Erysipelas or, as people say, erysipelas represents infection, manifested in serious lesions skin. Inflammation is provoked by streptococci, but repeated cases of the disease are largely due to hereditary predisposition, that is, a characteristic immune response to streptococci. Provoke the mechanism reappearance erysipelas weakening of the body's defenses due to diabetes, hypothermia or insufficient or poor nutrition.
The name of the disease comes from the word rouge, which means red in French. Among infectious pathologies, erysipelas is now on the list of the most common diseases. Most often it manifests itself in women after forty to forty-five years, as well as among men twenty to thirty years old, but somewhat less frequently. As a rule, these are people whose work is accompanied by frequent microtraumas (cuts, scratches, bruises, injuries, abrasions, etc.) and skin contamination, sudden changes temperatures (loaders, builders, military, etc.). The favorite places for erysipelas are the legs and arms, sometimes it occurs on the face, thighs, torso, genital area and perineum, as well as the chest (against the background of a previous operation to remove the mammary gland during cancerous tumor). The disease causes a number of unpleasant sensations, including psychological ones, because such inflammatory lesions noticeable to others, especially in the summer, when most of the body is open.
Causes of the disease.
The period from the moment streptococci enter the body through damaged tissue until the symptoms of the disease appear is called incubation and in most cases it takes from three to five days. Those people who have already encountered a similar disease in the past can “meet” it again; the next attack usually occurs against the background of hypothermia or severe stressful situation, and immediately in an acute form.
The presence of streptococci in the body does not always cause inflammation of the skin; for this there must be provoking factors. Predisposing factors for the development of erysipelas are also foot fungus, diabetes mellitus, alcohol addiction, chronic heart failure, obesity, varicose veins, lymphostasis, presence of lesions streptococcal infection and somatic diseases in chronic form. In addition, caries, tonsillitis, sinusitis, otitis media, periodontitis contribute to the development of disease on the face, thrombophlebitis and on the legs or arms. trophic ulcers. The source of the spread of infection can be sick people, as well as healthy carriers.
Signs of erysipelas.
Erysipelas of the skin is usually classified taking into account the nature of local changes (erythematous, erythematous-bullous, erythematous-hemorrhagic, bullous-hemorrhagic), the severity of the disease (mild form, moderate form, severe form), frequency of manifestations of the disease (primary, recurrent and repeated) and the degree of prevalence of skin lesions (widespread, localized, migratory, metastatic).
At the very beginning of its development, the disease is characterized by the rapidity of manifestation of general toxic symptoms, among which can be noted increased body temperature, muscle pain, general weakness, headache, chills, nausea and vomiting, increased frequency of heart rate. In particularly severe cases, cramps, hemorrhages and blisters may occur. After a day or two, local symptoms begin to appear, in particular, fever, swelling, pain, redness develop, as well as a burning sensation and a feeling of fullness in the affected area.
The erymatous form is characterized by swelling of the skin and severe hyperemia, accompanied by painful sensations.
The manifestations of the erythematous-bullous form at the initial stage are the same as with the erymatous form, only after a couple of days, blisters of various sizes filled with transparent contents form on the affected areas of the skin. Subsequently, bubbles break through and form instead brown crusts, which are subsequently exfoliated, being replaced by young and healthy skin. IN in rare cases bursting bubbles turn into erosions, which in some cases can transform into trophic ulcers.
The erythematous-hemorrhagic form is characterized by the occurrence of hemorrhages due to intense redness and inflammation.
The bullous-hemorrhagic form of the disease is characterized by the formation of vesicles filled with serous-bloody (hemorrhagic) contents, which is associated with damage to the capillaries at a deep level.
The process of disease spread is classified into:
Recurrences of erysipelas are classified into late, which appear a year or two later in the same area of the body after a previous case of infection, and seasonal, which appear annually for several years (usually in the autumn-summer periods) against the background of accompanying pathology associated with various violations of the integrity of the skin . Seasonal relapses may also be the result of influence negative factors that are directly related to a person’s professional activity.
