Bacterial eczema treatment. Treatment and prevention of microbial eczema

Microbial eczema.

Clinic. It often occurs as a result of secondary eczematization of foci of pyoderma, mycosis (mycotic eczema), infection of injuries, burns, fistulas (paratraumatic eczema), against the background of trophic disorders on lower limbs with phenomena trophic ulcers, lymphostasis (varicose eczema). In this case, the lesions are often located asymmetrically, have sharp borders, rounded or scalloped outlines, along the periphery of which the collar of the exfoliating stratum corneum is often visible. The focus is represented by juicy erythema with lamellar crusts, after removal of which an intensely weeping surface is revealed, against which bright red small punctate erosions with drops of serous exudate are clearly visible. Microvesicles, small pustules, seropapules are visible around the main focus. Allergic rashes (allergides) can occur far from the main focus. A peculiar variety of microbial eczema is nummular (coin-shaped) eczema, characterized by the formation of sharply limited rounded lesions with a diameter of 1.5 to 3 cm or more of a bluish-red color with vesicles, seropapules, weeping, scales on the surface. lesions are more often localized on the back of the hands and extensor surfaces of the limbs.

Treatment. It is carried out according to the general scheme (see answer 87) with the use of AB (taking into account the sensitivity of the microflora) and sulfanilamide preparations in combination with immunomodulators. Specific therapy for microbial eczema is carried out with staphylococcal toxoid, antistaphylococcal gamma globulin, staphylococcal vaccine. In patients with microbial eczema with varicose symptom complex, trophic ulcers, it is recommended to use xanthinol nicotinate, parmidine, trental, diprofen. It is advisable to apply bandages with staphylococcal bacteriophage for a short period.

Prevention. Various medical, dietary, sanitary and hygienic and sanitary measures, exclusion from the diet of diseased foods, causing allergies. In the prevention of recurrence of the disease, certain sanitary and hygienic measures are important: the exclusion of contact with synthetic washing and cosmetics, laundry soap, dyed furs, as well as synthetic products, shoe polish, indoor flowers, etc. Unfortunately, very often, despite great efforts, it is not possible to find ways to prevent eczema.

67. Professional dermatoses. Etiopathogenesis. Professional stigmas. Occupational dermatoses of chemical chemical etiology. Occupational melasma. Diagnostics. Types of skin tests.

Occupational skin diseases. Definition. The value of professional factors and the reactivity of the organism in the development of occupational dermatoses.

Occupational dermatoses are skin diseases caused by production factors.

Classification of occupational skin diseases. Professional signs (stigmas).

Classification.

Profdermatosis caused by chemical irritants.

Caused by obligate stimuli.
Caused by facultative stimuli.
Caused by occupational allergens.
Caused by substances of photodynamic action.

Occupational dermatoses caused by industrial hazards of plant origin.

Occupational diseases caused by physical factors.

Professional signs (stigmas). stigmas differ from occupational dermatosis in that they do not lead to a decrease in working capacity, but serve as a sign of belonging to a particular profession and develop after a long working life. Professional signs are divided into transient and persistent. Transient include staining, callosity, pigmentation, cracks. To persistent - introductions, scars, telangiectasia, atrophy, burns.

Callosity - the most common of professional signs, is formed as a result of prolonged friction or pressure, has a yellowish color, round or oval outlines, a dense texture, is due to a reactive thickening of the stratum corneum of the epidermis (hyperkeratosis) and is the result of chronic mechanical dermatitis.

Pollution (deposits, intrusions) is the second most common professional sign. Most professional stains can be easily removed after work is completed. detergents. Contaminants from metal dust in combination with mineral oils are highly resistant, as a result of which the skin acquires a persistent dirty gray color.

Coloring is the third most common professional sign. It is the result of penetration into the skin of various coloring substances. Hair and nails are also dyed. The durability of staining depends on the depth of penetration of dyes into the skin.

Occupational skin diseases due to exposure to chemicals (epidermitis, non-allergic contact dermatitis, oil folliculitis, occupational ulceration). Clinic. Treatment. Prevention.

Classification of chemicals.

Chemicals that have a primary irritant effect on the skin:

Obligate skin irritants that cause chemical burns and ulceration (concentrated organic acids and alkalis, alkali metal salts, blistering agents).

Optional (optional) primary skin irritants:

defiant contact dermatitis(weakly concentrated inorganic acids and alkalis, most organic solvents);

causing damage to the follicular apparatus of the skin: lubricating oils, pitch, fuel oil, naphthalene, etc.;

causing toxic melasma (naphthenic hydrocarbons);

causing organic hyperkeratosis and epithelioid growths of the skin (benzatren, pyrene, chrysene, phenanthrene).

Skin sensitizing chemicals.

Sensitizers acting mainly by direct contact (chromium, cobalt, nickel, natural and artificial polymers, turpentine).

Sensitizers that act predominantly by non-contact means (with oral, inhalation routes of allergen administration).

Chemicals that have a photosensitizing effect and cause photodermatitis (some medium and heavy fractions of hydrocarbons, in particular pitch, tar, asphalt, polychloronaphthalene, phenothiazine drugs, in particular chlorpromazine, some sulfanilamide drugs).

Clinic. epidermatitis. Occurs upon contact with degreasing agents. It flows easily. It is clinically manifested by dryness, fine-lamellar peeling, skin cracks.

Simple (non-allergic) contact dermatitis. Skin edema, erythema, then - often papular, vesicular or bullous elements, erosion in the contact area. Patients experience itching, burning, soreness in the focus area. The lesions spread along the periphery and quickly regress after contact with the stimulus ceases.

Oil folliculitis. They occur after prolonged contact with kerosene, as well as with petroleum and coal oils. Lesions are localized more often on the extensor surfaces of the forearms, thighs, sometimes on the chest. At the same time, comedones in the form of black dots are first formed in the mouths of the hair follicles, which then turn into dense horny or inflammatory acne.

Occupational ulceration. Occur on the hands, forearms after prolonged contact with weak fumes solutions of inorganic acids and alkalis. With yat, the skin gradually degreases, swells, turns red, and becomes covered with cracks. As a result, non-allergic (simple) contact dermatitis develops. Against its background, at the site of skin damage (scratch, puncture, abrasion), round sores are formed with a highly infiltrated edge and a black crust covering their bottom. Particularly severe lesions cause chromium compounds. They can cause the formation of ulcers on the mucous membrane of the nasal septum, which often leads to its perforation. After cessation of contact with the irritant, skin ulcers heal quickly.

