deep pustulosis
Introduction
Introduction to deep impetigo Deep impetigo (ecthyma), also known as acne, is a deep impetigo caused by hemolytic streptococcus infection. The basic damage is pustules and ulcers covered by adhesive sputum, mainly invading the calf. Common in poor nutrition and chronic illness, the body is scarred and pigmented. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: acute nephritis, sepsis, pneumonia
Cause
Cause of deep impetigo
(1) Causes of the disease
The pathogen is -hemolytic streptococcus, and a few lesions can produce coagulase-positive Staphylococcus aureus, which is often thought to be caused by secondary infections. It is more common in poor sanitation, malnutrition, and anemia associated with chronic wastage. The disease can also be secondary to minor trauma, pruritic skin disease and the like.
(two) pathogenesis
The basic damage is pustules and ulcers covered by adhesive sputum, mainly invading the calf. It is common in those with poor nutrition and long-term illness, and scars and pigmentation are left behind. A few cohesive enzymes can be cultured in a few lesions. Staphylococcus aureus, often thought to be caused by secondary infections, more common in poor sanitation, malnutrition, anemia associated with chronic wasting disease, can also be secondary to minor trauma, pruritic skin disease.
Prevention
Deep impetigo prevention
To pay attention to hygiene, remove the cause, strengthen nutrition, enhance the body's resistance, actively treat various chronic diseases and pruritic skin diseases that induce the disease, pay attention to skin hygiene, prevent isolation in kindergartens and baby rooms, prevent expansion of infection, and itching Sexual skin diseases, trauma should be given active treatment, increase nutrition and enhance physical resistance.
Complication
Deep impetigo complications Complications acute nephritis septic pneumonia
There is mild pigmentation around the scar, and there is no systemic symptoms. If the patient is weak, the body's immune function is low, the skin lesions develop rapidly, and may be accompanied by fever, toxemia, etc., nearby lymph nodes may be swollen, and individual necrosis occurs. Ulcers, sometimes accompanied by acute nephritis, sepsis, pneumonia and death, may be complicated by glomerulonephritis, severe cases may have fever and sepsis.
Symptom
Deep impetigo symptoms common symptoms herpes redness lymph nodes swollen lower limbs erythema nodule pustules
The pathological changes of the disease can be seen as non-specific ulcers, and there are more neutrophils in the dermis and ulcerated basal serous exudation.
Clinical manifestation
From the beginning to the miliary to pea mound herpes, it quickly turns into mung bean to pea-sized pustules, the base has inflammatory infiltration, gradually enlarges and develops deep, forming ulcers, the edges are neat and steep, surrounded by edematous redness, severe cases The skin is thick and has a clam shell shape. The peeled suede can be seen on the bottom of the ulcer with gray-green pus and granulation, conscious pain, often accompanied by swollen lymph nodes, which occur in the calf, but also in the femur, waist, buttocks, etc. The number of damages is uncertain. It has its own inoculation characteristics. The course of disease is 2 to 4 weeks. The scar remains after the ulcer is healed. Due to self-inoculation, new damage is continuously generated. If the treatment is improper, the course can be prolonged, and the glomerulonephritis can be complicated. In severe cases, there may be fever and sepsis. In malnourished children, deep penetrating abscesses, called ecthyma terebrant infantum, may be formed.
Examine
Deep pustulosis examination
Beta-hemolytic streptococcus can be found in the pus, and thrombin-positive Staphylococcus aureus can be positive in the case of infection.
Histopathological examination: see non-specific ulcers, epidermis, dermal necroinflammation, and more neutrophil infiltration.
Diagnosis
Diagnosis and differentiation of deep impetigo
diagnosis
According to the clinical manifestations of easy diagnosis, Chinese medicine believes that the body is qi deficiency, re-sensitization, dampness and heat, evil spirits, positive and evil spirits, can not be out of poison, out of poison and evil invagination.
Dialectical analysis: local inflammation is obvious, the secretion is thin and purulent after rupture, or bloody, often forming shallow ulcer, sore surface is not easy to heal, may also be accompanied by systemic burnout, weakness, low fever and other symptoms, pale tongue, Moss white or yellow, pulse Shen string micro, dialectical is qi and blood weakness, relapse of poison and evil, causing skin ulceration.
Differential diagnosis
Mainly should be identified with the following diseases:
1. Impetigo damage is superficial, with blisters, pustules are waxy yellow, but no ulcers are formed, no scars are left behind, and the infection is large.
2. The inflammatory infiltration is obvious, the pain is obvious, there is a central pus, and there is a jump pain after the pus matures.
3. Chronic calf ulcers are often secondary to varicose veins of the calf, with a longer course.
4. Allergic vasculitis is mainly characterized by erythema, papules, nodules, ulcers and other polymorphic lesions. There are systemic symptoms. Pathological examination shows changes in fibrin-like degeneration and necrotic vasculitis in the vessel wall.
5, infectious impetigo mainly manifested as superficial pustules and purulent sputum, no ulcer after the recovery, occurs in the exposed area.
6, skin allergic vasculitis rash polymorphism, there are papules, erythema, cyanosis, nodules, ulcers, etc., pathological examination of dermal vasculitis of small vascular small blood vessels.
