Pyoderma Flashcards
DF of Pyoderma
-Pyoderma is a group of dermatoses based on purulent inflammation of the skin, its appendages, and subcutaneous fatty tissue.
Classification
-Depending on the pathogen and the depth of the lesion, pyoderma is divided into the following types:
I. Staphyloderma
1. Superficial:
1.1. ostiofolliculitis 1.2. folliculitis
1.3. sycosis 1.4. vesiculopustulosis
1.5. epidemic pemphigus of newborns
1.6. exfoliative dermatitis (Ritter’s disease)
1.7. Staphylococcal scalded skin syndrome (SSSS)
1.8. Staphylococcal toxic shock syndrome (TSS)
2. Deep :
2.1. furuncle 2.2. furunculosis
2.3. carbuncle 2.4. abscess
2.5. pseudofurunculosis
2.6. hidradenitis
II. Streptoderma
1. Superficial :
1.1. impetigo streptococcal 1.2. crevice impetigo
1.3. paronychia 1.4. papulo-erosive streptoderma
1.5. intertriginous streptoderma
1.6. erysipelas
1.7. Streptococcal toxic shock syndrome (STSS)
1.8. acute diffuse streptoderma
2. Deep :
2.1. cellulite 2.2. ecthyma vulgaris
III. Streptostaphyloderma :
Superficial impetigo vulgar
Etiology and pathogenesis
-The causative agents of the disease are most often representatives of the Micrococcaceae family: staphylococci (Gram-positive facultative anaerobic bacteria) and streptococci (Gram-positive aerobic and facultative anaerobic bacteria), most often - Staphylococcus aureus, S. haemolyticus, S. epidermidis, β-hemolytic streptococcus.
-Exogenous factors that contribute to the development of pyoderma and their relapses include violation of the integrity of the epidermis (microtrauma, skin maceration), skin contamination, increased sweating, a shift in skin pH to the alkaline side, and exposure to high and low temperatures.
-Endogenous risk factors for the development of the disease include various endocrinopathies and, above all, impaired carbohydrate metabolism (diabetes mellitus), insufficient intake of proteins in the body, the presence of severe somatic diseases, hypovitaminosis, chronic intoxication, the presence of foci of staphylococcal infection in various organs and tissues.
Clinical picture Symptoms, course of Staphyloderma
Ostiofolliculitis (Bockhart’s impetigo)
-The causative agent is S. aureus, less commonly S. epidermidis. It is characterized by the appearance of a pointed yellowish-white pustule the size of a pinhead, riddled with hair. Occurs as a result of inflammation of the mouth of the hair follicle. Most often, rashes are localized on the face in the area of the beard, mustache, chest, and on the extremities in areas of hair. On the 3rd–4th day, the pustule shrinks to form a yellowish crust, after which a pink spot remains.
explain Folliculitis
-Folliculitis is purulent inflammation of the entire hair follicle. The causative agent of the disease is S. aureus. The disease is characterized by the appearance of a limited inflammatory infiltrate in the form of a bright red nodule, painful on palpation. On the 2nd–3rd day, a pustule is formed, filled with yellowish-green contents, in the center of which a hair or the mouth of the follicle is visible. After 5–7 days, the pustule dries out to form a yellowish crust. After resolution of ostifolliculitis and folliculitis, scars do not form.
explain Sycosis vulgaris
-Sycosis vulgaris (staphylococcal sycosis, non-parasitic sycosis) is a chronic recurrent inflammation of the follicles in the growth area of bristly hair (beard, mustache, eyebrows, pubis, axillary fossae). The causative agent of the disease is S. aureus or associations of different strains of staphylococci. The disease is characterized by the appearance of foci with pronounced infiltration of the skin of a bluish-brown color, on which there are pustules, erosions, and serous-purulent crusts.
explain Vesiculopustulosis
-Vesiculopustulosis (periporitis, osteoporitis) is a purulent inflammation of the mouths of the merocrine sweat glands. The causative agent is S. aureus.
-The disease often occurs in newborns. The appearance of vesiculopustulosis is preceded by prickly heat. Initially, prickly heat appears in the form of multiple red dotted spots, then bubbles with milky-white contents appear on their surface. The rashes are localized on the torso, in the folds of the skin, and on the scalp.
explain Epidemic pemphigus
-Epidemic pemphigus of newborns (pyococcal pemphigoid, pyococcal pemphigus) is a superficial purulent skin lesion that appears on the 3-5th day, less often on the 8-15th day after birth. It is characterized by the appearance of disseminated “flaccid” blisters (phlycten) ranging in size from a pea to a hazelnut with cloudy contents on non-infiltrated skin. In place of the opened blisters, wet erosions with remnants of a covering of exfoliated epidermis are observed, on the surface of which crusts do not form.
-The period of blistering lasts from several days to 2-3 weeks. The rashes are localized on the skin in the navel, lower abdomen, anogenital area, area of natural folds, and with extensive damage - on the skin of the chest, back, limbs, rarely - on the palms and soles. The disease occurs with an increase in body temperature. Epidemic pemphigus is highly contagious to newborns. Infection of newborns occurs from mothers and medical workers suffering from pyoderma.
explain Ritter’s exfoliative dermatitis (acute neonatal epidermolysis)
Ritter’s exfoliative dermatitis (acute neonatal epidermolysis) is the most severe form of neonatal staphyloderma and is considered a severe variant of epidemic pemphigus neonatorum. Caused by staphylococcus
-There are three stages of the disease - erythematous, exfoliative and regenerative.
explain Staphylococcal Scalded
-Staphylococcal Scalded Skin Syndrome is a skin lesion similar to exfoliative dermatitis, observed in children aged 1 month to 5 years. The disease is associated with staphylococcal infection
explain Furuncle
-Furuncle is a purulent-necrotic inflammation of the hair follicle and surrounding subcutaneous fat. It is characterized by the formation of a cone-shaped pustule with the formation of a necrotic core and an area of inflammation, swelling, and pain on palpation of the skin around the lesion. An ulcer forms at the site of the detached necrotic core.
explain Furunculosis
-Furunculosis is characterized by the appearance of multiple boils in limited areas and may be disseminated. Relapses of the disease are possible over a period of several weeks to several years.
explain Carbuncle
-Carbuncle is a conglomerate of boils, combined general infiltrates. It is a dense dark red or purple nodule with a diameter of 5–10 cm, indistinctly separated from the surrounding tissue, on the surface of which there are several pustules. After opening, this pustule formed deep tissue necrosis with the formation of a deep, extensive ulcer.
explain skin abscess
-A skin abscess is a circumscribed purulent inflammation accompanied by necrosis. The causative agent of the disease is S. aureus. Localized in the dermis and subcutaneous tissue, muscle tissue may be affected. It is characterized by the appearance of a painful node followed by the formation in the center of the element of a cavity filled with pus. A formed abscess is characterized by fluctuation.
explain Pseudofurunculosis
Pseudofurunculosis (multiple abscesses of newborns) occurs in children in the first months of life, often against the background of dystrophy, with concomitant severe diseases (pneumonia, anemia). The causative agent of the disease is S. aureus or its association with other pathogens. It is characterized by the appearance of subcutaneous nodes ranging in size from a pea to a hazelnut, purple-red with a bluish tint.
-The rashes are localized in the back of the head, back, buttocks, and back of the thighs. There is a fluctuation in the center of the nodes; when the nodes are opened, yellow-green, creamy pus is released. No necrotic core is formed. After the process resolves, scars remain, since the entire eccrine sweat gland is affected.
