Pustular Skin Disease Classification & Treatment
Pyoderma (pustular skin disease) is the most common skin diseases in all the age groups. Apparently, this is explained by the fact that pathogens of pyoderma, staphylococci and streptococci, are often found in the human environment (air, dust premises, as well as clothing, human skin). Bacterial infections of the skin form an interdisciplinary problem, they occur in practice of surgeons, internists, pediatricians and gynecologists. Pyoderma features a large group of different clinical forms, based on a purulent inflammation of the skin and its appendages and subcutaneous adipose tissue.
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Skin diseases associated with the activity of bacteria, both pathogenic and opportunistic, characterized by nosological variety. Infectious process in pyoderma sometimes has not only limited local effect – the development of inflammation – but also causes serious damage to the general state of the organism (e.g., staphylococcal and streptococcal syndromes toxic shock).
Pyoderma pathogens are mainly represented by staphylococci and streptococci, gram-positive related to microbial flora. The occurrence of suppuration of the skin under the influence of staphylococci and streptococci is explained by the influence on it of various metabolic products allocated by pyogenic cocci in the process of their life (exotoxins, enterotoxins, enzymes, etc.). According to several classifications, pyoderma depending on the pathogen traditionally is divided by etiological principle: staphyloderma, streptococcal and a mixed one.
Clinical manifestations of pustular skin diseases may vary. The most common are folliculitis, sycosis vulgaris, boils, carbuncles, hidradenitis, impetigo and chronic ulcerative pyoderma. In Infants may develop epidemic pemphigus.
Pyoderma often complicates itchy skin diseases (so-called secondary pyoderma), especially scabies, eczema, atopic dermatitis and atopic dermatitis. Secondary pyoderma is oftentimes observed in case of pemphigus, herpes zoster and necrotizing angiitis.
Effective treatment methods
Pustular skin diseases treatment approaches remain pose a considerable problem. Treatment of pyoderma should always be comprehensive and include a special mode of behavior and skin care, diet, local and systemic medications and physical therapy. In the treatment of pustular skin diseases the basic principle must be observed: namely conducting etiotropic treatment, acting on the core of the problem, and pathogenetic, designed to eliminate the contributing factors and correction of pyoderma comorbidity.
Treatment approaches primarily involve rational skin care, as in the lesion, and outside it. With a localized form of the disease it is not recommended to wash the skin only in the lesion and near it; in disseminating process washing is prohibited. The hair in the region of the elements should be cut (not shaven).
Unlesioned skin must be treated very carefully with disinfectant solutions (2.1% alcoholic solution of salicylic acid, 0.1% aqueous solution of potassium permanganate, etc.). In order to prevent the spread of infection nails should be cut short and treated with 2% alcoholic solution of iodine. During the treatment period special attention should be paid to diet: nutrition should be a regular, full and rich in vitamins; the amount of salt and carbohydrate must be limited, alcohol consumption should be eliminated completely.
For topical treatment of superficial pyoderma alcohol solutions (salicylic acid, camphor), aniline dyes (potassium permanganate 0.1%), topical antiseptics and antimicrobials can be used. If necessary, pustules may be autopsied, followed by washing with a 3% solution of hydrogen peroxide and lubrication disinfectants: nitrofuralom 0.1% iodine alcohol solution of 5%. As antiseptic agent chlorhexidine (0.5% alcohol), eucalyptus leaf extract and microzide. The effective external treatment may also include effective aerosols: uniformly applied to the surface they quickly penetrate the skin ( triamcinolone, hydrocortisone, Panthenol may be used). Ointments containing antibiotics and sulfonamides are also added to the complex of measures: e.g. 2% Fucidinum cream. The course of treatment typically equals 7-14 days.
Topical glucocorticosteroids combined with anti-inflammatory drugs offering anti-bacterial action is prescribed for secondary pyoderma major dermatoses cases (atopic dermatitis, scabies, eczema and others). Fusidic acid and hydrocortisone may also be prescribed. The average course of effective treatment typically equals 7 -14 days.
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