If unpleasant symptoms of the disease appear, in particular with an increase in body temperature, it is recommended to take an antipyretic and drink more clean water, unsweetened fruit drinks. If the disease is accompanied by the appearance of blisters, you need to apply an antiseptic bandage. Furacilin is usually used for this purpose. These are the measures that the patient can take independently to alleviate general state and well-being. Otherwise, you should consult your doctor and follow his recommendations and prescribed treatment.
Diagnosis of erysipelas.
The diagnosis of this infectious disease is carried out by a therapist or infectious disease specialist. The diagnosis is made taking into account the existing symptoms, as well as the results of prescribed laboratory tests.
Treatment of erysipelas.
In therapy of this disease antibiotics are used for infections of an infectious nature. Treatment of mild forms of erysipelas is allowed in outpatient setting, in other cases only a hospital is indicated. Simultaneously with antibiotic therapy, physiotherapeutic procedures are used (UVR, UHF, laser treatment in the infrared light range, therapy with weak electrical discharges).
It is important to note that treatment for the disease should be started as early as possible, that is, when the first signs of the disease appear, you must go to the doctor.
Complications of erysipelas.
If left untreated, severe forms of the disease can provoke the development of complications. All of them are usually classified into general and local. To complications general include diseases of the kidneys and cardiovascular system (nephritis, rheumatism, myocarditis). Local, that is, specific to the disease, complications can manifest themselves in the form of abscesses, ulcers, necrosis, thrombophlebitis, inflammation, sepsis, and impaired lymph circulation in the affected area (elephantiasis).
Prevention of erysipelas of the skin.
Prevent development undesirable consequences the disease is real, but only with timely treatment with antibiotics (taking into account the sensitivity of microbes to them), the elimination of factors contributing to the occurrence of the disease (fungal infections and cracks in the feet, wounds, cuts, diabetes, vascular disorders, etc.). In addition, constant monitoring by an infectious disease specialist at a dispensary and health promotion can prevent complications.
A distinctive feature of erysipelas is frequent relapses. Patients often experience up to fifteen exacerbations of the disease during the year, which indicates a chronic form of the disease. To prevent relapses, it is necessary preventive measures, in particular:
In addition, it should be noted drug prevention erysipelas, which occurs in the patient with enviable regularity. The essence of such prevention is the prescription of long-acting antibiotics that prevent the proliferation of streptococci in the body. As a rule, drugs of this kind are taken from a month to one year. The course and duration of treatment is determined only by a specialist.
About such a pathological condition as erysipelas It was known to Hippocrates, but they began to talk about the fact that it is also contagious only in the 19th century. This disease is often called face. The term " erysipelas" comes from the word " rose" The thing is that with this disease, the face acquires a crimson hue similar to the color of this flower. In addition, the shape of the resulting swelling resembles the shape of rose petals.
Provoking factors:
According to the severity of the disease, this disease can be:
They can be:
Recipe No. 1: We take the leaves of plantain, grind them to a pasty form and apply to the affected areas 5 - 6 times a day. Recipe No. 2: take honey in equal quantities, rye flour, as well as black elderberry leaves, having previously crushed them into powder. Mix all the ingredients and apply the resulting mixture to the affected areas 3 - 4 times a day.
Recipe No. 3: steam a teaspoon of white birch buds in 1 glass boiled water. After 10 minutes, filter the infusion and take 1/3 cup orally 3 times a day. The same infusion can be used for compresses, lotions and baths.
Recipe No. 4: Boil 50 g of the aerial part of the prickly tartar for 10 minutes in 500 ml of water. The resulting infusion is used for compresses.
Recipe No. 5: Boil a teaspoon of crushed thorn bark for 10 - 15 minutes in 1 glass of boiled water. We filter the broth, let it brew, and use it for lotions.
Common disease of the mucous membranes and skin infectious nature called erysipelas (erysipelas). Both healthy carriers of infection and chronically ill individuals are sources of pathology, therefore disease is one of the most pressing problems. The doctor decides how to treat erysipelas in each individual case, because this skin disease has many symptoms and forms, and therefore develops differently.
