How to recognize streptoderma in adults and children: symptoms and stages of the disease

, medical expert
Last reviewed: 01.09.2019

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Skin diseases are one of the most numerous groups of health disorders known to mankind. A wide variety of manifestations and reasons for which it is difficult for an ignorant person to understand causes some confusion when we find strange spots on our body, rashes, redness, which can be accompanied by pain, burning, itching, or nothing of which to remind ourselves. After all, the skin is an external organ, and all the symptoms of health problems are immediately visible to the naked eye. For example, the external symptoms of streptoderma, differ little from most skin pathologies and are visible only a week after the infection. And this is actually in the absence of internal discomfort. So maybe you should not worry about this disease?

Skin diseases - evidence of body health

The skin is considered the largest and most important organ of the human body, because our body is the only protective sheath that protects internal organs and systems from the destructive effects of the environment. It is the skin that first of all experiences the negative influence of thermal, chemical, mechanical and biological factors, so when making a diagnosis, doctors have to consider many skin pathologies in order to establish the truth by exception.

For example, many infectious skin diseases caused by biological factors have similar manifestations: rash in the form of pustules or vesicles, more or less pronounced discomfort in the area of their localization. But the person who took the Hippocratic Oath is not limited to the contemplation of external symptoms, but will “dig” deeper, looking for such moments that are characteristic of a particular disease.

It would seem, why go deep, if the main symptoms of streptoderma here they are visible on the surface of the skin? In fact, this should be done in order to identify the causative agent of the disease (in this case it is multiplied and become dangerous streptococcus) and prevent it from penetrating deeply into the body, provoking the development of serious internal complications (rheumatism, myocarditis, glomerulonephritis, etc.) with seeming safe first external signs of the disease.[1], [2]

In fact, the diagnosis of the disease by external symptoms is not as simple as it may seem at first glance. Is it because most of the diagnoses we set ourselves are wrong? The fact is that the same streptoderma can manifest itself differently in different people. And here it is necessary to take into account the patient's age, the characteristics of his work or other activities, associated diseases, the state of the immune system, etc.

Let's try to figure out which manifestations of streptoderma are characteristic of children and adults, in which places we can expect the appearance of a rash in this disease, transmitted by contact and contact-household, what internal changes may indicate this disease.

Streptoderma in children

How is a child physiologically different from us adults? First of all, its vulnerability in the face of many pathogens of infectious nature. Immunity of the child is formed and strengthened for several years after birth, so young children suffer from infectious diseases much more often than adults, and the list of such diseases is supplemented with purely childhood diseases.[3]

Streptoderma can not be attributed to childhood diseases, although the incidence among children is much higher than among young people and mature people. This is facilitated by the spread of the pathogen in large children's groups (nurseries, kindergartens, school groups, extracurricular work groups, sports clubs, art groups, etc.), where toddlers and adolescents are in close contact with each other.

It is especially difficult to protect children up to 3 years from trouble, for which tactile sensations (to feel, to feel the properties of an object with fingers) are especially attractive, allowing you to explore the world in all its manifestations. And the touch itself is very important at such a tender age. Here are just a persistent hygiene skills in a young child yet. In addition, the disease appears outwardly much later than the ability to infect others, so when the first signs of streptoderma appear, one child is more likely to have already infected a large part of the team.

Manifestations of the disease in children may vary depending on the degree of formation of the immune system and the strength of immunity, the number of pathogenic microorganisms on the skin, the presence of large and small skin lesions, the focus of the disease, the presence of concomitant pathologies.

In large children's groups, the disease develops on the principle of an epidemic, i.e. A sick child in a short time spreads infections throughout the children's team, and sometimes beyond its chapels. That's just to manifest streptoderma will be different children in different ways. If a child’s immunity can withstand the onslaught of bacteria, the clinical picture will be limited to external signs: local rashes on the skin, i.e. Lesion of certain parts of the body. In this case, the decisive role is played by the local immunity.

The rash, as a characteristic symptom of streptoderma, usually appears 2-10 days after infection in the form of bright pink papules or fluid bubbles, which after opening can turn into erosion. With proper care, such elements quickly dry up with the formation of crusts, then painlessly disappear.