Treatment. In the treatment of epidermitis, nourishing creams with vitamin A, corticosteroid ointments (sinoflan, fluorocort, gioksizon, oxysone, etc.) are prescribed. For the treatment of the acute stage of contact dermatitis, cooling, astringent, anti-inflammatory lotions are used, then ointments and creams containing corticosteroid preparations are applied to the affected area. Ulceration treatment is carried out by applying a tissue impregnated with carotolin 1-2 times a day, as well as applying a cream and ointment containing vitamin A, corticosteroid hormones, 5-10% methyluracil ointment, cygerol. For the treatment of oil folliculitis, ultraviolet radiation is prescribed, baths with a solution of potassium permanganate (1: 20,000), immunotherapy, the covers of the pustules are opened, and the foci are lubricated with a solution of aniline dyes.

Prevention. In order to prevent epidermitis, when working with an irritant, washing-protective pastes, ointments are used, and gloves are used. Reliable disease prevention is ensured by sealing, mechanization and automation, robotization of technological processes that use chemical irritants. For the prevention of simple dermatitis during work, it is necessary to use protective rubber gloves, observe safety regulations, and after work, nourishing creams and ointments should be applied to the skin. To prevent ulceration, it is necessary to exclude contact with the irritant, ensure the sealing of technological equipment, and workers - with personal protective equipment (protective gloves, overalls, wash-protective pastes). Prevention of oil folliculitis: workers should take a shower daily, change their overalls regularly, and wash them regularly; a preventive effect is exerted by periodic general UVR, wiping the skin with a swab soaked in 2% salicylic alcohol, as well as vitamins A, C, B 1.

Occupational eczema. Etiology. Pathogenesis. clinical course. Diagnostics. Treatment. Prevention. VTE.

Etiology. Multiple contacts with industrial allergen.

Pathogenesis. There is a sensitization of the body at the site of action of the allergen. At first, the reaction is in the nature of allergic dermatitis, it can be resolved when the action of the allergen ceases, but it can become persistent, and its exacerbations can occur not only under the action of industrial, but also household irritants.

Clinic. At first, rashes are most often localized on the hands and forearms. Gradually, they spread to other parts of the body remote from the place of contact with the irritant. The elements of the rash, as in true eczema, are polymorphic (erythematous spots, papules, vesicles, weeping, crusts that appear on edematous skin, etc.). Occupational eczema has a pronounced tendency to a chronic course, accompanied by a recurrence of the rash. According to the activity of the process, acute, subacute and chronic course are distinguished.

Diagnostics. The clinical characteristic of the process (the occurrence of the disease, taking into account the workplace and profession of the sick person) facilitates the diagnosis of the professional nature of the disease. Information about group lesions (similar to this patient) in persons performing similar work and in contact with the same industrial stimuli is very important. Auxiliary methods for diagnosing allergic occupational dermatoses include various occupational tests such as leukocyte blast transformation reaction (RBTL), Fleck leukocyte agglomeration reaction, basophil degranulation to detect the presence of sensitization to a suspected allergic chemical. AT practical work skin-allergic tests are usually used with those industrial irritants that can cause sensitization of the body.

Treatment. The basis for the treatment of the disease is the most rapid and thorough removal of industrial hazards. For the treatment of the disease, the same methods and drugs are used as in the treatment of patients with true eczema (question 87).

Prevention. Exclusion of contact with industrial allergen, cessation of alcohol and smoking, as well as treatment of diseases internal organs, nervous and endocrine systems.

VTE. With a limited subacute course of occupational eczema, the ability to work is lost for the time necessary to resolve the process (treatment is carried out in a hospital for 23-25 days); during the period of remission of occupational eczema, the ability to work may not be lost.

Occupational skin diseases caused by exposure to physical factors. clinical course. Treatment. Prevention.

Callosity.

Most often, calluses occur on the skin of the hands, on the tubercles of the ischial bones of cavalrymen. They have the appearance of dense (palpation), yellowish, dirty gray or brown thickening of the stratum corneum and dermis. Their sizes vary from the size of a pea to a child's palm and larger.

Mechanical dermatitis. It develops in manual labor workers with prolonged mechanical irritation of the skin, usually on the palmar surfaces of the hands. In this case, its redness, swelling occur, with very strong pressure, blisters (water corns) may appear. Dermatitis can also occur with traumatic damage to the skin as a result of strong impacts on it with tools when working with bare hands with metal shavings. There are production microtraumas (scratches, punctures, abrasions, abrasions, burrs, superficial cuts) and deeper skin lesions.

Refreshment. See related question.

Frostbite and burns.

actinic dermatitis. It unites a group of professional skin lesions caused by insolation and ionizing radiation. Solar dermatitis occurs after exposure to the skin sunlight. It happens acute and chronic. On the skin, inflammatory erythema, swelling of open areas of the body, the appearance of vesicles and blisters. After the rupture of their tires, erosions form, patients feel a burning sensation in the focus, and sometimes pain. With extensive acute sunburn, the general condition may be disturbed. The inflammatory process is accompanied by itching and peeling, 12-24 hours after irradiation, it begins to regress. The skin of open areas gradually becomes hyperpigmented, coarsens, atrophic scars, warty growths may occur. Chronic develops in sailors, workers, mountaineering instructors as a result of constant exposure.

Treatment. For the purpose of treatment, mechanical minor injuries are immediately treated with antiseptic solutions. They do not require special treatment if they are not complicated by inflammatory processes or pyoderma. Otherwise, treatment is directed at the treatment of complications. Severe mechanical injuries are treated by surgeons. The prognosis is favorable. Treatment of the acute form of solar dermatitis includes rubbing the foci with alcohol, vodka, cooling soaks are applied to the blisters, erosion; in the chronic form, it is recommended to use photoprotective creams, ointments containing corticosteroids and vitamin A.

Prevention. For the prevention of microtraumas and light mechanical injuries, mechanization and automation of labor, the correct organization of the production process, workplace kept in proper condition. In order to prevent purulent complications, timely rehabilitation of injuries is performed with a 2% solution of iodine or a 1-2% alcohol solution of one or another aniline dye, dibo antiseptic adhesives BF-6, lifusol. Prevention of solar dermatitis comes down to observing safety precautions when working near the source of radiation, creating protective screens, providing workers with glasses, ointments, shields, and creams.

