Otitis

Staphyloderma of newborns and infants. The appearance of pyoderma

In newborns under 1 year of age, staphylococcal skin lesions of a non-follicular nature often occur. Most often manifested by the formation of pustules in the orifice area sweat glands. In weakened children and with untimely treatment, the process spreads deeper with the formation of multiple abscesses (pseudofurunculosis), phlegmon, and the development of a septic condition with an unfavorable outcome. In some cases, there is an extensive exfoliative reaction of the epidermis with severe toxicoseptic syndrome (Ritter's exfoliative dermatitis), which in terms of severity of development and course is compared with staphylococcal scalid skin syndrome (SSSS). Exfoliative toxin in newborns is formed in the primary foci of infection (purulent conjunctivitis, otitis media, nasopharyngeal infections) and enters the skin hematogenously or forms in the blisters themselves (bullous impetigo). In adults, SSSS almost never occurs, since in them the epidermolytic toxin is quickly destroyed and eliminated from the body due to more advanced immune mechanisms.

Vesiculopustulosis (periporitis)

Purulent inflammation of the mouths of the eccrine sweat glands, mainly in newborns who are bottle-fed.

Predisposing factors. Develops in premature babies, with artificial feeding, violation of the rules of swaddling children (excessive sweating).

Favorite localization . Scalp, skin folds.

Clinical picture . Pustules with a pin head and a rim of hyperemia with a dense covering, often grouped and spreading quickly. In weakened children, the process can progress deeper with the formation of abscesses, phlegmon, lymphadenitis, the development of a septic condition, anemia, otitis media, bronchopneumonia, pyelonephritis (poor care, untimely treatment).

The duration of the disease with a favorable outcome is 7-14 days.

Differential diagnosis . Bullous impetigo.

Treatment . The lesions are treated with antiseptic and bactericidal agents(0.25-1% solution of silver nitrate, 2% solution of brilliant green), ointments with antibiotics (erythromycin, heliomycin, lincomycin, etc.). At severe course Treatment is carried out as for pseudofurunculosis.

Finger's pseudofurunculosis (multiple abscesses in children)

Purulent melting of eccrine sweat glands. Develops in weakened, premature, bottle-fed and insufficiently well-groomed children with increased sweating.

Favorite localization . On the scalp, back of the body, buttocks, thighs.

Clinical picture . The affected sweat glands are initially palpated in the form of hard nodes the size of a cherry pit of a bluish-purple color, which then soften, open with the release of creamy pus, without the presence of a necrotic core, the subsequent formation of fistulous tracts and ulcers, which with rational treatment and care are scarred, infiltrates are resolved .

As the child's condition worsens, new inflammatory nodes, abscesses, phlegmon, meningitis, peritonitis, sepsis, enlarged liver, spleen, malnutrition may develop. The prognosis in these cases is unfavorable.

Differential diagnosis . Vesiculopustulosis, furunculosis.

Treatment . Wipe the skin with disinfectant alcohol solutions. The abscesses are opened and lubricated with solutions of aniline dyes, ointments (levomekol, levosin), paste with zinc oxide and xeroform (5-10% xeroform).

For abscesses, UHF, bandages with 10% sodium chloride solution, and general ultraviolet irradiation (10-15 sessions) are prescribed.

For general toxic phenomena, antibiotic therapy, transfusion of native and antistaphylococcal plasma, hemodez, albumin, polyglucin, polyglobulin, 20% glucose solution; antistaphylococcal immunoglobulin.

Hemotherapy with maternal (donor) blood, ferroplex, hemostimulating agents, phytoferrolactone, vitamins C, B6, calcium pantothenate, A, E.

Epidemic pemphigus of newborns (epidemic pemphigoid)

Acute contagious superficial staphyloderma, which occurs in the first days of a child’s life, mainly before the 7-10th day after birth.

Pathogen : Staphylococcus aureus, less often - other strains of staphylococci, streptococci and other microorganisms. The main effect on the epidermis is staphylococcal ecfoliative toxin, which causes a superficial bullous reaction.

Sources of infection – women in labor, medical personnel. In maternity hospitals, the disease may have the character of an epidemic outbreak.

Predisposing factors : pathogenic staphylococci can enter the skin of a newborn from a poorly treated, infected navel through airborne droplets and mechanical means during child care.

Favorite localization : torso.

Clinical picture. Epidemic pemphigus of newborns often begins with the appearance of blisters on a hyperemic background. The lining of the bladder is whitish, flaccid, flabby, wrinkled and rises above the level of the skin. The blisters increase in size due to severe acantholysis in the stratum spinosum and are easily peeled off. The contents of the blisters are initially serous, then serous-purulent.

The blisters rupture easily, forming erosive surfaces with jagged, scalloped edges and a juicy, rose-red or pale pink bottom. If the course of the disease is unfavorable, the erosions merge with each other, quickly capturing a significant part of the skin.

With a favorable course and therapeutic measures, erosions epithelialize with the formation of temporary secondary pigmentation and peeling.

Sometimes widespread skin lesions can be complicated by impetiginization of the mucous membranes of the mouth, eyes, genitals, and the severe general condition of the child. The severity of the disease is usually proportional to the area of skin and mucous membranes involved. Pneumonia, otitis, dyspepsia, sepsis are possible. In such cases, the prognosis for the child’s life becomes unfavorable.

Differential diagnosis. Pyococcal pemphigoid of newborns should be differentiated from syphilitic pemphigus, in which the blisters are localized primarily in the area of the palms and soles. The diagnosis is confirmed by the detection of pale treponema, as well as serological tests of the blood of the child and mother.

Pyococcal pemphigus of newborns must also be distinguished from congenital pemphigus. Bubbles with serous, serous-hemorrhagic contents appear in the area of the palms and fingers, on the skin of the elbows and knee joints, on the soles, buttocks, less often - on other areas subject to friction and pressure.

Treatment . In severe cases, antibiotics are administered with a preliminary determination of sensitivity (cephalosporins, fusidine sodium), intravenous infusion of antistaphylococcal plasma, albumin, intramuscular administration of antistaphylococcal immunoglobulin, thymalin are indicated.

External treatment : daily baths with potassium permanganate 1:10,000 and change of linen. Opening the blisters, treating healthy skin with fucorcin, salicylic alcohol, boiled vegetable oil. On the lesions - pastes and ointments with antibiotics, zinc oil, naphthalan liniment, aerosols with antibiotics. General Ural Federal District. It is necessary to isolate children in boxes and carefully care for them. Examination of mothers and medical staff for carriage of pathogenic staphylococci. Quartzization of chambers, boxes. Disinfection of departments, quarantine measures.

Ritter's exfoliative dermatitis

Severe form of epidemic pemphigus of newborns (syn.: staphylococcal scalded skin syndrome). It is characterized by the development of diffuse erythema and the formation of large flaccid blisters. Resembles a superficial burn reaction.

Pathogen: Staphylococcus aureus of phagogroup II, secreting an exfoliative toxin and causing massive acantholysis in the epidermis and the formation of large superficial blisters.