However, in some forms of the disease, vesicles are not formed at all, limited to the formation of small pinkish or reddish foci with exfoliating particles of the epidermis (the dry form of streptoderma).

Itching for streptoderma is usually mild or absent altogether, so the child is not particularly worried. Another thing is that children tend to touch unusual elements on their skin with their fingers, to scratch them out of children's curiosity and thus spread the infection to other parts of the body, complicating the course of the disease.[4]

But if the child’s immunity is not able to cope with the pathogens, and also if streptococci hit the delicate lining of the mucous membranes, it is likely that more severe forms of the disease may develop. In addition to external symptoms, the clinical picture of streptoderma in this case also has internal manifestations:

  • Increase in body temperature to febrile values (above 38-38.5 degrees). A child may become sluggish, apathetic, his appetite deteriorates, and strange whims may appear. Other children, on the contrary, become overly excitable and only unusually pink baby cheeks point to the temperature.
  • The appearance of symptoms of intoxication of the body (the child may have a headache, hence lethargy and whims, nausea and vomiting that do not depend on food intake, appetite decreases, sleep is disturbed). In some cases, there are pains in the joints and muscles, which limits the mobility of the child and causes crying in babies and complaints of health in older children.
  • The enlarged lymph nodes  near the lesions in the course of the lymph, which can sometimes be detected from the first days of the disease (under the skin of a child, you can feel the seal, often painful to palpation).
  • Blood tests of the child will show the presence of a pronounced inflammatory process characteristic of bacterial damage.

Streptoderma in adults

The high incidence of streptoderma among children does not preclude the development of this disease in adults, because in infectious diseases, immunity plays a decisive role, not age. And is it worth mentioning that in conditions of an environmental catastrophe in which most of us live, it is not particularly necessary to count on strong immunity. According to a study conducted in 2005, at least 18.1 million people suffer from invasive diseases of S. Pyogenes, and another 1.78 million cases occur every year.[5]

In addition, streptococcus penetrates through the skin through various, even microscopic lesions on it, so it is not as difficult to catch the disease as it seems. Another thing is that in people with more or less normal local and general immunity, it can flow almost imperceptibly, while a person who is weakened by chronic diseases may experience noticeable discomfort.[6]

An adult can become infected at work, while traveling in public transport, while visiting public places, including swimming pools and gyms. You can catch the infection without even leaving your home if someone from your family, for example, a child attending a kindergarten or school, has become a source of infection. It is not necessary to closely contact the patient or the carrier, it is also possible to detect the symptoms of streptoderma after contacting the skin with the patient's bed, his clothes, household items, dishes, etc.

Understand how streptoderma begins in adults, i.e. It is possible to detect its first signs by the appearance of the skin, on which, with this pathology, small pink spots slightly elevated above the body are formed without painful spots. A little later there is a slight itching and flaking on the surface of the pathological elements.

Further, the papules, in most cases, begin to emerge more strongly above the skin and turn into bubbles of small diameter, inside of which a cloudy yellowish liquid is seen. In the absence of treatment, individual closely spaced elements can merge into groups, covering large areas of the skin.

After some time, the bubbles burst with the formation of cracks and ulcers, on the surface of which dry crusts or scales appear, resembling lichen.

In the dry form of streptoderma, the rash has a slightly different character, the bubbles in this case are not formed, and the foci of the disease have not a pink, but a whitish tint due to the resulting peeling. They have a rounded shape and size up to five centimeters. On them, almost immediately, flaky scales of the epidermis are formed, after which, for a long time, a slightly pigmented skin area remains. Pathological lesions are less prone to increase in size and spread to visible and hairy areas of the body than in other forms of the disease.

Complaints that the skin itches, with the defeat of streptococcal infection do not occur often. Itching, if present, is insignificant, not causing particular discomfort, as is the case, for example, with chemical burns with alkali solutions, allergies or herpes, which have similar external manifestations with moist forms of streptoderma.

The temperature of streptoderma in adults usually does not rise, except that a person is diagnosed with immunodeficiency, severe vitamin deficiency or his body is greatly weakened by a long illness, excessive physical and mental stress, constant stress, which could not but affect the state of immunity.

