Pyoderma in children

Pyoderma is one of the three most common childhood skin diseases along with scabies and fungal infections of the skin. As practice shows, it is impossible to completely protect a child from an illness, and at least once in their life children are faced with this unpleasant and rather painful phenomenon. We will tell you about how to recognize pyoderma and how to treat it in this article.

What it is?

Translated from ancient Greek, the term "pyoderma" literally means "purulent skin". This fully reflects the essence of the disease. Pustules appear on the skin due to the penetration of bacteria into it - cocci. These are very common pathogens that literally surround a person, even if he is very sensitive to personal hygiene.

Globular cocci bacteria can infect not only children, but also adults, but in childhood, the disease occurs ten times more often due to the physiological characteristics of children's skin. It is more delicate, thin, vulnerable, its protective functions are significantly reduced in comparison with the skin of an adult. The child's local immunity is less developed, and therefore the body often cannot resist the penetration of foreign and aggressive bacteria. The younger the child, the weaker the protective functions of his skin, and therefore pyoderma, like other dermatological diseases, is especially dangerous for children under one year old, whose local immunity is practically not developed.

According to medical statistics, annually in the world more than 100 million children fall ill with pyoderma. Moreover, the incidence rate in developed countries is no less than that in third world countries. But there is a certain climatic factor that influences not even the incidence of the disease, but the severity of its course.

In hotter countries and regions, especially in countries with tropical and subtropical climates, pyoderma in children is more pronounced and difficult.

Causes

Pyoderma can develop primarily on perfectly healthy skin, and also become a complication of any skin ailment, accompanied by a symptom such as itching. A child with an itchy disease (for example, with dermatitis or scabies) scratches the skin, violating its integrity. The resulting wound is an excellent breeding ground for cocci. Pyoderma usually affects the skin, which has scratches, cuts, abrasions or other lesions - burns, frostbite areas. Bacteria - staphylococci, streptococci and other representatives of this family, getting on the wound surface, quickly begin to multiply, causing suppuration.

Sometimes the starting mechanism that makes the skin vulnerable to cocci is violation of the temperature regime - if the baby is overheated and sweaty or cold, overcooled, then the local immunity weakens, and pathogenic bacteria rather quickly begin to "master" the pores and hair follicles. Weakness of local cutaneous immunity it can also cause some damage to the central nervous system, metabolic diseases, pathology of internal organs.

Quite often, babies with diabetes mellitus are susceptible to pyoderma.

Rarely enough, but it also happens that a child has an increased individual sensitivity to pyogenic bacteria. His appearance of pustules is always accompanied by signs of an allergic reaction, and the pustules themselves are quite large. All the reasons that can cause pyoderma are usually divided in medicine into endogenous (internal) and exogenous (external). Other internal reasons, in addition to those listed above, can be indicated as follows:

congenital diseases associated with immunodeficiency;
weakness of immunity after an illness;
a state of hypovitaminosis (deficiency of vitamins important for the development of a child).

External factors that contribute to the multiplication of disease-causing cocci are as follows:

damage to the integrity of the skin;
non-observance of hygiene rules, insufficient care of the child's skin;
rather close contact with a person who is sick with a bacterial infection, the use of common toys, things, dishes, bed linen (pyoderma is contagious!);
contact with a person who is not sick at the moment, but is a carrier (one that has recently had a bacterial infection, sometimes a hidden carrier);
psychological trauma, a state of severe or prolonged stress, overwork of the child;
inadequate nutrition, improperly composed diet, rich in carbohydrates and fats.

Separately, it should be noted that a violation of hygiene should not be regarded as the main cause of the disease. Parents whose child is sick with pyoderma usually begin to blame themselves for not overseeing.

Washing hands with soap, daily water procedures, of course, reduce the risk of developing pyoderma, but do not exclude it. And therefore, often in a prosperous family, where the child is well-groomed and surrounded by care, they are faced with such an unpleasant bacterial infection.