Infection of newborns occurs in the coming days after birth from infected Staphylococcus aureus mothers, medical staff. The disease develops less frequently in older children age groups and adults (against the background of immunosuppressive therapy).

Favorite localization . Starts in the navel and mouth area and spreads to other areas of the skin.

Clinical picture . There are 3 stages of the disease: erythematous, exfoliative and regenerative.

The disease usually begins in places of favorite localization with the appearance of rapidly spreading erythema. In these areas, blisters with a flabby tire appear, which quickly open and form erosions with the epidermis peeling off along the periphery (Nikolsky’s symptom is positive). Within a few days, the entire skin is affected, with the clinical picture of “scalded skin.” There is a high temperature, weight loss, diarrhea; complications are possible (pneumonia, otitis, purulent conjunctivitis, sepsis). In the blood there is leukocytosis, increased ESR, anemia, dysproteinemia. The prognosis is very serious.

Differential diagnosis . Congenital pemphigus, syphilitic pemphigus; in adults - Lyell's syndrome (drug-induced).

Treatment. Antibiotics are administered parenterally with a preliminary determination of sensitivity (cephalosporins, fusidine sodium), intravenous infusion of antistaphylococcal plasma, albumin, intramuscular administration of antistaphylococcal immunoglobulin, thymalin are indicated. Daily baths with potassium permanganate 1:10,000 and change of linen. Opening the blisters, treating healthy skin with fucorcin, salicylic alcohol, boiled vegetable oil. On the lesions - pastes and ointments with antibiotics, zinc oil, naphthalan liniment, aerosols with antibiotics. General Ural Federal District. It is necessary to isolate children in boxes and carefully care for them. Examination of mothers and medical staff for carriage of pathogenic staphylococci. Quartzization of chambers and boxes. Disinfection of departments, quarantine measures.

Vesiculopustulosis (periporitis) in newborns is observed quite often. Its appearance is usually preceded by prickly heat, the development of which is facilitated by overheating of the child. The disease occurs from the 3rd to 5th day of life or later, sometimes towards the end of the neonatal period. Initially, miliaria red and crystalline appears, having the appearance of red dotted spots that arise due to the dilation of blood vessels around the pores of the eccrine sweat glands, and transparent bubbles the size of millet grains, most often located on the body.

Then, in the folds of the skin and on the body, sometimes on the head, miliaria alba appears - blisters filled with milky white contents and located on a hyperemic base. This is actually staphylococcal pyoderma, called vesiculopustulosis. The disease lasts from 2 - 3 to 7 - 10 days with timely treatment and proper good care. But this one surface form pyoderma is dangerous, as the infection easily spreads to neighboring areas and deep into the skin. IN in rare cases possible hematogenous or lymphogenous spread of infection with damage to internal organs, skeletal system, with the development of septicopyemia. In some children, vesiculopustulosis occurs as a manifestation of umbilical sepsis or other forms of general staphylococcal infection. Among staphylodermas of newborns, vesiculopustulosis is the most common and in almost 70% of patients it is combined with multiple abscesses, which indicates the common essence of these diseases, which are phases of a single pathological process.

Multiple abscesses (pseudofurunculosis) appear when infection spreads deep into the ducts of the eccrine sweat glands in the 1st, most often at 2-4 weeks of life, sometimes at the age of 1-2 to 4-6 months and rarely at the age of 6 months to 1 year. Infiltrates appear on the skin in the form of nodes the size of a pea or slightly larger with swelling of the soft tissues. They are more difficult to treat than vesiculopustulosis, since the process develops in the thickness of the skin, capturing the entire eccrine sweat gland, the body is more slowly freed from microbes, so relapses are often observed. Having begun in the first month of life, the disease with irrational treatment can last 2 - 3 months or longer, often accompanied by a violation general condition. The temperature is initially subfebrile, then rises to 38 - 39 °C. In children, appetite worsens, pallor increases, body weight begins to decrease, dyspepsia appears, moderate enlargement of the liver and spleen, intoxication, and malnutrition are noted. IN peripheral blood leukocytosis with neutrophilia, anemia are noted, ESR increases to 30 - 50 mm per hour. Protein, leukocytes, erythrocytes, granular and hyaline casts are determined in the urine. Septicemia develops with pyeemic foci in the form of purulent otitis, phlegmon and extensive skin abscesses and subcutaneous tissue, abscessing staphylococcal pneumonia with pyopneumothorax and pleurisy, purulent meningitis, osteomyelitis, peritonitis, ending in death. It should always be taken into account that in some children multiple abscesses are the entry point for the development of sepsis. Therefore, children suffering from multiple abscesses must be hospitalized for thorough examination and treatment.

Epidemic pemphigus of newborns (pyococcal pemphigoid) is a superficial purulent skin lesion, characterized by a rash of superficial “flaccid” blisters (phlyctenas) ranging in size from a pea to a hazelnut, in places of which there are erosions, surrounded by the remains of the bladder tire; crusts do not form. After epithelialization, erosions are visible age spots, disappearing after 10 - 15 days. The period of rash lasts from several days to 2 - 3 weeks. At severe forms diseases, the number of blisters is large and they are larger. Lesions are localized in the abdomen, limbs, back, and skin folds.

Sometimes septicopyemia may develop. In 50 - 70% of patients, an increase in temperature to 37.5 - 38.0 ° C is observed. The blood test showed moderate leukocytosis, neutrophilia, increased ESR.

The disease is very contagious for newborns. In the neonatal ward, it can affect many children, since the infection is easily transmitted through the hands of staff, through linen and care items. Sick children should be isolated from healthy ones.

Differential diagnosis should be carried out with syphilitic pemphigus and hereditary epidermolysis. In syphilitic pemphigus, the blisters are located on the infiltrated base of the skin, mainly in the area of the palms and soles and are surrounded by a brownish-red inflammatory halo. Other signs characteristic of congenital syphilis are also revealed (specific rhinitis and papules, hepatosplenomegaly, osteochondritis, positive serological reactions blood). With epidermolysis bullosa, blisters appear immediately after birth on areas exposed to friction, most often on the extremities. In dystrophic forms of hereditary epidermolysis, cicatricial atrophy remains at the sites of the blisters; blisters are often present on the mucous membranes. There is no atrophy after pyococcal pemphigoid.

Ritter's exfoliative dermatitis appears after the 5th - 7th day of life, sometimes earlier, is caused by staphylococcus of phage group II, phagotype 71 or 55/71, is the most severe form of skin lesions during staphylococcal infection of newborns and is considered as a malignant variety of pyococcal pemphigoid. Clinical and epidemiological data indicate a connection between these diseases. The disease begins with the appearance of redness, cracks, and desquamation of the epidermis around the mouth or near the navel, which resembles a second-degree burn. The process quickly, usually within 6 - 12 hours, spreads to the entire body. Sometimes the disease begins with the appearance of blisters (as in pemphigoid, which quickly increase in size and coalesce; when they burst, they leave the dermis bare) from the epidermis. At the slightest touch, the epidermis moves away, and if you pull the hanging remains of the bubble, the epidermis slides off like a stocking or glove - a positive Nikolsky symptom. After healing, no scars remain. The general condition of the patients is severe: high temperature (38.0 - 39.0 °C), damage to the mucous membranes, visceral organs (pneumonia, otitis, abscesses, phlegmon, pyelonephritis). Hypoproteinemia, dysproteinemia, anemia, leukocytosis are detected, and ESR increases. In recent years, a milder and benign course of exfoliative dermatitis has been observed in the form of an “abortive form” with lamellar peeling and mild hyperemia of the skin, without the formation of erosions. Mortality has dropped sharply to 50 - 70%, but the prognosis remains serious.