Erysipelas have been known to people since ancient times. Descriptions of skin pathology were found in the works of ancient Greek authors. The causative agent of the pathology, group A beta-hemolytic streptococcus, was isolated in 1882. Erysipelas is a skin infection characterized by symptoms of intoxication, fever, and the appearance of red foci of inflammation on the epidermis and mucous membranes. Complications of the disease are characterized by severe infectious lesions soft tissues, which rapidly progress, accompanied by severe intoxication of the body.
Group A streptococci are not only the cause of erysipelas, but also other skin diseases (osteomyelitis, boils, cellulitis, abscesses). Bacteria penetrate the skin from the outside. Wounds, abrasions, abrasions, cracks or minor injuries are the gateway to streptococcal infection. The two main routes of infection for erysipelas are airborne and contact. The inflammatory process affects the dermis - the framework of the skin. The disease is localized on the mucous membranes, torso, arms, legs, face, perineum or scrotum.
Women suffer from erysipelas more often than men. In 60% of cases, the disease develops in people over 40 years of age. What does the mug look like? First, a small red spot appears on the mucous membrane or skin. Within a few hours it turns into a clearly limited inflammation with jagged edges. The epidermis in the affected area is hot to the touch and moderately painful on palpation. Along with redness, lymphedema develops, spreading beyond the spot.
Next, blisters develop at the site of inflammation, which spontaneously burst after a certain time. Fluid leaks out of them, after which superficial wounds occur. If the blisters retain their integrity, they gradually dry out, forming brown or yellow crusts. Residual effects of erysipelas, which are observed for weeks and even months, are pigmentation, swelling of the skin, dry dense crusts in place of the blisters.
Erysipelas is usually treated with medication. Immunomodulatory and/or desensitizing therapy is carried out simultaneously with antibiotics. Since harmful microorganisms produce toxins during their life, they can cause allergies in the patient. To prevent the development allergic reactions during the treatment of erysipelas, patients are prescribed antihistamines.
Often the pathology develops in the lower extremities. How to treat erysipelas on the leg? If the disease affects a limb, then the acute onset of the disease may occur only after a week. A person may suddenly develop symptoms such as muscle aches, migraines, heat(up to 40°C), general weakness. Often the diagnosis is made without analysis based on a combination of visual signs. Treatment of erysipelas of the leg is carried out with medication, both inpatient and outpatient.
According to statistics, erysipelas ranks fourth in the prevalence of infectious diseases. How to treat erysipelas? Antibiotics have been and remain the priority in the fight against infection. The course is calculated by the doctor, depending on the form of the disease and antibacterial drug. Immediately after starting to take antibiotics for erysipelas, the development of infection decreases and body temperature returns to normal. To treat erysipelas, 1st or 2nd generation antibacterial agents are used - cephalosporins (Cedex, Suprax, Vertsef) and penicillins (Retarpen, Benzylpenicillin, Ospen).
When treating erysipelas on the leg, which is located on early stage, pastes are not used for external use. When the form of the disease becomes cystic, then Ichthyol ointment or Vishnevsky is prescribed. Naftalan gives excellent results at the recovery stage. Ichthyol ointment for erysipelas of the leg quickly helps get rid of itching, softens keratinization, gives effective healing wounds, provoking rapid skin regeneration.
The medicine has anti-inflammatory and antiseptic effects. For erysipelas, it is necessary to apply the product to the affected area, but not in its pure form, but in equal proportions with glycerin. The mixture is rubbed into a thin layer, then covered with gauze folded in 3-4 layers. The bandage is fixed with adhesive tape. It must be changed at least three times per day. The procedure is carried out until healing open wounds.
How to treat erysipelas with Vishnevsky ointment? The topical preparation is also called balsamic liniment. The product contains three components: xeroform, Birch tar And Castor oil. Now the latter substance is often replaced fish oil. Vishnevsky ointment has a pronounced anti-inflammatory and antiseptic effect. When treating skin pathologies, it helps restore the epidermis, accelerates the healing process, and has drying, antipruritic, and anesthetic properties.
