Local treatment of erysipelas. How to treat erysipelas of the leg at home

Erysipelas is a dangerous infectious disease that affects the skin and the tissue located underneath it. The disease does not go away on its own and requires mandatory medical intervention and treatment.

Causes

Inflammatory processes can occur at any age. This rapidly spreading disease is caused by streptococci. For the development of erysipelas on the leg, it is not enough for microorganisms to enter the skin, because not everyone who gets streptococcus develops the disease. For the appearance of this disease, a number of factors are necessary that promote reproduction:

Mechanical damage:

scratches;
abrasions;
burns;
frostbite;
abrasions;
cuts.

Condition of the body leading to decreased immunity:

stress;
hypothermia;
overwork.

Diseases that increase the body's susceptibility to infections:

alcoholism;
diabetes;
obesity;
trophic ulcers;
diaper rash;
fungus;
phlebeurysm;
lymphatic edema.

The risk of developing erysipelas on the leg increases among representatives of certain professions. For loaders, military, builders there is increased danger for the occurrence and development of streptococcus in the skin due to the frequent likelihood of skin damage, pollution and abrupt changes temperature.

Symptoms of the disease

Distinguish different symptoms diseases erysipelas on the leg. Erysipelas, if it occurs in mild form– erythematous, often limited to only local manifestations: redness, swelling and soreness of the skin area. The peculiarity of this inflammation is its bright red color and clear boundaries of the inflammatory focus. In shape it resembles flames.

A more complex form is erythematous-bullous. In this case, on the first or third day of the disease, bubbles with clear liquid form at the site of the disease. They burst, forming crusts. Favorable treatment leads to healing and formation of young skin after it falls off. Otherwise, ulcers or erosions may form.

If antibodies damage the capillary vessels that arise to fight streptococcus, hemorrhage forms inside the affected skin. This form of the disease is called erythematous-hemorrhagic.

In the most severe cases, the lesion becomes covered with blisters into which blood seeps. This form is bullous-hemorrhagic.

In addition to the occurrence of a focus of the disease, the patient experiences the following symptoms:

weakness;
increased body temperature;
chills;
headache and muscle pain;
nausea or vomiting;
possible tachycardia.

These signs are common for an organism that has been intoxicated. Before an obvious focus of the disease appears, swelling and redness form on the leg. At the site of inflammation, pain, skin tension and burning are felt.

Drug treatment

How to cure erysipelas on the leg? Before starting treatment for the disease, consultation with a doctor is required. Otherwise, complications may occur. Severe form of the disease in mandatory serves as a reason for hospitalization. The patient is subject to inpatient treatment if:

the disease is accompanied by diabetes mellitus, allergic reactions, kidney, heart or vascular diseases, lymph circulation disorders;
erysipelas occurred in a child or an elderly person;
ulcers or rough scars have appeared on the skin;
the disease manifests itself repeatedly, regardless of the form of its course;
erysipelas caused any kind of complication.

Treatment of erysipelas on the leg is necessarily accompanied by antibiotics. To maximize their effect, the doctor must first find out the most effective of them in each specific case. For this purpose, an anamnesis must be collected. Of all the groups of antibiotics, the most commonly used are:

sulfonamides;
macrolides;
tetracyclines;
penicillins.

Treatment is also necessarily accompanied by other means:

Ascorbic acid or ascorutin;
Nicotinic acid and vitamins A and B;
Biostimulants;
Drugs that enhance immunity;
Physiotherapy and cryotherapy.

Treatment with folk remedies

A mild form of erysipelas on the leg is completely curable at home under the supervision of a doctor. In addition to medications, treatment is also acceptable traditional methods. As a rule, these are various compresses. It will lead to relief from erysipelas next procedure. Moisten a cloth in cool water (about 22 degrees) and wrap it around your leg on the affected area. Another piece of cloth is placed on top, which must be moistened in water cooled to 16 degrees. After this, the leg is wrapped in dry woolen cloth. After heating, usually after a quarter of an hour, the bandage must be changed.

Many remedies are used to treat erysipelas. Among them are chalk, rye flour, currant and elderberry branches and leaves, cabbage leaves, cottage cheese and even frog caviar. When using any traditional methods, consultation with a doctor is required. As a result of improper treatment, dangerous complications are possible that can lead to serious consequences and even death.

Some people prefer prayers for erysipelas on the leg. This is not the most the right way, in case of illness, consultation with a specialist is mandatory.

Danger of infection

If you get sick, you should remember that erysipelas on the leg is contagious to others. The disease can be transmitted by airborne droplets, through touch or household objects. Therefore, the patient should be in isolation.

Prevention of the disease

To prevent the appearance of erysipelas on the legs, and especially if you are predisposed to the disease, you should follow simple rules:

the wound and any damage to the skin must be disinfected and dirt must not be allowed to enter;
avoid the formation of calluses with uncomfortable shoes;
if a skin disease occurs, begin treatment immediately;
avoid sudden changes in temperature conditions;
be observed by a doctor after suffering from erysipelas for two years.