Exfoliative dermatitis must be differentiated from desquamative erythroderma and congenital ichthyosis, as well as toxic epidermal necrolysis of Lyell. In contrast to exfoliative dermatitis, with congenital ichthyosis, already at the birth of a child, erythroderma, a symptom of “collodion film” with the subsequent formation of large-plate peeling, cracks in the folds of the skin, and the presence of a number of dystrophies are noted: ectropion of the eyelids, deformation of the ears, “fish mouth”. With desquamative erythroderma, there are no deformations, peeling is noted within the stratum corneum without exposing the dermis, dermatosis occurs more often by the end of the 1st month of life.

Nikolsky's symptom in congenital ichthyosis and desquamative erythroderma is negative.

The severe form of exfoliative dermatitis is very similar to Lyell's toxic epidermal necrolysis (TEN), which occurs due to increased sensitivity to various medications(antibiotics, sulfonamides, barbiturates, analgesics, anti-tuberculosis drugs, etc.), especially when using so-called drug cocktails.

Children aged 1 month to 5 years may develop staphylococcal scalded skin syndrome. Clinical picture skin with it corresponds to Ritter's disease. This syndrome is associated with the penetration into the child’s body of staphylococcus belonging to phage group II, which produces a special toxin that causes detachment of the epidermis under the granular layer. With drug-induced TEN, the deeper layers of the epidermis are affected, involving its basal layer.

SSSS syndrome - A skin lesion similar to exfoliative dermatitis can be observed in children after 1 month of life (usually up to 5 years of age) and is called staphylococcal scalded skin syndrome, or SSSS for short.

Brick-red, dim, spotty rashes appear, usually occurring after purulent conjunctivitis, otitis or infection of the upper respiratory tract. Foci of skin maceration are found in the inguinal and axillary folds. The child’s face takes on a very sad, as if “whining” expression, and impetiginoinous crusts accumulate around the natural orifices of the face. Skin lesions progress over 24-48 hours from a scarlatiniform rash to spontaneous large and flaccid blisters. A positive Nikolsky sign is noted. After opening the blisters, a weeping erythematous surface is exposed. All skin has the appearance of being scalded or burned. Severe damage to the mucous membranes of the mouth, as a rule, is not observed. Within 5-7 days, epithelization of erosions occurs, followed by exfoliation. The contents of intact blisters are usually sterile.

It is very important to carry out a timely differential diagnosis between SSSS and toxic epidermal necrolysis (TEN), or Lyell's disease. TEN is an acutely onset widespread lesion of the skin and mucous membranes: blisters, erosions, and a sharply positive Nikolsky sign appear. The general condition of the patients is severe due to large losses of fluid, protein, and electrolytes. TEN occurs due to increased sensitivity to medicines(sulfonamides, antibiotics, barbiturates, analgesics, etc.), especially when using so-called drug “cocktails”. The disease can occur at any age. With drug-induced TEN, unlike SSSS, deeper layers of the epidermis are affected, with the involvement of basal layer cells in the pathological process.

It is also necessary to carry out a differential diagnosis with desquamative Leiner's erythroderma, congenital epidermolysis bullosa, congenital ichthyosis, bullous ichthyosiform erythroderma, congenital syphilis.

Staphyloderma - contagious dermatological disease caused by various types of staphylococcal infections. With this pathology, damage to the hair follicles of the dermis is diagnosed, cellular structures deep layers of the epidermis. The disease is characterized by the development of an inflammatory process in the apocrine (sweat) glands due to the localization of staphylococcal bacteria. Staphyloderma is most often diagnosed in children.

Staphyloderma: signs and types

Staphyloderma is a rather unpleasant dermatological disease in which pustules form in the area of hair follicles, sweat, and sebaceous glands, which are pathological formations, shaped like half a ball with a thick surface crust. Inside the pustules, which can be located in various structures of the epidermis, there is purulent exudate. In fact, staphyloderma is a type of pyoderma.

Superficial and deep staphyloderma is noted in adults and children. In medical practice, dermatological diseases are classified into several types:

folliculitis;
ostiofolliculitis;
pemphigus of newborns;
staphylococcal sycosis;
furunculosis.

In young children, staphyloderma can manifest itself in the form of multiple abscesses, vesiculopustulosis, false furunculosis, Ritter's exfoliative dermatitis, and epidemic pemphigus of newborns.

In adults with staphyloderma, staphylococcal sycosis, carbunculosis, furunculosis, hidradenitis are diagnosed (“ bitch udder"), osteofolliculitis.

Causes of staphyloderma in adults and children

The causes of the development of dermatological pathology are exo- and endogenous factors of various natures. The disease is caused by Staphylococcus aureus, or less commonly white Staphylococcus, which is widespread everywhere - in the air, dust, and on household items. In addition, dangerous microorganisms live on the skin, in the folds of the dermis, under the free edge of the nail plate, and on the wings of the nose.

Important! Staphyloderma infection occurs by contact, through an infected bed sheets, personal hygiene items, household items.

Despite its high pathogenicity, dermatological pathology manifests itself when:

reduction of the protective functions of the epidermis;
weakening the body's resistance, reducing immune forces;
autoimmune connective tissue diseases;
disruptions in the functioning of the endocrine system;
increased sweating;
the presence of chronic foci of infection in the body.

Treatment of staphyloderma

Treatment of staphyloderma in children and adults involves complex therapy, application pharmacological drugs local and general, complex action.

Important! Treatment methods, medicines should be prescribed by the attending dermatologist, based on the diagnostic results obtained.

The duration of treatment depends on the age, general physiological condition of the patients, the form, stage of staphyloderma, and the severity of pathological processes. Treatment methods, which are selected individually by a dermatologist, are aimed at relieving the clinical symptoms of dermatological pathology and normalizing the general condition. In this case, it is very important to establish the root cause that led to the development of staphyloderma.

Main task therapeutic therapy consists in reducing the activation of androgens in the body, normalizing the functioning of the sebaceous and sweat glands. Patients are prescribed complex antibiotics to reduce the number of pathogenic flora, local antibacterial drugs - medicated creams, ointments, gels, emulsions.

Important! To achieve positive effect when treating staphyloderma in children and adults, antibacterial creams and gels should be used only in combination with antibiotics, retinoids, and other symptomatic drugs.