An enlarged lymph nodes can be observed only when the infection spreads deep into the body. But this symptom usually appears already at the stage of appearance of possible complications, and not at the very beginning of the disease, as happens in children, the barrier function of the skin is much weaker, which allows the infection to quickly penetrate into the deeper layers of soft tissue and lymph.

With a mild course of the disease and appropriate treatment, the symptoms that appear will disappear within 3–10 days, without causing a deterioration in the person’s well-being. But even with the severe form of streptoderma in adults you can cope rather quickly - within 3-7 days, if adequate treatment is prescribed and all its requirements are met. Only with strongly weakened immunity or unsystematic implementation of therapeutic measures, treatment can be delayed up to 10-14 days with a certain probability of the transition from the acute form of the disease to the chronic one.

At the same time, an important feature of streptoderma is the fact that even the usual daily body hygiene in case of illness can do a disservice because it is not recommended to moisten the lesions with water, because it only delays the healing process.

Streptoderma in women and men

It is believed that in women the skin is thinner and tender than in men, it is logical that various wounds and scratches appear on it faster and more often, even with a slight effect of the damaging factor. Given that streptococcus is considered a permanent resident of our skin, it can be assumed that women are more likely to get streptoderma than men.

In fact, morbidity statistics for men and women is not very different, because the majority of the stronger sex work in conditions of increased risk of injury, and hygienic conditions in many factories and factories in public transport (and many work as drivers) are not up to par. In such conditions, the only protection against bacteria can only be a strong immunity, which is not all.

In addition, both men and women also have other specific factors that predispose to the development of streptococcal disease. Such factors include diabetes mellitus, which can be of 2 types. Type 2 diabetes (non-insulin-dependent) most often affects women, but insulin-dependent diabetes is more likely to affect men. And since with this disease the risk of formation of long-healing wounds on the body is higher, then the representatives of both sexes equally at some point may notice symptoms of streptoderma. In addition, the disease in most cases is chronic, as is diabetes itself.

In men, the likelihood of streptoderma increases while serving in the army or in prison. This is facilitated by a large team, where the infection spreads in a short time, active physical exertion, provoking increased perspiration and the occurrence of prickly heat, foci, where bacteria are most easily penetrated into the skin, poor hygiene, etc. Streptoderma in the army and prisons often has a sharp epidemic character.

It is believed that men are more likely to detect symptoms of the dry form of streptoderma, i.e. Non-oozing flaky small foci on an almost oval-shaped body, which, if left untreated, can spread over large areas.

In women, the risk of developing streptoderma increases during pregnancy. And this is not surprising, because hormonal alteration in the future mother's body is a blow to her immunity, which is exactly what bacteria need. Sensing weakness, they immediately begin to actively proliferate.

It is clear that not all women develop streptoderma during pregnancy, but only those whose body experiences an acute lack of vitamins and minerals necessary for the good functioning of the immune system, are tormented by chronic diseases or stress.

Streptoderma develops during pregnancy not so often, and it doesn’t particularly pose a danger to the future mother, as long as it concerns only external symptoms (slight itching and local rashes on the body), in which external use of antibiotics is completely acceptable.

True, many moms, fearing to harm the baby in the womb, do not hasten to resort to the help of potent drugs. And it is in vain, because the local use of antimicrobial drugs, in which their absorption into the blood is small, is practically impossible to harm the child. But if untreated, there is a risk that the fetus will suffer. If microbes penetrate the placenta to the baby through the mother’s blood, they will adversely affect the development of various organs and systems of the baby, especially if the mother falls ill in the first trimester of pregnancy, which is most often the case. And after all, it is in the first 3 months of the development of the fetus that practically all the main vital systems of the future person are laid and formed.

As you can see, the chances of being infected by people of different sexes and at certain points in the existence of an individual, they may increase. In this case, we do not always treat the symptoms that appear correctly, therefore the statistics cannot even approximately estimate what the prevalence of this disease actually is, especially since the variety of forms of streptoderma and the characteristics of its course predispose to a certain proportion of erroneous diagnoses.

Pockets of destruction: where to find them?

Knowing that streptococcal infection is transmitted by contact and household contact, we can assume that the first symptoms of streptoderma appear mainly on the hands. In reality, specific rashes can be found on different parts of the body, namely, where there are micro-or macro-lesions of the skin. In addition, after contact with a site of infection, a person can himself contribute to the spread of infection to other parts of the body.