Skin diseases are unfortunately very common. One and the same disease can have many varieties. Each species has its own nuances in the treatment. Microbial eczema is no exception.

When the skin is weakened due to immune, nervous, allergic causes She is prone to a number of diseases. In the emergence and development of microbial eczema, bacterial pathogens play an important role.

Description

One of the varieties of eczema - bacterial or microbial - along with general characteristics for this disease, has its own pronounced features and symptoms.

Eczema is an inflammatory skin disease caused by allergic reactions organism, immune pathologies, disorders of nervous activity.

The eczemotogenic areas themselves are non-contagious, but in this case, the risk of infection exists from the bacteria that cause the rash (fungus, staphylococcus aureus).

The disease has increased level recurrence. People who have recovered from eczema and are prone to it are at risk of getting sick again with a high probability.

Bacterial eczema often becomes true with the wrong treatment.

The disease is accompanied by a rash (wet or dry), itching, burning, redness and inflammation of the skin. The microbial form is observed as a secondary condition on damaged areas of the skin.

Its causes are associated with bacterial factors. The disease is provoked by damage or primary disease of the epidermis.

Due to the weakening of the immune system, nervous tension, the level of skin protection and the effectiveness of the healing process are reduced.

Weakened areas near wounds, abrasions, ulcers become infected with microbes, which, with normal immunity, are absolutely harmless to the body.

This provokes a microbial form of the disease. A rash occurs near allergic skin reactions, chafing, chapping, diaper rash, varicose veins.

The reasons

There are several factors that provoke the disease. They are divided into common, characteristic for all types of this disease and inherent in microbial eczema. In all cases, the causes of the disease complement each other.

General:

psychovegetative disorders;
neuroendocrine diseases;
immune disorders.

The following causes are characteristic of all types of disease, but in particular they provoke precisely the microbial variety:

high sensitivity to the ingress of pathogens of infection and inflammation on the skin;
varicose veins;
skin injuries: abrasions, ulcers, wounds, diaper rash, chafing, frostbite or burns;
fungal infections: mycosis, lymphostasis;
two groups of pathogens are often observed. First: streptococcal or staphylococcal infection. Second: a fungus of the genus Candida.

Symptoms

There are symptoms inherent in all types of the disease and characteristic of the bacterial type.

They often develop rapidly. Literally in a day you can see:

skin redness;
the formation of a rash, vesicles;
death of the upper thin layer of the skin.

Symptoms covering all types:

redness and inflammation of the skin. The very first sign;
itching, burning. Possess varying degrees expressiveness. In most cases, strongly pronounced. At severe forms their diseases are hard to endure, just like ordinary pain. Often the discomfort is so severe that the patient cannot sleep. It is in these cases that serious treatment is used up to intravenous injections of special sedatives (sedatives);
rash of several varieties. Dry or wet. In all cases, dead skin (white, yellow) is exfoliated, sometimes it resembles psoriasis;
when combing a wet rash, the top thin layer of skin peels off. Fluid (pus) oozes from the ulcer. It lasts a long time, the wound dries up hard;
eczematous areas have pronounced boundaries and a clear geometry;
sometimes after successful treatment, the areas where there was eczema change color (they become darker) or the skin remains deformed.

Characteristic features for the bacterial type:

preceded by skin lesions of various types. It develops around pyodermic (purulent) foci: near ulcers, areas of abrasions, fistulas, scratches;
sharply defined segments of inflammation with a dying layer of skin and cells;
in the center of the site - an accumulation of cavityless hills (papules) or blisters with serous fluid. Weeping segments, purulent crusts are formed, a thin top layer of skin easily peels off when touched;
accumulations of the rash are located next to each other at intervals affected by separate small formations that gradually grow;
asymmetric shape with jagged edges, coin-like or other;
severe burning and itching.

Types of this pathology:

nummular. It is in the form of plaques or coin-shaped. The foci are rounded, small in size, clear with intense blood flow, weeping, edematous. Microbial eczema on the hands is often of this type;
varicose. Accompanied by varicose veins, venous insufficiency. Ulcers sometimes form around diseased veins. An eczemotogenic area appears around them with swelling, inflammation and moderate itching;
post-traumatic. Occurs as a result of violations in wound healing after operations, injuries;
sycosiform. Reminds me of seborrheic. It is observed in patients with inflamed hair follicles. It has weeping, itchy red lesions. Location: Where the hair grows, including the chin and upper lip in men. As it progresses, it spreads to other areas with hairline;
papillary. In women who are breastfeeding or who have scabies. Weeping cracks form around the nipple and on it.

Video: The nuances of the disease

Localization

Hands and feet are areas where eczematogenous areas most often occur. It is difficult to keep the limbs in a calm state and keep them constantly in sterile conditions. Together, these factors provoke the development of the disease.

On hands

chemical agents;
paints;
varnishes;
irritants;
allergens.

Hands should be kept warm, do not expose them to hypothermia or sudden changes in temperature, chapping.

If microbial eczema on the hands occurs on the lower parts of the limbs and it is difficult to completely isolate the skin from irritants, it is necessary to treat the skin with disinfectant creams immediately after contact with them.

It is advisable to work with protective gloves. Jewelry on the fingers and hands must be removed.

There are special creams against itching:

Dermovate;
Advantan.

Water provokes the development of the disease, so contact with it should be minimized. The skin is disinfected with a weak solution of potassium permanganate, boric acid or alcohol.

Hands are washed with hypoallergenic hygiene products, neutral soap is chosen, herbal lotions (celandine), drying ointments (zinc) are allowed.

Make lotions from calendula, aloe. Drying powders are used, for example, a composition of zinc oxide (30 g), menthol (2 g), wheat starch (50 g), sulfur color (5 g).

On foot

For the legs use the same means as for the hands. If microbial eczema on the legs is accompanied by varicose veins, therapy is combined with the wearing of special compressor knitwear, preparations for toning blood flow.

Legs should not be loaded. When walking, excessive exercise swelling may appear, and inflammation will increase.

When the rash is located on the lower parts of the limbs, shoes should be well ventilated, socks should be worn only from natural fabrics. At night, it is recommended to make lotions, powders and sleep with your feet on a hill.