Before antibacterial drugs are prescribed to patients with staphyloderma, a series of laboratory tests to determine the sensitivity of bacteria to certain active components of drugs.

Among antibiotics for the treatment of carbuncles, boils, and other types of staphyloderma, patients are prescribed antibiotics: Rifampicin, Azithromycin, Erythromycin, Amoxiclav.

For local treatment antibacterial ointments, liniments, aerosols are applied and rubbed into the affected areas of the epidermis. Before applying medicinal creams, the skin is wiped with 3% salicylic alcohol.

For local treatment ointments Levomekol, Levosin, boron-tar emulsion with antibiotics, Sangviritrin in the form of liniment, Chlorophyllipt, antiseptic are prescribed medications for treating the epidermis around the affected areas.

As additional therapy for the treatment of staphyloderma in children, the following may be prescribed:

Immunomodulators to increase resistance and activate the immune system.
Vitamin and mineral complexes to normalize general condition.
Physiotherapeutic procedures promoting tissue regeneration.
Symptomatic medications to relieve symptoms chronic infections, pathologies.
Proteolytic pharmacological agents(topically) for deep necrotic lesions of the dermis.
Enzyme medications (Bifidum, Bifiform) to normalize and restore intestinal microflora.

The course of physiotherapy procedures takes seven to ten days, which depends on the form and stage of the dermatological disease. If necessary, physiotherapeutic treatment can be resumed after a break. To speed up the resorption of infiltrates, UHF is prescribed. Ultrasound, laser therapy indicated for furunculosis, ostiofolliculitis, carbunculosis.

In case of severe purulent skin lesions, the presence of abscesses, carbuncles, they are aspirated (opened) surgically. In addition, globulins, staphylococcal antiphagin, and toxoid may be prescribed.

Opening of pustules for folliculitis and ostiofolliculitis is carried out in a hospital with a sterile medical needle, after which the affected areas are treated with antiseptic drugs.

Advice! During treatment, it is worth adjusting the diet, giving up smoked, fatty, salty foods, marinades, and spices. It is very important to adhere to the dosage, frequency of administration, and follow all recommendations of the attending physician.

Treatment of staphyloderma with alternative medicine

In the treatment of staphyloderma in children and adults, in addition to the main therapy good result gives the use of alternative medicine. Decoctions and tinctures based on medicinal plants are rubbed into the affected areas of the epidermis: chamomile, calendula, sage, St. John's wort, yarrow, plantain.

Rubbing the inflamed areas of the skin with cloudberry, blackberry, black currant juice, white willow tincture, string decoction, and aloe juice will help eliminate the symptoms of an unpleasant dermatological disease.

Important! When treating with folk remedies, be sure to consult with your dermatologist to prevent the development of serious complications.

You can not only treat the affected areas of the body with decoctions medicinal herbs, but also take a bath with medicinal plants.

In addition, it is worth including greens, grains, fresh fruits, berries, and vegetables in your diet. If you have staphyloderma, you should completely avoid bad habits, stick to the regime, daily routine. The treating dermatologist will help you select and coordinate the diet.

In case of common forms of dermatological pathology, chronic, relapsing course, it is necessary to constantly undergo diagnostic examinations and not delay treatment of concomitant diseases. Patients may be prescribed nonspecific restorative therapy, drugs to increase protective immune forces, and diet adjustments may be made.

Prevention of staphyloderma implies compliance elementary rules personal hygiene, healthy image life, as well as visiting medical centers to undergo a comprehensive examination.

Staphyloderma of newborns and children infancy

This group of diseases includes: vesiculopustulosis, multiple abscesses in children, epidemic pemphigus of newborns, Ritter's exfoliative dermatitis, bullous impetigo of newborns.

Vesiculopustulosis

Cause of the disease. This disease is common among newborns in the first days of life. It is expressed in the appearance of multiple pustules (purulent vesicles) of different sizes, filled with whitish-yellow contents, with a bright red border and swelling.

The etiological factor is different strains of staphylococci.

Development mechanism. Prematurity plays a major role in the mechanisms of occurrence of this disease. low weight newborn, increased sweating, artificial feeding.

Clinical picture. First, pustules form at the mouths of the sweat glands, which are usually located in the axillary and inguinal folds, on the scalp and torso. Pustules tend to merge and can be located on large areas skin and form deep lesions. This course occurs in weakened children.

Diagnostics. The diagnosis is made without much difficulty. Vesiculopustulosis is differentiated from scabies complicated by pyoderma.

Treatment and prevention. Swimming is prohibited for the entire treatment period. Processing is carried out with weak disinfectant solutions unaffected areas of the skin. Pustules are lubricated with aqueous and alcohol solutions of aniline dyes.

Multiple abscesses in children, or Finger's pseudofurunculosis

This disease is the result of the development infectious process in the excretory ducts and glomeruli of eccrine sweat glands.

Cause of the disease. Most often, the etiological factor of Finger's pseudofurunculosis is Staphylococcus aureus, but the disease can also develop as a result of the introduction of hemolytic staphylococcus, Escherichia coli, Proteus, etc.

Development mechanism. In the mechanism of development of this disease, the following are of great importance: poor care for children of the first year of life, in particular dirty underwear and bed linen, overheating, increased sweating, which causes maceration of the skin, malnutrition with the development of enteritis, infectious diseases. Children with insufficient body resistance and premature babies are most susceptible to this pathology.

Clinic and course. In case of capture inflammatory process Only the openings of the excretory duct of the sweat gland form small superficial pustules. This process is called periporitis. These pustules quickly turn into crusts, which then fall off, leaving no traces behind. But more often the entire excretory duct and glomeruli of the sweat gland are affected. As a result, numerous nodes of increased density, red and blue in color, are formed, sharply demarcated from healthy skin, tending to increase in size (usually reaching the size of a hazelnut). After a short period of time, the nodes in the center soften, where the skin becomes thin and where purulent contents accumulate. After the nodes open and the pus drains, scarring occurs. Abscesses are most often located on the back of the head, back, hips, buttocks, i.e. on those parts of the body that come into contact with the bed.

If a lot of nodes are formed, up to several dozen, then this is already considered a generalization of the process. The general condition of the children during the normal course of the disease is quite satisfactory, the temperature does not rise. But when the body’s defenses are weakened and exhausted, the disease can be complicated by phlegmon, otitis, and there may be damage to the liver and spleen. In particularly severe cases, sepsis can develop and be fatal.

Diagnostics. The diagnosis in a typical course does not cause any difficulties; it is made when nodes are detected in infants without signs of inflammation, but which, when palpated, give a sensation of fluid movement under the fingers (fluctuation). Differential diagnosis is carried out with furunculosis, which is extremely rare in infants, with folliculitis, multiple papulonecrotic tuberculosis, with scrofuloderma.

Treatment. Abscesses are treated by applying pure ichthyol to them in the form of a cake. Sometimes abscesses are opened surgically. The skin around the lesions is wiped camphor alcohol. Water procedures during the acute period are prohibited. Antibiotics and sulfonamides are used, and β-globulin is administered if necessary. Good effect provide general strengthening agents.