Localization of lesions in streptoderma may be different, which to some extent affects the final diagnosis of the doctor. For example, streptoderma in the corners of the lips (zaeda) may have a diagnosis of “impetigo caused by streptococcal infection” or “streptococcal impetigo.”

In most cases, streptoderma occurs on the arms and legs - parts of the body that are more likely to be open, not protected by clothing, less often on the feet, mainly in people with excessive sweating of the feet, because this creates particularly favorable conditions for the reproduction of pathogens (and bacteria, and fungi). It should be understood that various skin lesions on the extremities are more likely than, for example, on the back or buttocks. And if the skin also sweats (for example, on the feet), this makes it more vulnerable.

Oddly enough, but the steptoderma on the face, as well as on the head, for example, behind the ears or on the lower part of the chin is not inferior in its prevalence. Not only children, but also adults tend to often touch their faces with their hands, without worrying about their cleanliness. But the skin of the face is very delicate, so any rubbing or scratching can cause microdamages, and if a secret pest was hiding on the fingers or under the nails, it is quite likely that it will settle in a new place, penetrating the skin in a suitable area.

There is a high risk of wounds on the face and infection in them in those who shave (the vast majority of men and a small proportion of women), especially without the use of hygiene products, i.e. To dry. And we remember that any wound on the body is attractive for infection because in this place the protective barrier of the body is broken.

If the first signs of streptococcal infection appear on the skin near the hairline, there is a great risk that if improperly treated or not, the disease will turn into streptoderma of the scalp, spreading to the hair growth zone. At the same time, a person in the hair has an accumulation of exfoliating skin particles (like dandruff), and the crusts after drying of the ulcers can fall off together with the hair follicles, causing their local thinning.

The skin around the eyes is considered to be especially tender and vulnerable, therefore the foci of the disease are often found precisely in this area, one has only to rub the eyelid with the hand in contact with the infection. Century Streptoderma is characterized by the appearance of pimples and bubbles on the mucous membrane of the organ of vision or in the lateral folds around the eyes. In this case, streptoderma in the eyelid is sometimes confused with a cold, herpes or barley, which in 90-95% of cases is caused by staphylococcus aureus.

Streptoderma in the nose or in the ear in many ways resembles a herpetic infection, but at the same time, itching occurs much later (in case of herpes even before the appearance of the rash), and in intensity it is much weaker. Moreover, after the opening of herpetic elements, there is practically no trace on the soft tissues, while with streptoderma, cracks and ulcers remain at the site of the vesicles.

Streptoderma in the mouth, on the tongue, as well as the situation when the rash reaches the throat, is a variant of bacterial stomatitis, provoked by streptococcal microflora. Our skin is a more durable barrier than the mucous membranes, so it is not surprising that through them it is easier for bacteria to penetrate soft tissues. In addition, while eating and brushing the teeth, the mucosa is often injured, and the wounds on it due to the increased humidity of the mouth are tightened much longer than on the surface of the skin.

Streptoderma in the corners of the mouth, where microcracks occur very often during a wide opening of the mouth or active chewing, usually develops in children. This may contribute to the use of food by someone else's or unwashed spoon with the "living creatures" that are on it. Although in adults and adolescents (especially during hormonal adjustment), such situations cannot also be ruled out, although they occur with much lower frequency.

Streptoderma on the lips (again, delicate skin, which can be damaged even by wind) can easily be confused with herpes, because the external symptoms of a viral infection and a bacterial disease are very similar. But again, you should pay attention to the itching, which is much stronger with herpes.

Any area with delicate skin and mucous membranes is more susceptible to various injuries, and therefore the probability of infection in these places is higher. For example, you should not be surprised if streptoderma is found in the groin. This is a skin area with high humidity, and therefore sensitivity to various kinds of negative effects. It is in such hidden areas, where it is warm and humid, bacteria and fungi multiply with particular diligence, and the lesions grow with greater speed, spreading to the perineum and anus.

The appearance of streptococcal symptoms on the mucous membranes is accompanied by a noticeable pain that increases when you touch the inflamed elements. If a rash appears on the skin, it does not cause perceptible pain.

