Types of pyoderma
Doctors divide pyoderma according to the depth of the lesion and the causative agent. Superficial forms affect only the upper layers of the skin and pass without scars: these are impetigo with characteristic honey crusts, superficial folliculitis, and seizures in the corners of the mouth. Deep forms involve the entire thickness of the skin and subcutaneous tissue - boil, carbuncle, hidradenitis, ecthyma - and often leave a scar. Streptococcal lesions are usually superficial and spread quickly over the skin, while staphylococcal lesions are more often associated with hair follicles and sweat glands.
- Impetigo - blisters and honey-yellow crusts, a common infection in children
- Folliculitis - pustules around the hairs
- Furuncle and carbuncle are deep painful nodes with necrosis
- Hidradenitis - inflammation of the sweat glands in the armpits and groin
- Ecthyma - an ulcer under a crust, usually on the legs
- Seizures in the corners of the mouth
Why does the skin stop protecting itself?
Healthy skin inhibits bacteria due to the integrity of the stratum corneum, acidic environment and normal microflora. Any violation opens the gates of infection: scratching for eczema and bites, cuts when shaving, rubbing with clothes, prolonged humidity. The general condition is also important: with diabetes, anemia, nutritional deficiency and taking drugs that suppress the immune system, pustular diseases occur more often and are more severe. A separate reason for persistent relapses is carriage of staphylococcus in the nose, when a person constantly transfers the bacterium to the skin with his hands.
- Microtraumas, shaving, scratching
- Heat, sweating, tight clothes
- Diabetes and obesity
- Atopic dermatitis and other pruritic dermatoses
- Decreased immunity, taking immunosuppressive drugs
- Carriage of staphylococcus in the nasal cavity
Symptoms
Superficial pyoderma looks like small pustules on a reddened base, which quickly open and dry out into yellow crusts. The itching is moderate, there is almost no pain, the general condition does not suffer. Deep pyoderma begins with a dense, painful lump, which within a few days enlarges, turns red, and a yellowish head appears in the center. The pain is throbbing, the skin around is hot, there may be an increase in temperature and enlargement of the lymph nodes. A carbuncle with several purulent holes and severe intoxication is a condition that requires urgent help.
- Pustules and blisters on a red background
- Honey-yellow crusts with impetigo
- Dense painful nodes with a boil
- Throbbing pain and local heat
- Enlarged regional lymph nodes
- Fever and weakness in deep forms
Diagnostics
Most often, the diagnosis is made during examination based on the characteristic appearance of the elements. Culture of the discharge with determination of sensitivity to antibiotics is needed in cases of widespread rash, repeated episodes and lack of effect from the treatment started - it allows you to select the drug accurately. A general blood test shows the severity of inflammation. Adults must have their blood glucose and glycated hemoglobin checked: recurring boils are a classic reason to suspect diabetes mellitus. In case of frequent relapses, a nasal swab is examined for carriage of staphylococcus.
- Examination by a dermatologist
- Culture of discharge with antibiogram
- General blood test
- Blood glucose and glycated hemoglobin
- Nasal swab for relapses
- Ultrasound of soft tissues with deep infiltrate
Treatment and prevention
For limited superficial pyoderma, treatment with antiseptics and external antibacterial agents prescribed by a doctor is usually sufficient. Systemic antibiotics are needed for a common process, deep forms, fever, and in people with weakened immune systems; The course and drug are selected by the doctor, preferably taking into account the culture. The formed abscess does not resolve with ointments - it is opened and drained by a surgeon. It is strictly forbidden to squeeze out elements, especially on the face: the venous outflow from there goes into the cranial cavity, and the infection can spread.
- Antiseptic treatment and external antibacterial agents
- Systemic antibiotics as prescribed by a doctor
- Opening and draining the abscess by a surgeon
- Separate towel, frequent linen changes, high temperature washing
- Treatment of itchy dermatoses and blood sugar control
- Do not wet or heat a fresh abscess, do not squeeze it out