Prevention. With this disease, prevention is very important, which consists of proper care for a child of the first year of life, primarily in maintaining hygiene in the form of regular bathing and frequent changes of linen. Diaper rash after bathing must be treated with special baby creams, powders, and oils. Great value has proper nutrition child, avoiding overheating.

Forecast. The prognosis is varied and depends on the state of the child’s body before the disease and the complications that the disease itself can cause.

Epidemic pemphigus of newborns

This is an acute disease that is highly contagious and rapidly developing.

Cause of the disease. The causative agent is Staphylococcus aureus. However, some scientists consider a special type of staphylococcus, streptococcus or a filterable virus as the causative agents of this disease.

Development mechanism. The unusual reactivity of the skin of newborn children plays a major role in the mechanism of development of the disease. This feature lies in the fact that some unfavorable factors, such as toxicosis of pregnancy, birth trauma, prematurity, penetration of bacteria through skin barrier, the skin reacts by forming blisters.

Epidemiology. Main feature epidemic pemphigus of newborns is its extreme contagiousness. The main source of infection is the medical staff of maternity hospitals, mothers of newborns suffering from pyoderma, and an infected umbilical cord. This disease can cause epidemic outbreaks in maternity hospitals, since the infection is very quickly transmitted from one child to another through the hands of medical staff or underwear. In such outbreaks, the maternity hospital is urgently closed for disinfection. In isolated cases, sick children must be isolated.

Clinic and course. The disease affects newborn children in the first days of life or after 7–10 days. Within a few hours, small bubbles, the size of a pea or slightly larger, form on normal or slightly reddened skin, which are covered with a thin covering and filled with transparent serous-yellowish content. Before their appearance, the child experiences an increase in temperature and anxiety. Quite quickly, the contents of the blisters become purulent, and the blisters themselves increase in size and spread over the entire surface of the body. Their cover is opened, the contents flow out, and in their place there remain eroded surfaces of a bright red color, wet and very itchy. The areas most often affected are the navel, abdomen, chest, back, buttocks and limbs, as well as the mucous membranes of the mouth, eyes, nose, and genitals. In weakened and premature babies, the disease develops rapidly with high fever, anxiety, loss of appetite, and poor blood counts. Such children often have complications in the form of edema, pneumonia, phlegmon and even sepsis.

If the disease proceeds without complications, it lasts for 3–5 weeks. During this time, periods of cessation of rashes are replaced by relapses of the disease.

Diagnostics. Epidemic pemphigus of newborns is diagnosed in the case of blistering rashes in children in the first 2 weeks of life in the form of attacks with rapid evolution and in the absence of infiltration of their base. The disease should be differentiated from syphilitic pemphigus of newborns, congenital epidermolysis, chicken pox.

Treatment. The blisters are carefully opened to remove scraps of the epidermis. Erosion is treated with ointments containing sulfonamide drugs and antibiotics, as well as aniline dyes and a solution of potassium permanganate. In severe cases, general treatment is carried out with antibiotics and sulfonamides. In the erythrodermic form, corticosteroids are used to save the child's life. Treatment and patient care are carried out with mandatory cleanliness.

Prevention. It consists of regular examinations of all maternity hospital staff and mothers in order to identify foci of pyodermatitis, and examination for bacilli-carrying material from the pharynx and nose. Requires wet cleaning and quartzing of chambers, use gauze bandages when in contact with newborns, change linen frequently.

Forecast. Depends on the form of the process and on the general condition of the newborn baby’s body. Favorable prognosis observed with a benign course of the disease, a serious prognosis - with a malignant form.

Ritter's exfoliative (foliate) dermatitis of newborns

At its core, this disease is epidemic pemphigus of newborns, its severe form. But, according to some scientists, exfoliative dermatitis is a separate form.

Cause of the disease. It is most often caused by Staphylococcus aureus, but can also occur as a result of mixed exposure to staphylococci and streptococci.

Development mechanism. The same as for epidemic pemphigus of newborns.

Clinic and course. Ritter's exfoliative dermatitis of newborns, like epidemic pemphigus of newborns, develops in the first weeks of a child's life. First, bright erythema with inflammatory swelling appears in the mouth area, then the process very quickly spreads to the areas of the folds of the neck, navel, genitals and anus. Against the background of erythema, large blisters with tense walls form; they quickly open with the formation of weeping erosions. There is a so-called Nikolsky symptom. It is considered positive if the epidermis around the erosions, when pulled with tweezers, peels off far beyond the limits of visible healthy skin. The disease can develop in different ways. In some cases the temperature remains normal, in others it rises and there is nausea. Also, at the beginning of the disease, rashes in the form of large blisters may predominate, and only later the disease develops as erythroderma. But it can begin immediately with changes of an erythrodermic nature. In these cases, almost the entire surface of the body is very quickly (within 2–3 days) covered by the pathological process. The disease occurs in three stages.

The first stage is characterized by diffuse redness of the skin, swelling and blisters. This is called the erythematous stage.

The second stage is called exfoliative. At this stage, exudate (liquid discharge) forms in the epidermis and under it, which leads to peeling and peeling of areas of the skin, i.e. Nikolsky’s symptom is observed. The second stage is a very difficult period of the disease, as erosions are formed that tend to grow and merge with each other, and therefore outwardly the sick child resembles a second-degree burn patient. During this period, severe general symptoms are observed: high fever, disorders gastrointestinal tract in the form of vomiting and diarrhea, poor performance blood, weight loss.

In the third stage, which is called regenerative, all acute phenomena decrease, i.e., redness and swelling of the skin gradually disappears and erosive surfaces epithelialize and heal.

How older child, the more benign the disease progresses.

Diagnostics. The diagnosis does not cause any particular difficulties. Nikolsky's symptom is indicative. They are differentiated from burns, epidermoliosis bullosa, pemphigus of early congenital syphilis, Leiner's desquamative erythroderma and congenital ichthyosiform erythroderma.

Treatment. Quite difficult and consists of maintaining careful hygiene, preventing cooling and rational nutrition sick child. Externally, 5% colymycin, heliomycin, dibiomycin, 0.5–1 – 3% erythromycin or 5% polymyxin ointments are used as a step-by-step treatment. Use ointments and creams containing corticosteroids along with antibiotics. These are Locacorten, Oxycort, Geocorton, Dermazolone. As a general treatment, antibiotics and sulfonamides are prescribed with the obligatory determination of the sensitivity of the microflora to them and the child’s tolerance to them. Group vitamins are required IN And WITH, in especially severe cases, hormones are used.

In cases of septic condition, low molecular weight dextrans, native plasma, fresh blood, kontrikal and filling.

Prevention. The same as with epidemic pemphigus of newborns.

Forecast. It is quite serious and depends on the strength of the process, its prevalence and the body’s resistance.