So, streptoderma on the genitals is no longer just an inconvenience, but a certain discomfort that affects the patient’s quality of life. In addition, there is a high risk of spreading the infection inside the body during sexual intercourse and during hygiene procedures.

The genital streptococcus lives constantly, but with a decrease in immune protection, it can actively multiply, causing damage to the epidermal cells and inflammation of the tissues. But even with sufficiently strong immunity, such a “gift” can be obtained from a sexual partner during sexual contact or intimate caresses, as well as streptoderma on the face with kissing.

Armpit streptoderma develops for the same reason as in the groin, i.e. Due to high humidity and vulnerability of the skin of this area. In addition, many adults (mostly women) find it indecent to have “vegetation” in this place, so they regularly shave their armpits. And shaving is a trauma to the skin, especially for its tender areas. As a result, it almost always remains on the skin as small, imperceptible to the eye, and larger injuries, through which the infection subsequently penetrates.

But streptoderma on the back, abdomen, chest or buttocks has other reasons. It usually occurs after contact with an infected bed or clothes, less often after contact with the patient's skin (which is quite possible during the incubation period, when even the patient himself is unaware of his illness). Usually, it appears as a large number of individual red or pink small elements, resembling at first the usual acne rash, which later turns into bubbles with turbid contents and tends to merge individual formations into larger foci.

The absence of pronounced itching and discomfort causes patients to not rush to seek help until the infection becomes frightening to spread or symptoms of a different nature appear.

Stage Streptoderma

Streptoderma is an infectious disease that can have various manifestations at different stages of its development. Thus, for each stage of development of streptoderma is characterized by its own specific symptoms.

At the first stage of its development, the disease has no external symptoms. This period is called incubation. Its beginning is the moment of infection penetration through damaged skin. Within 2-10 days, the bacteria are activated and begin to multiply rapidly. It is possible that the wound through which the infection has penetrated may finally be delayed by the end of the incubation period and no manifestations of the disease will be visible on the skin.

In the second stage, small foci of hyperemia appear at the site of infection, with the formation of reddish seals (pustules). This indicates the development of the inflammatory process triggered by streptococcus bacteria. Already at this stage, some children begin to feel unwell, become lethargic, quickly tired. Adults, as a rule, do not feel unwell.

The third stage of the disease can be considered the transformation of the pustules into a vesicle with muddy contents, which is soon opened with the formation of sores and in its place a yellowish-brown crust forms. With some oozing forms of the disease, bubbles form almost immediately, and after that a red, inflamed halo appears around them. All these are characteristic manifestations of beta-hemolytic streptococcus vital activity: excretion of toxins and specific poisons.

In the dry form of streptoderma, vesicles usually do not form at all. At the same time, the foci of infection are initially larger and very quickly become covered with whitish peeling crusts (the epidermis flakes off). This is a superficial form of the disease that is fairly easy to treat, and recovery usually occurs within 3-5 days.

At the last stage of the disease, the crusts dry out and disappear, leaving behind them spots with a pink or bluish tinge, which subsequently disappears. After dry streptoderma, as a rule, areas with weak pigmentation remain for a long time.

From the appearance of the pathological element on the skin to the separation of the crusts, an average of 5-7 days elapse. But keep in mind that not all elements appear at the same time, therefore the duration of treatment may be longer. In addition, careless combing of pimples, bathing, probing can cause the spread of infection to other parts of the body, and again it will take time to activate it. Thus, new foci may appear when the first will leave a barely noticeable mark.

If the process is not stopped on the body, new elements of streptoderma will consistently appear in different places, weakening the protective functions of the body, and the disease threatens to become chronic. In this case, any decrease in immunity will be accompanied by the appearance of lesions on the body, and the person will become an almost constant source of infection.

The symptoms of streptoderma are direct evidence that not everything is all right in the body and this reduces its defenses. By itself, the disease does not pose a danger to life, but it is an alarming signal to come to grips with your health, and first of all strengthen your immune system.

It is important to know!

Streptoderma in children has several features. It is a skin disease of bacterial origin, in which a rash appears on the skin, which can then develop into weeping wounds, fester. 

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