In the absence of relapses, Vishnevsky ointment is prescribed for the treatment of erysipelas. The medicine promotes exudation and breakthrough of blisters. Apply ointment to gauze bandage a thin layer, after which it should be applied to the affected area of the skin. The bandage is changed once every 12 hours. Since the drug is capable of dilating blood vessels, when severe forms Doctors do not recommend using it for erysipelas.
At primary period erysipelas, as soon as blisters begin to form, you can try to remove the infection folk recipes, but after consultation with a specialist. Treatment of erysipelas of the leg at home is carried out with propolis or pork fat. These substances should be lubricated on the affected areas and another 2-5 cm of skin around them to stop the spread of the disease. Also treatment of erysipelas folk remedies includes the use of such tools as:
Treatment of erysipelas becomes difficult if the patient has a disease such as diabetes mellitus, which causes the death of small blood vessels and impaired circulation of lymph and blood. You can avoid getting and developing an infection if you adhere to the rules of personal hygiene, especially when treating skin pathologies. Prevention of erysipelas includes:
Skin is the outer covering human body with an area of about 1.6 m2, performing several important tasks: mechanical protection of tissues and organs, tactile sensitivity (touch), thermoregulation, gas exchange and metabolism, protection of the body from the penetration of microbes.
But sometimes the skin itself becomes the target of attack by microorganisms - then they develop dermatological diseases, among which is erysipelas.
Erysipelas is spicy diffuse inflammation skin (less commonly, mucous membranes) infectious origin, usually affecting the face or legs.
Erysipelas is caused by beta-hemolytic group streptococcus A when it penetrates into the thickness of the skin through minor abrasions, cuts, insect bites, scratches, abrasions.
Erysipelas is more common in men of working age and in women over 45 years of age. For children under one year of age, it represents mortal danger(photo 3).
The prevalence of the disease is high - fourth place after acute respiratory infections, gastrointestinal infections and hepatitis.
Group A beta-hemolytic streptococcus
Group A β-hemolytic streptococcus (GABHS) itself was discovered relatively recently (150 years ago), but humanity has been familiar with the diseases it causes for a long time.
Sore throats, pharyngitis, laryngitis, scarlet fever, rheumatism, severe lesions kidney tissue - far from full list pathological conditions caused by GABHS. The Ministry of Health states that the damage to the economy from β-hemolytic streptococcus is 10 times greater than the damage from all viral hepatitis.
It belongs to the opportunistic microflora, because it is present in almost all people in the oral cavity, respiratory tract, on the skin and external genitalia. Good immunity limits its virulence (degree of infectiousness).
GABHS spreads very quickly through the air, through the digestive tract and objects, so it is usually detected in rooms where children and children are present for a long time. labor collectives, 57.6% of sore throats and 30.3% of acute respiratory infections are caused by it.
Streptococci survive freezing and heating to 70° for 2 hours; in dried biomaterial (blood, pus) they remain highly infectious for several months. Toxins cause serious illnesses heart and kidneys.
For children, carriage of the pathogen in the upper respiratory tract is more common. When examining schoolchildren, GABHS is isolated in the nasopharynx of 20-25% of children.
The cause of erysipelas of the legs can be small ulcers, boils and carbuncles, purulent wounds. The spread of dangerous streptococcus in the skin can be facilitated by frequent hypothermia of the legs or excessive sunbathing, causing microtrauma to the skin.
Erysipelas on the leg is very often a consequence of other serious diseases:
Stressful situations that sharply reduce immunity can give rise to an attack by streptococcus on its carrier.
Chronic foci of infection in the form of decayed teeth and enlarged tonsils increase the risk of erysipelas on any part of the body by 5-6 times.
A week (on average) after the pathogen penetrates the skin, an acute onset of the disease occurs.
Signs of intoxication suddenly appear:
Within 24 hours, symptoms of erysipelas appear on the lower leg: the affected area swells sharply, becomes shiny from tension and becomes red. The name “erysipelas” comes from the word “red” in some European languages.