Bullous impetigo of newborns

It is an easily occurring, abortive form of epidemic pemphigus of newborns. It is considered a benign form of staphyloderma. It is manifested by the appearance of single-chamber bubbles, located separately from each other in a small number. The size of the bubbles is from a pea to a cherry, they are covered with a thin, tense tire, which quickly opens, revealing wet erosion. The blisters are filled with serous-purulent contents, after which crusts form after drying. The main locations of the pathological process are the torso and limbs. The prevalence of bubbles and their growth are insignificant. The condition of a sick child is often satisfactory.

Diagnostics. The diagnosis is not difficult to make.

Treatment. Bubbles are being opened with a sterile instrument, and erosions are treated with solutions of aniline dyes.

Forecast. Quite favorable, but concomitant diseases the course of the disease may worsen.

From the book Speech Pathologist's Handbook author Author unknown - Medicine

PRONUNCIATION IN PRESCHOOL CHILDREN Young children preschool age(from 2 to 4 years) master speech to a significant extent, but in terms of clarity of sound it is still very far from perfect. The most characteristic disadvantage for them is softening of speech. Children more often

From the book Hardening and hydrotherapy author Gennady Petrovich Malakhov

HARDENING OF NEWBORN AND INFANTS The body of a newborn child is the “material” on which you can act in the two directions described - to develop the “principle of functional redundancy” to the effects of cold, or to do everything so that it

From the book Polyclinic Pediatrics by M. V. Drozdov

17. Observation of school-age children in the clinic The school period is divided into the primary school period (6–9 years), the middle school period (10–14 years) and the teenage period (15–17 years). A pediatrician works with primary and secondary school age children, and a pediatrician works with teenagers.

From the book Children's Diseases. Complete guide author Author unknown

NEONATAL PERIOD, OR INFANTLY PERIOD This stage continues from the time the child is born and continues until the 28th day of life, being divided into two periods: early and late. The early period begins from the moment the umbilical cord is ligated and continues until the 8th day

From the book Spinal Diseases. Complete guide author Author unknown

FEATURES OF DIGESTION IN EARLY CHILDREN For children in the first months of life, the nutrients that come with mother's milk and are digested by substances contained in human milk itself are of decisive importance. With the introduction of complementary foods

From the book Propaedeutics of Childhood Illnesses: Lecture Notes by O. V. Osipova

PART II DISEASES OF NEWBORNS AND EARLY CHILDREN

From the book Learning to understand your analyzes author Elena V. Poghosyan

CHAPTER 2. SPINAL PATHOLOGY IN CHILDREN INJURIES IN NEWBORN DURING BIRTH Intrapartum spinal injuries and spinal cord are the result of mechanical factors (excessive traction or rotation) when pathological course childbirth leading to

From the book Children's diseases from birth to three years author Valeria Vyacheslavovna Fadeeva

2. Nutrition of school-age children (6-17 years old) Standardization of nutrition for schoolchildren is difficult due to the fact that at this age a wide variability in the constitutional properties of metabolism and stereotypes is formed motor activity and food stereotypes

From the book Violations heat balance in newborns author Dmitry Olegovich Ivanov

Chapter 17 Features of feces in infants Immediately after birth and in the first days of life, infants secrete so-called meconium. It is a dark brown, thick, odorless, viscous mass. It accumulates in the fetal intestines during intrauterine development And

From the book Acute Conditions in Children by Lev Kruglyak

Features of morbidity in infants Many very dangerous infectious diseases can be transmitted from breast milk child, for example HIV infection, lymphocytic leukemia. This means that the guarantee of the baby’s health is timely

From the book Complete medical directory diagnostics by P. Vyatkin

Dmitry Olegovich Ivanov Heat balance disturbances in newborns Contact information: Dmitry Olegovich Ivanov, Doctor of Medical Sciences, Director of the Institute of Perinatology and Pediatrics of the Federal State Budgetary Institution "Federal Center for Medical Examinations named after. V. A. Almazov" Ministry of Health and Social Development of Russia. 197341,

From the book All about massage author Vladimir Ivanovich Vasichkin

2.3. Normal temperature readings in newborn babies Measuring body temperature is probably the most popular, widespread, used and well-known medical test. IN clinical practice it was introduced by the German physician Karl Reinhold August (1815–1877),

From the author's book

Appendix 3 Clinical protocol management of newborns of gestational age 35 weeks or more who have suffered severe combined and intrapartum asphyxia using systemic passive hypothermia to protect the brain of newborns with hypoxic-ischemic

From the author's book

Chapter 5. Diseases of newborns and young children Many diseases, such as inflammation of the middle ear, are possible in children of any age. But some of them are characteristic almost exclusively of infants. This does not mean that they are overly prone to developing diseases.

From the author's book

Gymnastics for young children Active movements are actions performed voluntarily by a child. These movements can be caused by verbal instructions, a toy, or the initial position (initial pose) of the child. For more accurate performance of gymnastic exercises

impetigo, streptoderma, folliculitis

Pyoderma is the appearance on the skin of children of multiple deep foci of suppuration, externally similar to ordinary acne. Its cause is infection of the skin with strepto- and staphylococci, although other bacteria are also found in severely weakened immune systems. Symptoms of pyoderma in children are closely related to their habit of rubbing and scratching their skin with dirty fingers.

It is not always possible to distinguish pyoderma from acne by external signs, especially in initial stage and when the focus of the rash is located in typical place(face, buttocks). Meanwhile, the treatment of pyoderma in children and its success largely depend on the timing of its initiation. The most big problem the fact that pyoderma in a child causes itching and, consequently, reflex scratching of the lesions. This allows the pathogen to successfully spread to other areas of the skin. In the ICD 10 system ( international classification diseases) pyoderma is assigned code L08.0.

Origin and classification

Pyoderma is quite common among both children (one of the three most common worldwide) and adults. The causes of pyoderma in babies are the penetration of either staphylococci (staphyloderma) or streptococci (streptoderma) into the deep layers of their skin.

More often we're talking about about representatives of the skin’s own opportunistic microflora, which has become dangerous for it under the influence of a serious weakening of the immune system. Additional factors can also affect its development: scratching, poor hygiene, hormonal imbalance.

Species

In addition to differences in the type of pathogen, pyoderma in children can be:

primary - arising on healthy skin;
secondary - arising as a complication of another disease or its treatment (after chickenpox, with HIV, as well as autoimmune pathologies if they are treated with immunosuppressants);
superficial - when the process is localized not below the dermis layer;
deep - when it occurs or spreads deeper, sometimes even affecting the subcutaneous fatty tissue.

Exactly chronic course a number (but not all) causative diseases and becomes the answer to the question why pyoderma may return in a child. For example, if a baby has had chickenpox, immunity to it remains forever. But diabetes mellitus leads to a progressive deterioration of the skin due to the ability of high sugar to destroy the walls of blood vessels, especially capillaries, on which its blood supply directly depends.

Symptoms of pyoderma in children

The first signs of pyoderma in a child often mimic other skin diseases, especially acne (juvenile acne), atypical syphilis, or even burns. Differential diagnosis here it is carried out not according to external signs, but according to age, far from puberty and the lack of contact with scalding surfaces/substances. In the future, other pimples or blisters are added, already atypical signs: swelling, peeling and inflammation of the surrounding skin, high temperature, intoxication.