Diagnostics

If microbial eczema is suspected, a bacteriological examination is performed first. The test material is scraped off from diseased areas of the skin.

As a rule, microscopy reveals mycosis (fungus) cells, and when placed in an appropriate environment in the laboratory, bacterial pathogens are detected.

The task of diagnostics in the described case - precise definition the type of organism that causes the microbial rash. This will help to apply exactly those drugs to which the pathogen is sensitive.

At acute forms diseases, histological studies of the biomaterial from the subcutaneous layers of the foci of the rash are carried out.

This determines the degree of infection penetration into tissues, the level of plasma and other cells in the infiltrate.

Visual inspection allows you to note:

puffiness;
localization;
characteristic external manifestations.

Sometimes set differential diagnosis with signs of psoriasis, other types of eczema, dermatitis.

The microbial form of the disease often turns into true eczema.

In all cases, the doctor may prescribe:

general analyses;
studies of the level of immunoglobulins;
lymphocytes.

Treatment of microbial eczema

Complexity is an important characteristic of therapy. Its components: preparations externally or intravenously, systemic agents, diet therapy, hygiene measures.

outdoor

External treatments include:

lotions;
ointments;
creams;
antiseptic solutions;
talkers.

The main attention is paid to drugs with pronounced antibacterial properties.

If it is established which bacterium is the cause of the disease, they use exactly those means that destroy it. Use highly targeted drugs and ointments of general anti-inflammatory action.

Commonly used outdoor products:

lotions with resorcinol (1%), lead water;
treatment with Castellani liquid, “brilliant green” (diluted), in acute cases - solutions of aniline dyes;
naphthalene, ichthyol ointment, tar preparations are used for slight weeping;
ointments with antibiotics for a specific pathogen: bactroban, drapoene, dettol;
antifungal ointments, if the corresponding etiology is identified (exodril, bifonazole);
at acute manifestations- corticosteroid drugs (elokom, advantan, celestoderm);
with a large area of \u200b\u200bdamage, calcineurin inhibitors are used: pimecrolimus, tacrolimus. They reduce itching and inflammation;
well relieve itching, irritation antiseptics in the form of sprays: inhalipt, livian, cameton.

With a particularly severe course, systemic treatment is used:

antibiotics: ampicillin, cefazolin, doxycycline;
antimycotics (fluconazole), if a fungal pathogen is present;
during exacerbation: corticosteroids for systemic use (triamcilone, prednisolone) or cytostatic agents (methotrexate, cyclosporine);
drugs for desensitization, antihistamines: lorotadine, suprastin, diazolin;
intravenously: calcium chloride, sodium thiosulfate;
sedatives or sleeping pills(valerian, motherwort, bromine).

For this type of eczema, corticosteroid ointments and hormonal preparations used less frequently if initial treatment bacterial infection with antibiotics correct.

General

exclusion of overheating or frostbite;
it is forbidden to expose the damaged area to loads, and even more so to injuries;
regular hygiene (washing with antiseptic agents, solutions);
exclusion of prolonged contact with moisture of eczematogenous areas;
clothing made from natural fabrics;
for varicose veins - appropriate compression underwear, leg bandaging and vein treatment;
diet. The diet is dairy and vegetable with cereals and the addition of boiled meat. Add more fiber, greens, fruits and vegetables, except for spicy, citrus and irritating (pepper, garlic, onion). Spicy, smoked, pickled, canned is prohibited;
fluid intake is limited, alcohol is prohibited;
vitamin therapy (vitamins A, B, D, calcium, zinc);
eliminate stress, nervous tension and strong physical exertion, leading to exhaustion.

Physiotherapy

Physiotherapy methods are especially effective together with the right diet and vitamin therapy.

The following treatment procedures are used:

magnetotherapy;
ultraviolet irradiation;
laser and ozone therapy.

In addition to the healing effect, these methods contribute to the disappearance of traces after the rash.

Folk remedies

Folk remedies are used as an addition to the main therapy.

Locally on diseased areas or internally, the following agents are used:

lotions from herbs or plants: celandine, calendula, aloe, coltsfoot;
effective lotion from the collection: 20 g each, nettle birch buds, calendula inflorescences, yarrow, St. John's wort;
the rash is moistened with a decoction of pine needles and cones: 100 g per liter of boiling water, pour an hour, apply for 15 minutes;
100 g of freshly picked walnut leaves are poured with half a liter of water, boiled for 5 minutes and insisted for an hour. The agent wipes the affected areas;
elderberry leaves have a powerful antiseptic effect. They are washed, beaten off so that they let the juice flow, and applied to sore spots for 15 minutes, wrapped with cling film;
An infusion of dandelion root improves immunity, it is poured with boiling water, infused for 12 hours and drunk several times a day.

Prevention

Microbial eczema on the hands, feet, other parts of the body appears in people prone to skin diseases with neuro-allergenic and immune nature such as psoriasis, dermatitis.

Such people should especially pay attention to the following factors:

high-quality treatment of any pyoderma rash, allergic reactions, thermal, chemical or other damage;
care after dressings and removal of plaster;
try to use a dairy-vegetarian diet, include allergenic foods, minimize alcohol consumption, limit sweet, spicy foods;
chronic diseases, especially varicose veins, infectious diseases should be treated promptly.

It is strictly forbidden to comb the areas affected by the rash.
In order to leave fewer traces after eczema, the skin should be periodically lubricated with antiseptic, softening creams.
Contacts with water aggravate the situation, therefore they minimize water procedures, do not moisten the affected area or cover it with cling film.

Microbial eczema is not easy, but treatable. The main thing is to prevent it from flowing into its true form: this will complicate the therapy.

Microbial eczema is a fairly common variety, as it is diagnosed in 27% of cases among all patients diagnosed with eczema. It differs in that it is not an independent disease, but develops on lesions of the skin that were previously affected by any pathology.

Based on the name, it becomes clear that the main source of the disease is the pathological influence of pathogens, but there are a number of other predisposing factors.

The clinical picture will be somewhat different depending on the form in which the disease proceeds. Most hallmark the appearance of itchy and weeping foci of inflammation appears.

A dermatologist diagnoses and prescribes treatment. To establish the correct diagnosis, data obtained during the physical examination and a wide range of laboratory research.

Treatment of microbial eczema directly depends on the etiological factor, but is often limited to conservative methods.

AT international classification diseases, such a pathology belongs to the category of other dermatitis, which is why the ICD-10 code will be - L 20-L 30.