Classification

If the disease struck the child for the first time, and the parents quickly went to the doctor, then we are talking about acute pyoderma. If the baby often suffers from pustular diseases, and they are difficult to treat, then this is chronic pyoderma. If only one area of the skin is affected, for example, pustules appear in the nose or on the hands, then they speak of a localized form of the disease. If pustular lesions are present on two or more parts of the body, this is a diffuse form of pyoderma.

Purulent formations can be superficial if they affect only the outer layer of the epidermis, and deep if hair follicles and dermis are involved in the inflammatory process. The main classification concerns the causative agent of inflammation. For proper treatment, it is very important to know which microbe caused the painful process. There are three most common types of pyoderma:

staphylococcal;
streptococcal;
streptostaphyloderma (with simultaneous infection with both staphylococci and streptococci).

The danger

Acute pyoderma is not as dangerous as one might think. The sick person poses a real threat to others, because he becomes a source of infection. If it is not isolated during treatment, then the spread of bacterial infection is inevitable.

The forecasts of doctors regarding this disease are quite favorable. Timely, correctly treated pyoderma does not give complications, does not recur. However, chronic forms of the disease can significantly complicate the child's future life, especially if he has other serious diseases. Pyoderma in this case can often make itself felt, and in severe form lead to sepsis.

A dangerous disease can be for infants, if parents do not give it due importance. Their weak delicate skin is more quickly infected, pustular infections are very painful for children of the first month of life.

Symptoms and Signs

Outwardly, pyoderma is very similar to a lot of other dermatological diseases, and therefore it is quite difficult to recognize the disease and distinguish it from other skin ailments at home. Even a doctor will not be able to do this "by eye", since only laboratory diagnostics can confirm the origin of skin rashes, their belonging to the world of bacteria. However, parents need to know exactly when to see a doctor.

The symptoms of pyoderma are quite universal:

one or more pustules or bubbles with a cloudy liquid appear;
the rash can spread further, but can remain on only one part of the body;
rashes can be single, and can merge, forming an inflammatory layer that tends to "get wet";
most often in childhood, pyoderma begins on the scalp;
pyoderma on the face and neck is rarely deep.

The rash itself has its own characteristics. If you take a close look at it, then you can assume which microbe caused pyoderma.

Staphylococcus aureus most often affects the hair follicle and the surrounding space. In the abscess, therefore, if you look closely, you can see a growing hair in the center. This microbe causes a rather strong suppuration, which in a deep form will bear the name - a furuncle or carbuncle. Superficial staphylococcal inflammation is extremely rare.

Streptococcus is usually "based" on smooth skin, causing the appearance of blisters filled with cloudy serous fluid. There is always an inflammatory border around the vesicle. The bubble itself has very thin walls and bursts easily even with a slight touch. A yellowish-grayish crust appears in place of the bursting bubble. After falling off, it does not leave scars and depigmentation areas.

In its chronic form, streptococcal infection is called lichen simplex. In the acute stage, the microbe often causes impetigo, streptoderma and ecthyma. With a diffuse form of a bacterial disease, a child may have an elevated temperature (not higher than subfebrile values - 37.0-37.8 degrees). In newborns, the diffuse form of the disease can cause general symptoms of intoxication - lethargy, weakness, whims and almost unreasonable crying.

Diagnostics

If parents bring a child with a rash to the appointment, and the doctor suspects pyoderma, he will definitely prescribe several clinical studies that are important for understanding the ongoing processes. This is a general analysis of blood and urine, as well as blood to determine the Wasserman reaction (for syphilis). Specific diagnostics is based on taking a substance from vesicles on the skin or pustules for bacterial culture.

In laboratory conditions, the samples are placed in a nutrient medium and it is observed which microbe will grow. Then the grown bacteria are exposed to various antibiotics to determine which type of antimicrobial agents it is most sensitive to. For classical pyoderma, not complicated by serious diseases like HIV infection, this is quite enough to not only know the causative agent of the disease, but also to imagine how and how to treat it.

For classical pyoderma, not complicated by serious diseases like HIV infection, this is quite enough to not only know the causative agent of the disease, but also to imagine how and how to treat it.