Superficial staphyloderma

Among superficial staphylococcal pyoderma in children, science identifies the following options.

Ostiofolliculitis. It's about infection hair follicle, which results in a purple pimple without a purulent head, but with a “lid” of exfoliated skin. In its middle, a slightly modified hair continues to grow. The lesion does not itch, but aches when pressed or touched by clothing. It opens spontaneously during pyoderma, leaving purple spots that disappear over time.
Folliculitis. It differs from ostiofolliculitis only in the “maturation” of the lesion - the appearance of a purulent head around the hair growing in the middle. After an independent or forced (however, this is not recommended for pyoderma) opening of the abscess, the hair also most often falls out, but the hair follicle remains.
Sycosis. It is most easily confused with hormonal juvenile acne, especially if the age of the child with pyoderma is close to or corresponds to the period of their appearance. The only, although not always pronounced, difference is the redness of the skin, which persists in the intervals between pimples. Otherwise, they are very similar: ostiofolliculitis interspersed with mature folliculitis, locally located on the face, especially in the area of the nasolabial triangle. Staphylococcal sycosis is prone to periodic relapses throughout life, especially under the influence of hormones and other factors.
Pemphigus. Or epidemic pemphigus of newborns. Staphylococcus aureus, which causes it, is classified as opportunistic (dangerous if local or general immunity) skin microflora. A child becomes infected with it from parents or clinic staff, but pyoderma of this type develops only in children with severely weakened or absent immunity, and almost exclusively in the first year of life. After acute period Staphylococcus aureus is integrated into the child’s skin microflora and ceases to be dangerous. But in rare cases, neonatal pemphigus also appears in children older than one year if they are treated with immunosuppressants. Most of all, pyoderma of this type is similar to a second degree burn - one in which blisters form.

With pemphigus, the blisters are initially flaccid, easily damaged, filled with clear (or slightly cloudy) liquid. They form in the area of natural folds - where the skin is thinner and better hydrated. They can usually be found on the butt and navel, on the fingers (except the palms), on the feet (except the soles) or even in the nose (on the lining of the nostrils). But with this pyoderma, rashes from the primary lesion quickly spread throughout the child’s body, blisters are easily damaged by touch and movement, the baby is restless, loses weight and eats little.

Often with pemphigus there is an increase in temperature to 38-40 ° C. This form of pyoderma has two development options: benign and malignant. In the first case, the formation of new blisters gradually slows down, the swelling goes away, and the child recovers within one to two weeks. In the second case, death is possible.

Epidemic pemphigus of newborns is extremely contagious, including for adult carriers of Staphylococcus aureus. Therefore, its presence requires strict isolation of a child with pyoderma from other newborns and caution when contacting him, even on the part of the mother.

Deep skin damage by staphylococcus

Among deep staphylodermas, the following are distinguished.

Carbuncle and boil. Both types of pyoderma in children are large in scale - they involve not only hair follicle, but also the tissues surrounding it. A carbuncle occurs when the lesion affects the subcutaneous fatty tissue, and a boil affects the sebaceous gland next to it and the connective tissue surrounding it. This pyoderma forms a large bluish-purple painful protrusion on the skin. The purulent core is visible only in boils, and comes out only with successful treatment, usually simultaneously with a fair amount of thick pus and an admixture of blood. The appearance of several carbuncles and boils with this pyoderma is most likely on the back of the head, shoulders, and back. On the face, such phenomena are observed less frequently due to the relatively small amount sebaceous glands and fat layer.
Hidradenitis. This is the name given to the infection of the sweat glands located in the groin by Staphylococcus aureus. armpits, area of the auricle. They secrete sweat with a specific odor, beginning to function only during puberty. In children, these glands do not yet work, which makes their infection more difficult, but does not exclude it. Due to hidradenitis that occurs as a result of pyoderma, the iron becomes inflamed, and a swollen pimple with a flaky surface, but without a pronounced purulent head, is formed. At first it is barely larger than a normal one. mosquito bite, and most often that’s where it ends. But with a weakened immune system or a large-scale infection, it can grow to the size of a carbuncle. The process is accompanied by local blunt, shooting, aching pain when you press on the source of inflammation, the temperature rises. It can spread to the axillae and inguinal lymph nodes. In general, this type of pyoderma is less common in children than others.

Staphylococcal infections in pyoderma are somewhat more common than streptococcal infections, probably due to the more aggressive effect of streptococci on the condition and well-being. Thus, it is infection with Staphylococcus aureus that is associated not only with pyoderma on the scalp in children, but also with most cases of chronic tonsillitis. It is more common for staphylococci to enter a latent stage, which makes them sources of relapses of the disease.

Streptococcal infection

Streptococcal pyoderma in children most often occurs in the form of impetigo - red spots with blisters, like a burn, located on the skin without any connection with the pores, their sebaceous glands or hair growth. As the tumors mature, they burst and the skin covering them peels off. With such pyoderma, the contents of the head and the pimple itself (they are called phlyctenes) come to the surface and harden in the form of a translucent yellow crust of golden color, very similar to flower honey.

This type of childhood pyoderma is highly contagious, but has almost no effect on the patient’s well-being. Usually the process begins from the lower part of the face - the nasolabial triangle, but similar conflicts can occur anywhere on the body. Gradually, boils are added to the conflicts (a sign of a staphylococcal infection), the initial mild itching and burning are replaced by constant pulsation and dull ache when pressed. And in addition to streptococcal impetigo, a child with streptococcal pyoderma may experience other manifestations.

Bullous impetigo. The extreme stage of streptococcal impetigo described above. It is characterized by the formation on the hands, legs and feet of a peculiar “hybrid” of blisters with boils - large and dense neoplasms bordered by inflammation, filled with liquid pus mixed with blood. They are very painful to the touch, take place with pyoderma of this type large areas of skin, can spread to nearby lymph nodes.
Erysipelas. It is characterized by the appearance on the skin of large, shiny, red areas that protrude above the surface of healthy skin and are hotter to the touch compared to it. They do not have a purulent head, there are only clearly visible edges - the places where the source of inflammation transitions into healthy skin. In the old days, pyoderma in the form erysipelas led to death in more than 85% of cases.
Vulgar ecthyma. A large depressed (compared to the clearly superficial formations in all previous cases) phlyctena, the opening of which during pyoderma reveals deep erosion, similar to gangrene or bedsore. The contents of ecthyma are usually also serous-purulent, sometimes mixed with blood. Most often, with pyoderma in children, such neoplasms can be found on the child’s bottom, shoulders, legs, hips, and less often on the face and body.

All forms of staphylococcal and streptococcal pyoderma cause mild burning and itching at the sites of rashes during their formation. After they mature, the burning sensation usually goes away, but the itching remains. Deep forms pyoderma in children is also accompanied by a feeling of pulsation, heat, and dull pain when pressed during the entire period of existence of the lesion, right up to its opening.