Etiology

In the vast majority of cases, the causative agent of microbial eczema is:

beta hemolytic;
epidermal or;
Proteus and Klebsiella;
Neisseria causing or;
fungi of the genus Candida.

As background pathological condition, in which there was a violation of the integrity of the skin, may be:

poorly healing wounds received during surgery or injuries;
lymphostasis;
a wide range of sluggish fungal diseases of the skin.

In addition, abrasions and fistulas, as well as other structural skin lesions, can contribute to the formation of the disease.

The pathogenesis of the disease is that the underlying disease leads to a decrease in the barrier function of the skin, and the chronic influence of pathogenic agents causes sensitization human body. Against this background, the formation of autoimmune processes occurs, which actually cause such a disease.

Thus, the main risk group is made up of people who:

weakened the immune system;
there are signs of allergic diathesis;
there are problems with digestion;
increased susceptibility to stressful situations;
flow allergic diseases;
organ dysfunction diagnosed endocrine system, which include the adrenal glands and the pituitary gland, thyroid gland and ovaries;
non-compliance with personal hygiene.

All of the above etiological factors are responsible for the development of microbial eczema in children and adults. From this it follows that the pathology has no restrictions regarding gender and age category.

Classification

Specialists in the field of dermatology, it is customary to distinguish the following varieties of such a disease:

nummular- has a second name - coin-shaped. It is characterized by the fact that it most often affects the skin of the hands, on which isolated eczematous foci appear, no more than three centimeters in volume. In addition, it is prone to spread and does not respond well to therapy;
varicose- is formed due to varicose veins, which means that it is often localized on the lower extremities;
paratraumatic;
mycotic- a similar variety develops against the background of already existing fungal lesions of the skin of both the upper and lower extremities;
sycosiform- differs in that the source of this variety is sycosis, which, in turn, is a pustular lesion of the skin. The causative agent is most often Staphylococcus aureus. Favorite sites of injury are the face and hairy part head, armpits and pubis.

Separately, microbial eczema of the nipples is isolated, which occurs as a result of their injury in the process breastfeeding baby. In addition, it is often diagnosed in persons infected with scabies.

Symptoms

Since there are several types of disease, it is only natural that each of them has its own clinical manifestations.

Varicose eczema or microbial eczema on the legs is expressed in the following symptoms:

moderate skin itching;
the presence of clear boundaries of the inflammatory focus;
rash polymorphism.

Nummular nummular or plaque eczema is characterized by:

the appearance of rounded lesions, the volume of which can vary from one to three centimeters;
the presence of clear edges separating healthy skin from the patient;
pathological redness;
swelling and weeping;
the appearance of a layer of serous-purulent crust.

This variety is also known as microbial eczema on the hands, since only this area is involved in the pathology.

Sycosiform eczema or microbial eczema on the face is accompanied by the appearance of lesions on the skin, which are complemented by severe skin itching and weeping, i.e., the release of a specific fluid from the wound. The post-traumatic form of the disease has similar Clinical signs, but is localized around wounds, scratches or abrasions.

the appearance of foci of inflammation of a bright red color;
crack formation;
wetting;
severe itching;
pronounced pain;
formation of crusts on the surface of wounds.

It is also advisable to attribute similar signs characteristic of a particular type of disease to the development of microbial eczema in a child.

The chronic form of the course of the disease is characterized by an extensive erosive lesion of the skin, which means that microbial eczema is transformed into a true one.

Diagnostics

An integrated approach is needed to establish the cause of microbial eczema. Before prescribing laboratory tests, a dermatologist must independently perform several manipulations:

to study the patient's medical history - since such a disease has a pathological basis, this is often enough to establish the most characteristic etiological factor for a particular person;
perform a thorough physical examination of the foci of inflammation, which can be localized on the arms and legs, in the armpits and pubic area, on the face or on the scalp;
conduct a detailed survey of the patient - this is necessary to determine the first time of appearance and the severity of the infectious process.

Laboratory studies are based on the implementation of:

bakposeva discharge or scraping from the affected area of the skin - to identify the pathogen and evaluate its sensitivity to antibiotics;
scraping for pathogenic fungi;
histological examination of the biopsy;
general clinical and biochemical analysis blood.

During the diagnosis of microbial eczema in a child and an adult, they do not turn to the implementation of instrumental diagnostic measures.

All of the above diagnostic methods allow not only to make the correct diagnosis, but also to differentiate the disease from:

others;
primary reticulosis of the skin;
familial, with a benign course.

Treatment

The tactics of how to cure microbial eczema is directly dictated by the etiological factor, for example:

with fungal skin lesions, local or course treatment of the underlying ailment is carried out;
when taking medications, treating skin areas with antibacterial substances and therapeutic ointments is shown;
specific elimination of trophic ulcers and sycosis.

Directly in the treatment of microbial eczema, the following drugs are used:

antihistamines;
desensitizing drugs;
vitamin complexes;
sedatives;
antimicrobial ointments for local application;
astringents and antibacterial drugs;
antiseptics.

Among the most effective physiotherapy procedures, it is worth highlighting:

It is also allowed to treat microbial eczema with the help of lotions from decoctions based on:

strings and nettles;
birch and calendula;
hypericum and yarrow.

It should be noted that the elimination of eczema in infants and babies early age carried out by the most gentle methods.

In addition, therapy must necessarily include:

hypoallergenic diet for microbial eczema - sparing nutrition is compiled by the attending physician on an individual basis for each patient;
careful observance of the rules of personal hygiene;
a course of taking glucocorticoids - in cases of the transition of the disease to true eczema.

Prevention and prognosis

To prevent the development of bacterial eczema, you must:

observe the rules of personal hygiene;
prevent infection of wounds and other structural lesions of the skin;
treat on early stages those ailments that lead to the development of eczema on the legs, arms, face and any other localization.

When establishing such a diagnosis, patients are concerned about the problem - is microbial eczema contagious or not? The disease is considered conditionally contagious, since it is possible to become infected with a significant increase in the number of pathogenic microflora and in the presence of one of the predisposing factors.

As for the prognosis of microbial eczema, it is favorable in the vast majority of cases. Long-term and persistent therapy is observed only in debilitated and elderly patients.