The inflamed area is delimited from healthy skin by a demarcation roller. It is characterized by uneven scalloped outlines along the perimeter of the lesion. Severe redness of the skin is caused by hemolysis - the process of destruction of red blood cells (erythrocytes) by streptococcus.
When you apply pressure with your finger, the redness disappears for a few seconds. The lesion is warmer to the touch than the surrounding tissue.
Pain and burning cause severe suffering to the patient. The popliteal and inguinal lymph nodes become inflamed. Toward them from the affected area under the skin, dense reddish stripes are visible - lymphatic vessels, lymphangitis develops.
Often the diagnosis is made without tests, based on a combination of general and local symptoms.
In other diseases, they often appear first local signs, and only after them does intoxication appear.
Laboratory tests can confirm the presence of β-hemolytic streptococcus.
Based on the nature of local changes, the following are distinguished:
1. Erythematous form- the area has a bright, uniform color and clear boundaries.
2. Erythematous-hemorrhagic form- on the affected area, against the background of general redness (erythema), there are multiple pinpoint hemorrhages - a sign of damage to the blood capillaries.
3. Erythematous-bullous(bulla, lat. - bubble) form - with it, separation occurs on the third day upper layers skin with blistering.
The liquid in them contains a large mass of streptococci with high degree virulence, therefore, when opening blisters, it is necessary to carefully carry out antiseptic treatment. They heal with the formation of a crust, under which smooth skin is formed.
4. Bullous-hemorrhagic form - the blisters contain an opaque bloody fluid.
5. Gangrenous form with areas of skin necrosis.
Stands out wandering form, when within a few days the lesion moves to an adjacent area, and primary focus peels off and heals.
This form is typical for newborn children; if erysipelas spreads quickly, children can die.
According to the severity of the disease, they are distinguished:
Even after healing, the inflamed area of the skin remains sensitive to streptococcal infection, which gives rise to the diagnosis of “recurrent” and “recurrent” erysipelas.
Mild forms of erysipelas can be treated on an outpatient basis. Severe and advanced cases require hospital treatment.
1) The first and main purpose is antibiotics in the form of intramuscular injections or orally. Penicillin antibiotics have retained their effectiveness in the fight against hemolytic streptococcus.
They are combined with taking oleandomycin, furazolidone, erythromycin for one to two weeks.
2) Their effect is enhanced by sulfonamide drugs (Biseptol).
3) Vitamins and biostimulants (levamisole, pentoxyl, methyluracil) must be prescribed to restore immunity and speed up healing of the lesion.
4) Prescribed as anti-inflammatory and antipyretic drugs non-steroidal drugs: aspirin, diclofenac, ibuprofen, baralgin, reopirin.
5) In case of severe intoxication, glucose solution or reopirin is repeatedly administered.
6) To relieve intoxication, plenty of fluids and diuretics are prescribed.
7) Physiotherapeutic procedures:
The last three procedures improve lymph flow, preventing the development of elephantiasis.
8) Sensitization of the body is prevented by taking antihistamines.
9) Sclerotherapy - the introduction of a substance into the affected veins that causes narrowing and resorption of the vessel - promotes fast healing blisters and healing of the inflamed skin area.
10) Endovasal laser coagulation - leads to the disappearance of the lumen in diseased veins, preventing the development of lymphostasis.
11) Surgical treatment of the lesion:
12) In severe cases, blood or plasma transfusions are performed.
Treatment of erysipelas of the leg is carried out by a doctor. To avoid complications, the patient must strictly follow all medical prescriptions, even during outpatient treatment.
When treating erysipelas at home It is important to know:
1) You cannot tightly bandage the affected area; only light bandages are allowed, which are changed several times a day after antiseptic treatment of the skin.
2) Do not use and - they increase the flow of interstitial fluid and slow down the healing process;
Excessive softening of the skin with ointments will lead to additional infection of the wounds.
3) After opening the blisters, you can treat the erosions with hydrogen peroxide and dry the skin under them with powder, which includes:
Cover the wound surface with two layers of gauze on top.