In children and adults with clearly weakened immunity and if it remains in this state for a long period (AIDS, taking immunosuppressants), mixed infections and various complications are also possible. Among them are impetigo vulgaris (the result of infection with both staphylococcus and streptococcus) and ulcerative-vegetative pyoderma, in which the resulting erosion does not scar at all or partially scars, continuing to grow at one of its edges.

Therapy

The answer to the question of how long it takes to treat pyoderma in a child depends on the successful strengthening of the immune system and the early start of treatment much more than on the causes of the disease. Due to the fact that both staphylococci and streptococci are part of the normal microflora of the skin, the local areas affected by them, if they are small, are treated locally for pyoderma (after all, it is still impossible to completely get rid of this pathogen, and it is not necessary).

With cases complete refusal It is much more difficult to fight a child’s immunity when the uncontrolled spread of infection throughout the entire skin begins. With such pyoderma in children clinical guidelines indicate the need for a combination of general therapy with antibiotics and local therapy with corticosteroid drugs. However, both treatment options often cause criticism and negative reviews from doctors, because antibiotics, and especially corticosteroids, have the property of suppressing immunity - local or general, depending on the method of their use.

External means

In other words, in the case of pyoderma in children, treatment simultaneously solves the problem of bacterial proliferation in one lesion, but aggravates the likelihood of new lesions appearing. That is why among solutions and ointments for pyoderma in children, which affects no more than 10% of the total area of the skin, you can often find those containing only local weak antiseptics, and not a single antibiotic.

Salicylic ointment. Based on acetylsalicylic acid, the main component of Aspirin and Citramon. Acetylsalicylic acid has a pronounced anti-inflammatory, antipyretic effect, and is a weak anticoagulant (a substance that reduces blood clotting).
Diamond green. But not Novikov’s liquid, because if the usual “green stuff” simply dries out purulent foci well, then Novikov’s liquid with pyoderma in children covers them with an additional film on top, forcing them not to open, but to “go” deep into the tissues.
"Fukortsin". This is a solution boric acid. For pyoderma in children, it should not be applied to large areas of skin, since it contains the toxic component phenol.

For pyoderma in children, treatment of the affected area with a weak solution of potassium permanganate, alcohol, and chlorhexidine is also used. Cases of pyoderma in a child affecting more than 10% of the skin may require the use of combination drugs, which contain both immunosuppressants (corticosteroids) and antibiotics. Among them:

"Fucicort" is effective, in particular, against Staphylococcus aureus;
"Lorinden S" - effective simultaneously against staphylococcus and streptococcus;
"Gyoksizon" is a broad-spectrum drug, also intended for external use, effective against most pyogenic bacteria that provoke pyoderma in children, including staphylococci and streptococci.

Severe cases of pyoderma in children (damage to more than 30% of the skin and/or spread of pyoderma to internal organs) require oral antibiotics. More often active substance the composition of the ointment and the oral/intravenous drug are the same, but not always.

Preparations for oral administration

The lion's share of drugs for pyoderma are quite old and have been used for more than twenty years, although they have high rates of effectiveness against both of its pathogens in children. This applies, in particular, to Cefazolin and tetracycline antibiotics. The greatest hopes among them can be pinned on Ampiox, since it is a combination of two bases - ampicillin and oxacillin.

And one of the most widely used antibiotics for pyoderma in children is now Amoxicillin, as well as Augmentin and Ospamox. These semisynthetic penicillin antibiotics were available to doctors less than fifteen years ago. Therefore, it is assumed that most bacterial cultures have not yet developed immunity to them. In the case of deep staphylococcal and streptococcal lesions (subcutaneous fat, lymph nodes), pyoderma most often requires surgical intervention with forced opening or even excision of the inflammatory focus.

Alternative medicine methods

Regarding folk remedies, then, on the one hand, they are suitable for use in pyoderma in children, since the causative agents of the disease will still remain part of the skin microflora, and treatment is most often assumed local. On the other hand, home therapy is only suitable for mild to moderate cases of pyoderma. And generalized infections, which are accompanied by damage to more than 30% of the skin and/or spread to subcutaneous fat, lymph nodes and internal organs, should be treated only in a hospital.

The main problem with folk remedies in the case of pyoderma in children is the same as with pharmaceutical ones. It consists in the relatively poor accessibility of some layers of the skin to drugs applied externally or taken internally. Weak antiseptics like chamomile decoction are unlikely to help against pyoderma in a child - moderately poisonous plants are needed.

Oak bark, celandine herb, lilac-colored decoction or infusion contain alkaloids and tannins- natural antibiotics. They should only be used topically for pyoderma in children in the form of compresses, since they are poisonous not only to bacteria, but also to the body as a whole. In addition, their intake in the case of pyoderma is useless due to the not very intensive blood supply to some of its layers.

Possible consequences and prevention of relapses

The consequences of pyoderma in children usually boil down to rough scarring of the skin at the site of former deep erosions. But the severity cosmetic defects here directly depends on the extent of the spread of pyoderma and the efficiency of treatment. So, if doctors managed to prevent the appearance of deep lesions and their necrosis, damage from pyoderma will be local in nature. Most likely, they themselves will “polish” with age, as the skin renews itself, since in children this process is especially intense.

Maintaining and gradually increasing the number skin defects represents real threat only for pyoderma caused by chronic immunodeficiencies.

For HIV. Which eventually turns into AIDS.
For diabetes mellitus. Which is accompanied by a gradual decrease in skin and general antibacterial and antifungal immunity.
After organ transplantation. When suppression immune reaction donor tissue is required for the entire period of their presence in the body.
After complex operations. Which are accompanied by the installation of permanent implants. The immune system reacts to some of these by causing necrosis of bone around pins/plates used for osteoplasty or blood clots around prosthetic heart valves.

However, it must be remembered that the causative agent of pyoderma in children remains on the skin and, possibly, in other tissues of the body, since it is part of their natural microflora. And already suffered pyoderma leaves “gaps” in natural defense, for example, in the form of preserved structural changes in the skin.

Structural changes in tissue increase the risk of recurrence of pyoderma in a child, although with normally functioning immunity in the future, they remain low. The risk of pyoderma returning in a child increases only when infected with some new pathogen (especially the herpes virus) or when the body is weakened due to excessive stress, poor nutrition, and other typical factors that undermine the immune system.

Prevention

Unfortunately, in the first two to three years of life, preventing pyoderma in a child is almost impossible. This is due to the unpredictability of the behavior of his own immunity, which has not yet been trained to function properly, as well as the presence of staphylococci and streptococci on the skin of all adults in his environment without exception. But in the future, when “acquaintance” with pathogens has already clearly taken place, parents only need to monitor their health immune defense the baby’s entire body and the integrity of his skin.

The causes of pyoderma in children come down to damage to the skin (especially frequent, large-scale or chronic) and reduced immunity for some reason. As for staphylococci, streptococci and other bacteria, their presence on the skin is still inevitable. That is why, to protect against them, children only need a moderate summer tan and careful hygiene without a bias towards sterility, since the latter will wean the immune system from work.