By the nature of local changes distinguish the following forms of faces: 1) erythematous, it is characterized by erythema and edema erysipelatous 2) erythematous-bullous, where against a background of edematous, erythematous skin blisters appear, filled with serous (sometimes serous hemorrhagic) fluid, with subsequent formation of crusts on the spot bubble burst, and 3) abscess when purulent process involves the subcutaneous tissue, and 4) gangrenous or necrotic, in which necrosis occurs and subsequent rejection of the skin. The latter two forms are rare and are complicated cases, as for erysipelas and abscess subcutaneous fat necrosis of the skin is unusual. On prevalence of local changes are usually distinguished: 1) a local face (loss of one anatomical region, such as head, limb), 2) creeping or migratory, when the process extends from the focus on the stretch, and 3) metastatic when skidding through the lymphatic and hematogenous pathways appear distant foci of erysipelas. Adrift isolated primary, recurrent and re-face. The pathological process in the mug may also affect the mucous membranes. In complicated cases of erysipelas is not completed within 6-10 days. With modern methods of treatment on 2-3rd day the temperature drops to normal numbers, improving the overall health patient; starts back development of local phenomena, edema is less. Redness of skin on the affected area turns white and brownish tint takes.
In place of congestion appears lamellar desquamation, blisters on the spot - surface crust, which in the next 7-10 days disappear, without leaving scars. Recurrences of erysipelas are accompanied by a weaker overall response. At the height of the disease from the blood was moderate leukocytosis, neutrophilia and increased erythrocyte sedimentation rate. The prognosis for life in modern methods of treatment is quite favorable. Complications are rare (abscesses, cellulitis, sepsis). In recurrent cases may develop elephantiasis.
Diagnosis. Disease detected on clinical grounds, taking into account medical history (presence of excoriations, abrasions of the skin, eczema, etc.). The differential diagnosis should be made with an abscess, phlegmon, acute eczema pseudoerysipelas. Treatment. Effectively treated with penicillin (300 000 IU, 3-4 times a day for 6-7 days), chloramphenicol (0.5 g 6 times daily), tetracycline (oral 400 000 IU, 3-4 times a day for 6-7 days) intramuscular tetracycline can be injected at 100 000 IU 2-3 times a day for 6-7 days. An additional method of therapy may be radiation areas of the skin erysipelas erythema dose of ultraviolet rays. In cases of recurrent erysipelas, except this therapy, treatment is indicated foci of chronic infection, which served as a gateway (otitis, sinusitis, eczema, athlete), in combination with desensitizing therapy and bracing (diphenhydramine, blood transfusion), local - use of ointments and lotions are not recommended. Prevention. Most important are the skills of personal hygiene, prevention of abrasions, injuries, abrasions and fungal skin diseases, etc. Almost erysipelatous patient is not contagious, it can be left at home and the hospital put in a general ward (with the exception of pure surgical and obstetrical units). - Skin diseases
In place of congestion appears lamellar desquamation, blisters on the spot - surface crust, which in the next 7-10 days disappear, without leaving scars. Recurrences of erysipelas are accompanied by a weaker overall response. At the height of the disease from the blood was moderate leukocytosis, neutrophilia and increased erythrocyte sedimentation rate. The prognosis for life in modern methods of treatment is quite favorable. Complications are rare (abscesses, cellulitis, sepsis). In recurrent cases may develop elephantiasis.
Diagnosis. Disease detected on clinical grounds, taking into account medical history (presence of excoriations, abrasions of the skin, eczema, etc.). The differential diagnosis should be made with an abscess, phlegmon, acute eczema pseudoerysipelas. Treatment. Effectively treated with penicillin (300 000 IU, 3-4 times a day for 6-7 days), chloramphenicol (0.5 g 6 times daily), tetracycline (oral 400 000 IU, 3-4 times a day for 6-7 days) intramuscular tetracycline can be injected at 100 000 IU 2-3 times a day for 6-7 days. An additional method of therapy may be radiation areas of the skin erysipelas erythema dose of ultraviolet rays. In cases of recurrent erysipelas, except this therapy, treatment is indicated foci of chronic infection, which served as a gateway (otitis, sinusitis, eczema, athlete), in combination with desensitizing therapy and bracing (diphenhydramine, blood transfusion), local - use of ointments and lotions are not recommended. Prevention. Most important are the skills of personal hygiene, prevention of abrasions, injuries, abrasions and fungal skin diseases, etc. Almost erysipelatous patient is not contagious, it can be left at home and the hospital put in a general ward (with the exception of pure surgical and obstetrical units). - Skin diseases
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