Skin changes in erysipelas: causes, symptoms, diagnosis, treatment

Erysipelas - an acute inflammation of the skin. It occurs at any age, but elderly people are more often ill.

Causes and pathogenesis of erysipelas. The causative agent of the disease is Staphylococcus aureus, group A streptococcus (Streptococcus pyogenus). Gateway infection is any damage to the skin and mucous membranes. Infection can get hematogenous. Risk factors are drug addiction, alcoholism, malignant neoplasms, chemotherapy, diabetes mellitus, malnutrition, immunodeficiency states. The erysipelas can be a complication of various dermatoses, more often - itchy. The incubation period is several days.

Symptoms of erysipelas. In some patients, there are prodromal events - malaise, loss of appetite, fever, chills. Patients complain of pain and soreness with pressure on the lesion. When examined, the affected area is red, hot to the touch, swollen, shiny, slightly elevated above the level of healthy skin. The borders of the hearth are clear, irregular in shape, the dimensions can be very different. Sometimes on the surface of the lesion there are bubbles, erosion, suppuration. Violations of blood circulation, necrosis and lymphangitis are noted. The pathological process is most often localized to the tibia, but it can also be located on other sites (face, trunk). Regional lymph nodes are often enlarged and painful. Local complications include abscesses, phlegmon, skin necrosis, lymphadenitis, periadenitis, general complications - sepsis, toxic-infectious shock, pulmonary embolism. Cardiovascular failure.

Differential diagnosis. The erysipelas should be differentiated from thrombophlebitis, varicose eczema, Quincke's edema, contact dermatitis, erythema nodosum, shingles.

Treatment of erysipelas. Patients should preferably be hospitalized. Treatment is carried out depending on the severity of the disease, the degree of intoxication, the nature of local lesions and consequences. An important place is occupied by antibiotic therapy. Assign cephalosporins (0.5-1 g parenterally 2 times a day), sispres (ciprofloxacin) 500 mg 2 times a day, gentamicin, erythromycin (0.3 g 4 times daily), doxycycline (0.1 g 2 times per day), etc. With intolerance to antibiotics, furazolidone (0.1 g 4 times daily), delagil (0.25 g 2 times per day) is shown. A good effect is observed when non-steroidal anti-inflammatory drugs (voltaren, ibuprofen, etc.) join the treatment, complex administration of vitamins A, C, and group B. In severe form, detoxification therapy (haemodes, trisol, rheopolyglucin) is carried out. Locally prescribed ointments with antibiotics, 5-10% liniment of the dibunal, etc., physiotherapeutic procedures (UV, infrared laser, etc.).

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