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Microbial eczema - clinical variety eczema, which is secondary in nature and develops on areas of the skin affected by a microbial or fungal infection. Most often, chronic pustular foci around poorly healing infected wounds, trophic ulcers, abrasions, scratches and other skin lesions become the localization site of eczema. Inflammatory changes and eczematous manifestations in this pathology occur against the background of an already existing disease. Microbial eczema can appear due to varicose veins or as a result of chronic fungal skin diseases.

The most common causative agent of the disease is hemolytic streptococcus. In addition, Staphylococcus aureus or epidermal Staphylococcus aureus, Proteus, Candida fungi and other pathogens can act as microbial agents. Background diseases contribute to a decrease in the barrier function of the skin, and the addition of microbial agents causes sensitization of the body ( hypersensitivity to irritants) and provoke the development of microbial eczema.

According to statistics, the prevalence of this form of dermatitis is up to 25% of all cases of eczema. Microbial eczema is not contagious, but is prone to a chronic course requiring long-term treatment. What is the cause of the disease, what adverse factors provoke its development?

The emergence and development of microbial eczema occurs under the influence of a number of factors, both external and internal.

Decreased immunity
Diseases of the nervous system
Violation of the functions of the endocrine system
genetic predisposition
Allergic factor
Diseases of internal organs (liver, kidneys, gastrointestinal tract)

The cause of the disease is often varicose veins veins, lymphostasis, chronic fungal diseases of the skin. Hereditary predisposition and tendency to allergic reactions can provoke the disease. Allergic processes occurring in the body contribute to the development of pathological immune response tissues, accompanied by inflammation and damage skin.

When infectious irritants interact with possible allergens, it develops chronic course disease, with constant recurrent inflammation in the epidermis.

Microbial eczema often occurs around poorly healing postoperative wounds, fistulas, trophic ulcers and other skin lesions as a result of insufficient antiseptic treatment and seeding with pathogenic microflora (staphylococcus, streptococcus, fungi).

Symptoms of microbial eczema

The clinical picture in microbial eczema is characterized by the formation of inflamed, sharply demarcated large foci, with a stratum corneum shearing along the periphery. On the inflamed areas, rashes appear in the form of bubble elements (vesicles) with serous contents. After their opening, weeping erosions are formed, a layer of purulent crusts is formed on the surface of the foci of eczema.

Loose elements are prone to confluence and peripheral growth. Around the foci of eczema on apparently healthy skin, screenings are observed (separate small pustules and dry scaly areas). The process of appearance and opening of the elements of the rash is accompanied by severe itching. Developed foci of eczema are located asymmetrically, prone to growth and the formation of secondary rashes.

Doctors distinguish several subspecies of microbial eczema, which differ in characteristic symptoms:

When the first symptoms of microbial eczema appear, it is necessary to seek medical care otherwise, the further development of the disease threatens the spread of the infectious and inflammatory process and the defeat of extensive surfaces of the skin.

Diagnosis of the disease

Only a specialist can correctly diagnose the disease based on the history, the general picture of the disease and a number of laboratory tests. Visual inspection reveals characteristic external signs: rash, redness and swelling of the skin, the presence of weeping areas and purulent layers.

To clarify the diagnosis, there are special methods studies that examine skin samples for the presence of mycotic cells. Based on examination of a skin scraping under a microscope or using histological or bacteriological analysis, a doctor can diagnose microbial eczema with confidence.

An important point is to determine the type of microorganism and identify its sensitivity to medicines necessary for further successful treatment of the disease. In doubtful cases, do histological examination a biopsy specimen, a sample of which is taken from a deep focus of microbial eczema.

Microbial eczema must be differentiated from other types of eczema, other dermatitis, and manifestations of psoriasis. If you suspect the transition of microbial eczema to weeping (true), prescribe general analysis blood, determine the level of lymphocytes and immunoglobulins.

Only an experienced specialist knows how to treat microbial eczema and what drugs to choose in each case. It is unacceptable to engage in self-medication, the doctor will select the optimal treatment regimen, taking into account the patient's condition and possible contraindications that will achieve the best results and ensure a lasting positive effect.

Treatment of the disease is complex, it includes systemic therapy, local treatment, measures to prevent the spread of foci of eczema to healthy areas of the skin. An important role in the treatment of the disease is played by the adjustment of nutrition and personal hygiene.

Systemic therapy

In severe microbial eczema, accompanied by a bacterial infection, antibiotics are prescribed (ofloxacin, ampicillin, azithromycin, cefazolin). If eczema occurs against the background of a fungal infection, the use of antimycotic agents is indicated. With the spread of the process and the defeat of extensive skin patches, systemic corticosteroids (prednisolone, triamcinolone) and cytostatics (cyclosporine) are prescribed.

Antihistamines help to eliminate itching and reduce inflammation:

diazolin,
suprastin,
lorotadine.

To strengthen the body's defenses and reduce susceptibility to irritants, intravenous infusions of sodium thiosulfate, calcium chloride are indicated.

Relieve stress and calm nervous system sedatives will help:

bromine,
valerian,
motherwort.

In severe cases, with sleep disorders and nervous disorders sleeping pills and antidepressants will help.

The course of the disease is facilitated by the intake of vitamin-mineral complexes. To increase the body's resistance and strengthen the immune system, injections of vitamins (A, B, E), and immunomodulators are prescribed.

Local treatment (ointments and creams)

Foci of microbial eczema are treated with ointments based on zinc, tar, ichthyol, naftalan oil. Make lotions with a solution of resorcinol, lead water, Castellani liquid. In the acute period, eczema foci are treated with brilliant green or solutions of aniline dyes.

If a bacterial causative agent of eczema is identified, ointments containing an antibiotic (dettol, drapolene) are prescribed. In the presence of a fungal infection, ointments containing antifungal components (exoderil, bifonazole, loceryl) are used.

In the case of extensive lesions and a severe course of the disease, the use of sprays and ointments with corticosteroids (celestoderm, elocom, advantan) is indicated. They should be used in short courses and only as directed by a doctor.

A good effect gives the appointment of anti-inflammatory non-hormonal drugs. These are ointments and creams Radevit, Losterin, Eplan.

Recently, physicians are increasingly replacing hormonal ointments with serious side effects, for calciverin inhibitors. These are drugs such as tacrolimus, pimecrolimus. They cope well with the manifestations of eczema, even in large areas, quickly relieve inflammation and eliminate itching, without adversely affecting the body.

