Erysipelas

Erysipelas is an infectious disease caused by Streptococcus characterized by acute spilled inflammation of the skin, at least - of the mucous membranes.
Infection in most cases occurs at the scratching of the skin, wounds, surgical operations; sometimes face develops as a complication of local purulent process (boils, carbuncles, abscesses), rarely occurs by transferring the infection of superficial purulent foci.
The most commonly face is localized on the face, head and limbs. Characteristic faces acute inflammatory process depending on the phase of the disease and its severity may be expressed in different degrees. Inflammation can be localized in the papillary layer of the skin, causing a sharp red (erythematous face, figure. 1); the strengthening of the process and the formation of large amounts of exudate detachment occurs in the epidermis and the appearance of blisters filled with fluid, which contains streptococci (bullous face, figure. 2). Remember this, as on the possibility of disease transfer slip by. The dissemination process at subcutaneous tissue causing it purulent inflammation (flegmona face, figure. 3), which often ends with the development of extensive necrosis (gangrenous face, figure. 4).
Immunity after faces does not occur; on the contrary, there is increased sensitivity of the organism and the tendency to relapse, especially after injury and cooling (called a familiar face).

mug
Fig. 1. Erythematous face to face. Fig. 2. Bullous face of the forearm. Fig. 3. Flegmonas-gangrenous face to face. Fig. 4. Bullismo-gangrenous face of the leg.

Begins mug sometimes with precursors (malaise, weakness), but more often suddenly with fever, headache, rapid increase of body temperature to 40-41 degrees; often with nausea, vomiting. Then on the affected area of the skin appears bright red with a clear scalloped border, which compares with a geographical map, with flames. Redness accompanied by a burning sensation, often spreads quickly on the skin surface. Inflamed by touch dense, their edges are raised in the form of a roller. Erythematous face can go to bullous and, with further progression in phlegmonously and gangrenous (especially in the elderly, debilitated patients).
On the face mug been relatively positive, but is accompanied by a significant swelling of the face and eyelids. It is flegmona face of the scalp (with the formation of large accumulations of pus, pus satikov, a detachment of the skin). On the limbs are found mainly erythematous and bullous face, accompanied by severe clinical course. Gangrenous forms faces more often reaches for localization on the scrotum and centuries.
On the body, erysipelas usually goes with neighbouring regions and often bears wandering (migratory) character. In this form the inflammation can occur again in those areas of the skin where it has already subsided. A long with heavy intoxication. Recurrent erysipelas upper extremities leads to a prolonged swelling, violation of the functions of the brush, on the lower - to the development of elephantiasis (see).
Complications: the dissemination process of the surrounding tissue; purulent lesions of joints, mucous bags, tendon sheaths, muscles (the tendon parts), throm (see); metastasis infection, meningitis (see).
The diagnosis is not complicated, given the acute onset, accompanied by a high temperature and is characterized by redness of the skin, clearly delimited and rapidly spreading, does not disappear when pressed. Differential diagnosis is carried out with erisipeloid (pork rubella), which runs with less pronounced General phenomena and is accompanied reticular lymphangitis (see), in the absence of clear boundaries of the site of injury, and also with the eritem, dermatitis, acute eczema, thrombophlebitis, a cellulitis.
Forecast in uncomplicated (erythematous erysipelas) favorable; the disease duration up to 2 weeks. The probability of relapse the less, the sooner treatment is started.
Treatment. Hospitalization (in a private room), bed rest, immobilization of the affected limb, antibiotics (penicillin 300 000 IU intramuscularly, 2-4 times a day, 4-8 days prior to the disappearance of redness and downs of temperature; bicillin, streptomycin and other), sulfanilamidnye preparations (streptocide 0.5 a 4-5 times a day; sulfatsil, etazol), quartz in erythermal doses in the region faces, high-calorie dairy-vegetarian diet. When phlegmonously and gangrenous Roger - on indications for surgical intervention. Wet bandages and baths absolutely contraindicated. Folk remedies - wrapping in the red flannel and powder chalk is completely useless. Extremely important are activities aimed at the prevention of transmission from an infected man to a healthy persons by means of strict compliance with the rules upgrades (see) when caring for the sick, dressings; separate bed pan and urine.
Prevention of diseases of the face in introducing or operating wounds, sores processes is reduced to a careful toilet wound dressings (see). Relapses faces are often associated with the presence of the sources of infection (cracks, ulcers, fistulas, diaper rash between the toes and others) and, therefore, prevention is to eliminate these diseases.