Treatment

If pyoderma is detected as an independent disease, antibacterial drugs become the basis of therapy. What kind of funds will be prescribed for a particular child will be clear after receiving the results of the analysis for bacterial culture and the sensitivity of the microbe to antibiotics. If pyoderma has become a complication of another disease, for example, scabies, then treatment begins with the treatment of the main primary disease, dealing with pyoderma in parallel.

Staphylococci and streptococci have surrounded people for so long that they have already develop a certain "immunity" to most of the existing antibiotics. People themselves contributed to the resistance of microbes, taking antibiotics uncontrollably and for any reason. Now humanity has received what it has received - resistant bacteria, which are not easy to fight. That is why an analysis is carried out to determine which substance from the existing ones, the microbe will show the least resistance.

Usually, with pyoderma, doctors choose one or another drug from the penicillin group, macrolides or third-generation cephalosporins.

For a non-dangerous form of pyoderma, antibiotics can be prescribed in the form of an ointment for topical use. Taking antimicrobial drugs inside is indicated only for the diffuse form of the disease. At the same time, the use of ointment is shown at the same time. Acute pyoderma at home is treated according to the prescribed scheme for about 7 days. Chronic - longer, up to two weeks.

If a child has severe pyoderma, skin ulcers form, he will be shown treatment in a hospital, this is especially true for infants and children under three years of age. Along with antibiotic treatment, it is desirable for such patients to receive intravenous drugs that improve blood circulation, for example, Actovegin, Trental. To reduce the burden on the child's liver, one of the hepatoprotective drugs may be prescribed, for example Essentiale... All children with pyoderma are recommended to take B vitamins, especially B6 and B 12, as well as multivitamin complexes by age, which contain the necessary trace elements.

Chronic pyoderma with a deep course sometimes requires the use of ointments based on glucocorticosteroids. In the stage of exacerbation, the child is injected with "Prednisolone" in age-specific therapeutic doses for three days, after which the dosage of the drug is gradually reduced until it stops completely. Specific treatment is streptococcal and staphylococcal vaccines. External treatments for the child should be carried out 2-4 times a day. It should be remembered that alcohol-based agents against microbes are ineffective, and therefore you should not cauterize abscesses and pustules with alcohol-containing liquids.

It is best to carry out primary treatment using furacilin solution, 1% boric acid solution, 1% dioxidine solution or 2% chlorhexidine solution. If there are ulcerative crusts, then they are soaked and carefully removed before applying the ointment. Aniline dyes are very effective against streptococci and staphylococci - brilliant green, Fukortsin.

During treatment, the child is recommended to follow a diet. Parents should exclude carbohydrate foods, pastries, sweets from the baby's menu to the maximum. It is not recommended to wash and rub the affected skin with a washcloth during treatment.

Severe pyoderma - boils, carbuncles - sometimes require surgical treatment. The doctor under local anesthesia opens the abscesses, cleans out the cavities. After that, the treatment takes place according to the above scheme, with the use of antibiotics (systemically and externally), antiseptics, vitamins. After recovery, it is advisable to take the child to a course of ultraviolet irradiation. With chronic pyoderma - such courses are needed at least 2 times a year.

Prevention

The main preventive measure is vigilance. At the first signs of illness, it is necessary to exclude the child's communication with peers, attendance at kindergarten and school, so as not to spread the infection further. To reduce the risk of bacterial infection with wounds, abrasions and scratches (and there are many of them in a child!), Quick and correct treatment of the affected skin with antiseptics (not alcohol!) Will help.

The likelihood of developing pyoderma is lower in children whose parents care about strengthening their immunity, including local immunity. To do this, they practice pouring, rubbing, hardening from an early age, walking in the fresh air, playing sports. The child should be dressed for the weather and the house should not be too hot - sweating increases the risk of pyoderma.

All foci of inflammation, even minor ones, should be treated as quickly as possible. This also applies to the oral cavity of the child. The baby must receive a sufficient amount of vitamins, as well as comply with mandatory hygiene requirements.