Erysipelas can go away on its own: after two weeks from the onset of the disease, the redness subsides, but swelling and pigmentation of the skin remains for a long time. There is a high probability of a repeat process.
When not enough active treatment erysipelas causes general and local complications. It is especially dangerous for patients diabetes mellitus, allergies, varicose veins and thrombophlebitis, heart failure and HIV infection.
There is a risk of developing pneumonia, sepsis and meningitis.
Streptococcal toxins cause rheumatism, myocarditis and glomerulonephritis.
Local complications are phlegmon and abscesses, trophic ulcers and lymphostasis (elephantiasis), in which the volume of limb tissue sharply increases due to the accumulation of interstitial fluid and thickening of the skin.
Elephantiasis develops in 15% of all cases of erysipelas. It is accompanied by such phenomena as papillomas, eczema, lymphorrhea (lymph effusion from thickened pigmented skin). All this makes the patient’s life very difficult.
The prognosis after erysipelas on the legs depends on the severity of the disease and the body’s immunity.
Recurrent forms often develop when staphylococcal flora is also added to GABHS.
Due to acquired lymphostasis, ability to work may be reduced.
In general, the prognosis for the patient’s life is favorable if complications are avoided.
There is no specific prevention. To prevent erysipelas, you must follow some general and local measures.
Local measures:
In the international classification of diseases ICD 10, erysipelas is:
Class I
- A30 - A49 Other bacterial diseases
Patients with erysipelas are less contagious. Women get sick more often than men. In more than 60% of cases, erysipelas is suffered by people aged 40 years and older. The disease is characterized by a distinct summer-autumn seasonality.
The incubation period of erysipelas ranges from several hours to 3-5 days. In patients with a relapsing course, the development of the next attack of the disease is often preceded by hypothermia and stress. In the vast majority of cases, the disease begins acutely.
The initial period of erysipelas is characterized by the rapid development of general toxic phenomena, which in more than half of patients precede the occurrence of local manifestations of the disease by several hours to 1-2 days. Marked
The height of the disease occurs within a period of several hours to 1-2 days after the first manifestations of the disease. General toxic manifestations and fever reach their maximum. Characteristic local manifestations occur.
Most often, erysipelas is localized on the lower extremities, less often on the face and upper limbs, very rarely only on the torso, in the area of the mammary gland, perineum, and in the area of the external genitalia.
Skin manifestations
First, a slight red or pink spot, which within a few hours turns into a characteristic erysipelas. Redness is a clearly demarcated area of skin with uneven boundaries in the form of teeth, “tongues”. The skin in the area of redness is tense, hot to the touch, moderately painful when touched. In some cases, a “marginal ridge” can be detected in the form of raised edges of redness. Along with redness of the skin, swelling develops, spreading beyond the redness.
The development of blisters is associated with increased effusion at the site of inflammation. When the blisters are damaged or spontaneously rupture, fluid leaks out, and superficial wounds appear in the place of the blisters. While maintaining the integrity of the blisters, they gradually shrink to form yellow or brown crusts.
The residual effects of erysipelas, which persist for several weeks and months, include swelling and pigmentation of the skin, dense dry crusts in place of the blisters.
Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute
Diagnosis of erysipelas is carried out by a general practitioner or infectious disease specialist.
Diagnostic criteria for erysipelas in typical cases are:
Treatment of erysipelas should be carried out taking into account the form of the disease, the nature of the lesions, the presence of complications and consequences. Currently, the majority of patients with light current erysipelas and many patients with a moderate form are treated in a clinic. Indications for mandatory hospitalization in infectious diseases hospitals(branches) are:
The most important place in complex treatment Patients with erysipelas are treated with antimicrobial therapy. When treating patients in a clinic or at home, it is advisable to prescribe antibiotic tablets:
If antibiotics are intolerant, furazolidone is indicated (10 days); delagil (10 days).
It is advisable to treat erysipelas in a hospital setting with benzylpenicillin, a course of 7-10 days. At severe course diseases, the development of complications (abscess, phlegmon, etc.), a combination of benzylpenicillin and gentamicin, and the prescription of cephalosporins are possible.