Effective lotions based on undiluted fish oil, the use of neutral ointments, a variety of powders and talkers. After the acute process subsides, it is recommended to undergo a course of physiotherapy procedures.

Methods of physiotherapy treatment

The methods of physiotherapy in the treatment of microbial eczema include:

Ozone therapy.
Cryotherapy
Laser therapy
UHF, UFO

A good result is achieved by applying mud applications, aseptic dressings with decoctions of herbs that have anti-inflammatory effects.

Patients are advised to follow a dairy-vegetarian diet, with a predominance in the diet fermented milk products, fresh fruits and vegetables rich in fiber and vitamins. Food should be steamed, boiled or stewed. Spicy, salty, pickled foods, spices and seasonings are excluded from the menu.

You should stop eating chocolate, sweets, flour and confectionery products. Alcohol, canned food, coffee are completely excluded. Do not eat foods that can cause allergic reactions (citrus fruits, berries, chicken eggs, seafood, nuts, sweet carbonated drinks). The menu can include vegetable soups, boiled vegetables, cereals, dietary meat.

As an addition to the main methods of treatment, you can use recipes traditional medicine. Lotions and applications from decoctions of medicinal plants will help to effectively relieve inflammation, irritation and itching.

Remember that before using folk recipes, you should consult with your doctor.

Microbial eczema is one of the most common skin ailments, resulting in most cases from a predominant disease of a bacterial or fungal nature. A characteristic feature of this type of dermatitis can be called pyoderma. While for other skin pathologies this condition is considered serious complication. Many people are wary of patients with microbial eczema, believing that the disease is transmitted and extremely dangerous, since there is no treatment.

What is known about the factors provoking the disease?

Scientists still cannot give an exact intelligible answer as to why microbial eczema is so common among people. The causes of the pathology are often explained by psycho-emotional disorders, as well as problems in the functioning of the endocrine system. Violations in the processes of neurotrophic regulation occur due to the negative impact thyroid gland for the work of the CNS.

Speaking in simple and accessible words to the general public, when the body's defenses are weakened, the barrier functions of the skin also begin to falter. Ensuring full protection against the penetration of pathogenic microorganisms, as one of the main tasks of the epidermis, becomes impossible to a sufficient extent. To prevent pathogenic microbes from entering the bloodstream in case of damage to the skin, leukocytes, platelets and phagocytes enter the fight against infection. With normal immunity, these blood cells actively eliminate the danger, preventing penetration harmful bacteria inside. Otherwise, if the integrity of the epidermis is violated, microbial eczema develops.

The trigger for the onset of the disease on the arms or legs can be several factors. The etiology of microbial eczema is often determined among the following, the most likely causes:

high level of susceptibility to streptococci;
chronic diseases of the gastrointestinal tract;
disturbances in the work of the glands of the endocrine system;
the occurrence of frequent stressful situations;
ignoring the rules of personal hygiene;
damage to skin areas due to various factors (manifestation, mycoses, open wounds, fistulas, varicose veins, etc.).

Forms of the disease

This disease is most often a chronic skin pathology, with periodic exacerbations and a short remission. Inflammation, sometimes reaching the papillary layer of the dermis, is extremely difficult. Microbial eczema, unlike other types of dermatitis, is common and often diagnosed in patients different ages. At the same time, manifestations of the disease, localization and degree of complication of rashes are predetermined in patients by the evolution of the inflammatory process.

There are three main forms of eczema of bacterial origin:

Acute. It is characterized by erythema of the skin, swelling and the formation of papules. Further, the inflamed dermis cracks, the opening of the vesicles is followed by the release of a serous secretion. After a few days, crusts form.
Subacute. It is a subsequent thickening of the skin, accompanied by erythema. For this stage of the course of the disease, pigmentation disorders are characteristic, scales are formed.
Chronic. During this period, persistent hyperemia of partially recovered skin areas is noted. In individual cases, hyper- or hypopigmentation can be clearly expressed.

As a rule, the lack of proper therapy during the first acute wave of the disease contributes to the occurrence of immune abnormalities, and as a result, the development of irreversible changes in the epidermis at the cellular level. An increase in the individual sensitivity of the skin to the effects of external stimuli that provoke the progression of the disease also becomes inevitable.

The main phases of the course of microbial eczema

As already mentioned, bacterial eczema (or microbial) is a long-term inflammatory process on open skin fragments.

The first signs of the disease make themselves felt at the erythematous stage of the disease.

At the first stage, a patient with microbial eczema may feel only a slight reddening of the skin, a slight itch with a rapidly increasing intensity. The first phase of skin pathology, as a rule, does not present significant discomfort to the patient.
At the second stage of microbial eczema, which is called papulovesicular eczema, blistering rashes characteristic of this type of dermatitis occur. Each vesicle is filled with serous fluid. This stage of the course of the disease can bring pain and inconvenience to the patient.
Third stage. Vesicles are eczematous blisters that, a few days after the appearance, begin to burst. This process can determine the transition to the next stage of eczema - weeping on the skin. Serous foci of pathology have an unpleasant appearance, moreover, it is visually quite difficult to determine the exact boundaries of epidermal lesions on the arms and legs.
Moisture should disappear at the next stage of microbial eczema. All serous wells begin to crust, which has a dirty yellow-gray tint. The absence of exudate secretions and the drying of the affected areas of the skin indicates the onset of remission. However, along with it, in absolutely healthy places, there is always the possibility of the appearance of new foci of eczema.

Treatment and symptoms of eczematous manifestations on the legs

Microbial eczema on the legs is diagnosed much more often than the same type of dermatitis on the hands, or even less often on the neck, face. Only a doctor is able to confirm the diagnosis in order to exclude dermatological diseases that have similar clinical manifestations. The patient needs to urgently seek specialized help in case of the following symptoms of the disease:

the appearance of serous purulent papules on the lower extremities;
rapid growth of weeping erosions on the foot, lower leg, calves;
scalloped margins of lesions on the skin;
slight peeling, combined with severe itching.

With microbial eczema on the legs, a dermatologist usually prescribes complex treatment, which is preceded by the establishment of the exact causes and the passage of patients laboratory examination. As a rule, therapy for infectious eczema on the lower extremities is:

External treatment with antibacterial, anti-inflammatory ointments, creams of hormonal and non-hormonal nature.
Taking oral antimicrobial medications.
Intravenous injections.

