent diseases, activities that strengthen the human body are of great importance: regular physical education and sports, proper work and rest schedule, wet wipes, air baths, etc. General strengthening and hardening the body increases its resistance to various infections and, to one degree or another, determines a more favorable course and outcome in the event of the development of a purulent disease.

In the prevention of many purulent diseases, the improvement of the external environment in which a person lives and works, that is, the improvement of working and living conditions, is of great importance. For example, in the prevention of a number of purulent diseases (furunculosis, pyodermatitis, etc.), general hygiene measures and skin care (especially hands) play an important role.

This includes proper sanitary-hygienic and sanitary-technical working conditions in industrial enterprises and agricultural work, combating dust and contamination of premises, rational and clean workwear, organization of showers, baths, laundries, measures to combat skin contamination (various oils and liquids). ), as well as the struggle to improve everyday life (regular washing in the shower or bath, changing linen). To prevent diseases of the skin of the hands in some industries, it is advisable to use various protective ointments and methods of sanitation (health improvement) of the hands.

It should be remembered that continuous improvement of the culture of work and life is the main way to reduce morbidity in general and various purulent processes in particular.

Finally, in the prevention of many purulent diseases, sanitary and educational work among the population is of great importance. The role of sanitary educational work among the population (conversations, lectures, use of the press, radio, television) is especially great in the prevention of various microtraumas and pustular diseases (often the cause of more dangerous acute purulent processes), as well as complications acute diseases abdominal organs (appendicitis, cholecystitis, peritonitis). Purulent diseases, as a rule, require urgent hospitalization of patients and immediate surgical intervention.

Smart propaganda initial signs purulent diseases and advice on the need for early treatment medical care lead to a significant improvement in outcomes and a reduction in the number of various complications.

This is a group of infectious inflammatory skin diseases (Pyoderma). As follows from the word “infectious,” it becomes clear that pyoderma is caused by microorganisms, most often staphylococci and streptococci. On healthy skin, these bacteria can exist without causing any illness. But under certain conditions, such as: various microtraumas and with them dermatoses, accompanied by skin itching (scabies, eczema), skin contamination, decreased immunity, chronic diseases, changes in the composition of sweat and an increase in its separation ( oily skin), manifest themselves.

Symptoms of Pustular skin diseases (Pyoderma)

This pathology is a group of nosoologies, that is, several various diseases. Let's look at the main ones:

Folliculitis- inflammation of hair follicles. On the surface of the skin we will see pustules and papules (cavity-free formations protruding above the skin level). The rash occurs with slight pain or itching. If the entire hair follicle is affected, then this state called sycosis. Very often occurs in people with increased sweating, in people who shave (when the injury is deeper).

Furuncle - purulent lesion hair follicle and surrounding tissues. It presents as a dense, sharply painful node. The pain is pulsating. In the center of the node we will see a “purulent head”. The localization of a boil in the area of ​​the nasolabial triangle is very dangerous, since due to the abundant blood supply in this area, the process can spread to the brain. If several boils merge with each other, then this is already called a carbuncle. This is a more severe process, which is often accompanied by fever and deterioration. general condition. Well, the third nosoology is when limited tissue inflammation occurs - an abscess that requires emergency surgical intervention.

Hidradenitis- inflammation of the sweat glands, occurring most often in the armpits, less often in inguinal folds and scalp. The disease is accompanied by severe pain in the area of ​​the inflammatory focus, increased general temperature bodies. This combination of circumstances often requires surgical intervention.

Impetigo And ecthyma caused by staphylococci and streptococci. If impetigo is a superficial lesion, characterized by the formation of blisters, then erosions, and subsequently crusts, then ecthyma is deeper, with ulcers, with crusts tightly adjacent to it. Very often we find “gates of infection” - some kind of skin trauma or traces of scratching, as for example with itchy dermatoses.

Acne- inflammation of the sebaceous glands. Frequent localization on the face and torso. A very pressing problem in the modern world that requires additional examinations body, which I will talk about later. The course of conglobate acne is especially bad with the formation of massive rashes, and cosmetic problems in the form of scars. This severe course acne.

As we see, pyoderma is a broad, common group of diseases. Probably everyone has encountered it at least once in their lives.

Diagnosis of pustular skin diseases (Pyoderma)

A dermatologist deals with the problems of pyoderma, but what if, God forbid, it is required surgical intervention, then the surgeon accordingly. It is not enough to just cure the skin; you must understand the causes of the pustular disease.

In all of the above conditions, it is imperative to test your blood for sugar. On high sugar microorganisms grow and develop successfully. Particular attention should be paid to pyoderma if acne appears after puberty.

In addition to the above analysis, a fluorogram of the lungs is required, if it is not done, to exclude skin tuberculosis, a stool test for intestinal dysbiosis and an examination of the entire gastrointestinal tract. intestinal tract. As for the female sex, an examination of the condition of the uterus and appendages (ultrasound) is also necessary. Very often, inflammation of the ovaries and a shift in hormonal levels in favor of male sex hormones leads to the formation of both acne and folliculitis. It is very typical for this condition to have a rash in the chin area.

There is a misconception that there is no need to consult a doctor again if the patient is a teenager, arguing that “he will grow up or begin to have regular sex life and everything will be fine." This ends with complications in the form of the spread of infection or cosmetic defects.

Treatment of pustular skin diseases (Pyoderma)

The main drugs that are necessarily present in the treatment of all pyoderma are local treatment (antibiotic ointments, exfoliants, aniline dyes). In severe cases, antibiotics are prescribed in the form of tablets and injections. At protracted current and frequent relapses - immunotherapy (autohemotherapy, pyrogen therapy), vitamin therapy. Well, in severe, acute cases - opening a purulent focus with its subsequent treatment and drainage.

At the same time, treatment is carried out to eliminate the cause of pyoderma.

Old folk remedies are also prescribed along with the main treatment. For example, brewer's yeast for acne. They themselves contain B vitamins, which are involved in immunity and have a beneficial effect on the intestinal microflora, which is also involved in a high-quality immune response. For boils, dressings with onions, which have an antibacterial effect, help.

Complications of pustular skin diseases (Pyoderma)

If we talk about complications, they should be divided into two types: cosmetic and bacterial. We have already mentioned the first - the formation of scars and scars. Bacterial - penetration of infection into deeper sections: abscesses, purulent lymphadenitis and lymphangitis (inflammation of the lymph nodes and blood vessels). Well, if microorganisms affect organs and systems - blood poisoning.