For severe skin inflammation, anti-inflammatory drugs are indicated: chlotazol or butadione for 10-15 days.
Patients with erysipelas need a vitamin complex for 2-4 weeks. In case of severe erysipelas, intravenous detoxification therapy is carried out (hemodez, rheopolyglucin, 5% glucose solution, saline solution) with the addition of 5-10 ml of 5% solution ascorbic acid, prednisone. Cardiovascular, diuretic, and antipyretic drugs are prescribed.
Treatment of patients with recurrent erysipelas
Treatment of recurrent erysipelas should be carried out in a hospital setting. It is mandatory to prescribe reserve antibiotics that were not used in the treatment of previous relapses. Cephalosporins are prescribed intramuscularly or lincomycin intramuscularly, rifampicin intramuscularly. The course of antibacterial therapy is 8-10 days. For particularly persistent relapses, two-course treatment is advisable. Antibiotics that have an optimal effect on streptococcus are consistently prescribed. The first course of antibiotic therapy is cephalosporins (7-8 days). After a 5-7-day break, a second course of treatment with lincomycin is carried out (6-7 days). For recurrent erysipelas, immune correction (methyluracil, sodium nucleinate, prodigiosan, T-activin) is indicated.
Local therapy for erysipelas
Treatment of local manifestations of erysipelas is carried out only in its cystic forms with localization of the process on the extremities. Erythematous form of erysipelas does not require use local funds treatment, and many of them ( ichthyol ointment, Vishnevsky balm, ointments with antibiotics) are generally contraindicated. In the acute period, if there are intact blisters, they are carefully incised at one of the edges and after the fluid comes out, bandages with a 0.1% solution of rivanol or a 0.02% solution of furatsilin are applied to the site of inflammation, changing them several times during the day. Tight bandaging is unacceptable.
In the presence of extensive weeping wound surfaces at the site of opened blisters local treatment start with manganese baths for the limbs, followed by the application of the bandages listed above. To treat bleeding, 5-10% dibunol liniment is used in the form of applications in the area of inflammation 2 times a day for 5-7 days.
Traditionally, in the acute period of erysipelas, ultraviolet irradiation is prescribed to the area of inflammation, to the area of the lymph nodes. Ozokerite applications or dressings with heated naphthalan ointment (on the lower extremities), paraffin applications (on the face), lidase electrophoresis, calcium chloride, and radon baths are prescribed. Shown high efficiency low-intensity laser therapy of local inflammation. The applied dose of laser radiation varies depending on the condition of the lesion and the presence of concomitant diseases.
Complications
Complications of erysipelas, mainly of a local nature, are observed in a small number of patients. TO local complications include abscesses, cellulitis, skin necrosis, suppuration of blisters, inflammation of the veins, thrombophlebitis, inflammation lymphatic vessels. TO general complications erysipelas that develop in patients with erysipelas quite rarely include sepsis, toxic-infectious shock, acute cardiovascular failure, pulmonary embolism, etc. The consequences of erysipelas include persistent lymph stagnation. By modern ideas, lymph stagnation in most cases develops in patients with erysipelas against the background of already existing functional insufficiency of lymph circulation of the skin (congenital, post-traumatic, etc.).
Prevention of recurrence of erysipelas
Prevention of recurrence of erysipelas is integral part complex dispensary treatment of patients suffering from a recurrent form of the disease. Prophylactic intramuscular administration of bicillin (5-1.5 million units) or retarpen (2.4 million units) prevents relapses of the disease associated with reinfection with streptococcus.
With frequent relapses (at least 3 per Last year) continuous (year-round) bicillin prophylaxis is advisable for 2-3 years with an interval of bicillin administration of 3-4 weeks (in the first months the interval can be reduced to 2 weeks). In case of seasonal relapses, the drug is started to be administered a month before the start of the morbidity season in a given patient with an interval of 4 weeks for 3-4 months annually. If there are significant residual effects after suffering from erysipelas, bicillin is administered at intervals of 4 weeks for 4-6 months.
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