For effective therapy and achieving rapid results, the treatment of microbial eczema must be accompanied by unquestioning adherence to hygiene rules. In cases of profuse sweating, an optimal environment arises for the active reproduction of pathogenic microbes.

Features of bacterial eczema on the hands

On the hands, eczematous lesions occur on the hand, fingers, and interdigital areas of the skin. Often, rashes affect the epidermis area on the back of the hand. In advanced cases, the vesicles extend to the elbows or forearms.

The foci of inflammation are rounded, their diameter rarely exceeds 3 cm. Each plaque has smooth edges, and in its center it is easy to notice a bluish-red weeping, gradually covered with a serous-purulent crust. Quite often, at the beginning of the development of microbial eczema on the hands, it is mistakenly confused with manifestations of scabies. It is possible to recognize the disease by the formation of small cracks on the skin of the hands, which leads to damage to the epidermis layer and the release of exudate.

In patients with bacterial eczema on the palms, there is a constant feeling of moisture on the surface of the skin. Swelling interferes with the full movements of the limbs. It becomes impossible to clench your fingers into a fist because of the pain, resembling a burn manifestation. In severe cases, detachment of the nail plates occurs, and the burning and itching sensation in patients with eczema causes a lot of discomfort, preventing an active lifestyle, rest and sleep.

Therapy of microbial eczema on the hands follows a similar therapeutic scheme. The main feature of the course of the disease in these areas of the skin is the high probability of a secondary infection in the patient due to the slow healing of deep skin lesions. Dysfunctions of the body's defense systems, which are the primary causes of the development of the disease, serve as the main indication for the use of not only the symptomatic treatment of microbial eczema, but also the most powerful stimulation of the patient's immunity.

In addition, therapy eczematous manifestations on the hands must be accompanied by the observance of elementary hygiene rules. As much as possible, especially during an exacerbation of the disease, household chemicals, varnishes, other irritants and allergens should not get on the surface of the skin. The limbs should always be warm, not expose the hands to hypothermia, wetting or chapping. A sharp change in temperature can also have a negative effect.

Often, it is impossible to completely isolate the epidermis from contact with the external environment, but at the slightest threat of a secondary infection, the skin should be treated with disinfectants. For the period of the acute course of the disease, it is better to refuse to wear jewelry.

Microbial eczema: the degree of danger to others

It is not surprising that even the relatives of the patient react to the external manifestations of the disease with hostility. Visually, serous vesicles and purulent weeping are not the most pleasant picture. Whether microbial eczema is transmitted by contact or not, every person should know in order to protect themselves from infection when faced with a one-on-one problem.

In fact, infectious eczema is not at all dangerous to others. Only pathogenic microorganisms can move from the affected areas of the skin to the healthy one. Thus, not eczema, but its bacteriological, fungal or viral agent will pass to people in contact with the patient.

Regardless of the form of contact (airborne, sexual, direct, domestic, etc.), you don’t have to worry about whether microbial eczema is contagious or not.

Therapy for microbial eczema

As already briefly mentioned, the treatment of the disease for any localization of eczematous vesicles implies an integrated approach. Apart from medicines external and internal therapy, an important role is assigned healthy eating and observance of the rules of personal hygiene.

The use of external treatments

Local treatment of foci of bacterial eczema is performed using various ointments and creams. The most common, due to their high efficiency, are the following groups of external drugs:

Ointments based on zinc, ichthyol or medical tar. They act on the affected areas of the skin, providing anti-inflammatory and antiseptic effects, and help accelerate the regeneration of epidermal cells.
Antibacterial ointments (Drapolen, Dettol). Prescribe drugs of this spectrum in case of determining the exact pathogen. Can only be used after medical advice.
Antifungal creams (Loceryl, Exoderil, Bifonazole). To eliminate the fungus, the course of application of drugs can be more than 2 months. In addition to the antifungal components contained in the composition of the funds, there are elements whose action is aimed at accelerating recovery.
Non-hormonal ointments (Eplan, Losterin, Radevit). Effective drugs, actively fighting microbial eczema, can be prescribed by a specialist. A good result is shown in the early stages of the disease, but the use non-hormonal ointments in difficult clinical cases usually does not work.
Hormonal ointments (Elocom, Advantan, Celestoderm). They have the highest possible efficiency in the fight against dermatitis. Mass of contraindications and side effects- a consequence of the fact that hormonal ointments are prescribed in exceptional advanced cases.

Treatment of microbial eczema with ointments is an indispensable component of the entire complex of therapy. A doctor should choose an ointment for microbial eczema. Self-treatment in this case is fraught with, at least, the lack of results, as a maximum, the development of complications.

What pills can be prescribed for microbial eczema?

Systematic drug therapy with microbial eczema is of the same importance as the use of ointments and creams. In the case when the disease is accompanied by a bacterial infection, antibiotics are indispensable. Often the doctor prescribes such pills:

Ofloxacin;
Ampicillin;
Azithromycin;
Cefazolin.

In parallel with antifungal creams, the patient should undergo an antimycotic course of treatment for microbial eczema. In the later stages of the disease, corticosteroids and cytostatics with the following trade names are indispensable:

Prednisolone;
Triamcinolone;
Cyclosporine.

Antiallergic drugs will help eliminate unpleasant symptoms and relieve inflammation. Sedative tablets are prescribed to the patient for sleep disorders and neuroses caused by the course of the disease. To strengthen the immune system, the patient is prescribed vitamin-mineral complexes and interferon-containing drugs.

Folk recipes to help treat dermatitis

Treatment of microbial eczema at home is not excluded, however, rely on what exactly folk recipes help to eliminate the pathology, it is not worth it. As a symptomatic therapy, natural remedies can eliminate inflammation, itching and reduce irritation. Recipes of the most popular folk methods treatments for microbial eczema are as follows:

Lotions based on a decoction of walnuts. For two weeks, it is necessary to use a remedy for which you need 100 g of shell and 0.5 liters cold water. Bay nut waste, put the container on a slow fire and cook for at least 15 minutes. When chilled, use as a lotion.
Applications from coniferous infusion. It is not difficult to prepare homemade medicine, it will take about 100 g of needles of pine, spruce, fir or other coniferous plant. Prepared raw materials pour 1 liter of boiling water and set aside for an hour. Applying to the affected area of the skin for 15-20 minutes several times during the day, perform applications using sterile wipes soaked in the product.