At the first signs of illness, you should immediately seek medical help. Timely treatment will prevent the formation of severe forms of the disease and will not cause difficulties. Treatment of wounds and any skin lesions- An excellent way to prevent the occurrence of disease.

Candidate of Biological Sciences, certified treatment specialist erysipelas traditional methods:

Millions of people around the world become infected with infectious diseases every day. One of them is, for a long time now known to medicine, erysipelas.

In contact with

Erysipelas - what is it?

Erysipelas is an acute infectious disease caused by beta-hemolytic streptococcus. It is characterized by the appearance of redness on the skin, accompanied by elevated temperature and general intoxication of the body (including headache, weakness and nausea).

There are 2 forms of erysipelas:

Erythematous. In other words, the initial stage. The patient experiences a burning sensation, pain, and the area of inflammation becomes swollen and hot. Sometimes pinpoint hemorrhages occur.
Bullous. Characterized by the presence of bubbles containing clear liquid. After a few days they dry out, forming a crust on the skin.

In both forms, inflammation is accompanied by damage lymphatic system.

Important! Primary erysipelas most often appears on the face, but relapses of the disease are “favored” lower limbs person. The duration of the disease is 5 - 8 days. Residual manifestations of erysipelas can remain for life if you do not seek the help of cosmetologists.

Features of the structure of the skin on the legs, arms and face

Skin is the biggest human organ, consisting of three layers. It weighs approximately 15% of total mass bodies. On her legs, arms and face she has various features buildings. For example, the skin on the soles of the feet has high concentration sweat pores This is where its layers are thickest.

Absent in the skin on the palms hair follicles And sebaceous glands. Inner side The hand is characterized by great elasticity, thinness and softness. On the face, or rather on the eyelids, is the most thin layer skin all over the human body. In the area of the eyelids, ears, forehead and nose skin does not have a lower layer. Facial skin is the most susceptible to aging.

Causes of the disease

Erysipelas - is it contagious to others? The cause of the disease is streptococcal infection, caught in soft tissue. Its source is streptococcus carrier. More often " front door» for microorganisms in the human body are minor injuries, abrasions, cuts in the skin or mucous membranes.

Who is at risk?

According to statistics, most often erysipelas disease people over 18 years of age are affected. Moreover, in 65% of cases, doctors diagnose erysipelas in people over 50 years of age. Often, men and women whose work involves microtrauma and skin contamination become infected. Erysipelas can also be caused by neglect of personal hygiene.

Symptoms of erysipelas

There are 7 main symptoms of erysipelas:

Development of fever(convulsions, delirium).
Manifestation of symptoms of intoxication(including headache, chills).
On limited areas of skin there is a burning sensation, itching. Appear painful sensations when interacting with this area. Over time, the skin becomes redder. After a few days, swelling occurs and the pain intensifies.
Insomnia.
Fever.
Nausea and vomiting.
Muscle weakness.

Erysipelas in a child - the first signs

Erysipelas in children almost always occurs in the spring and autumn. The initial phase in children passes faster and more acutely than in adults. However, the first signs and symptoms of the disease are the same. Distinctive feature The only problem is heartburn, which 99% of children infected with the infection experience.

Important! Girls get sick twice as often as boys.

Diagnostic measures

Diagnosis of erysipelas is based on clinical symptoms and according to the results laboratory tests, which indicate the presence bacterial infection. After this, the dermatologist draws up a treatment plan.

Treatment

How to treat erysipelas? There are several methods for treating erysipelas. All of them are divided into 3 types:

Drug treatment. It has been scientifically proven that hemolytic streptococci, which provoke the disease, have high sensitivity to nitrofurans, penicillin antibiotics and sulfonamides. This means that they will be useful in the fight against the disease medications, which contain: penicillins, erythromycin, oleandomycin, clindamycin. They can be taken either orally or by injection. Treatment lasts 5-7 days. After 1-3 days from the moment it began, the temperature returns to normal, the inflamed areas gradually turn pale. After 10 days, the antibacterial agent Biseptol is prescribed. For topical use, that is, directly for use on affected areas of the skin, the doctor prescribes erythromycin ointment and powder in the form of crushed tablets, which contain enteroseptol. Drug treatment is often supplemented with biostimulants and vitamins.
Physiotherapy. In this case, we are talking about ultraviolet irradiation, which has a bacteriostatic effect on active bacteria. It is often prescribed to patients with erythematous erysipelas. In the treatment of relapses of the disease, ultra-high frequency and laser therapy. But short-term freezing with a stream of chlorethyl surface layers skin until whitening, in combination with antibacterial therapy, is practiced in cases where the disease is particularly acute.
Surgery . It is worth noting that the need for this method of treatment arises when the patient has a bullous form of erysipelas or purulent-necrotic complications arise. During the operation, the bullae are opened and the pathological fluid is evacuated. Only antiseptic agents are used locally.

Prevention

First of all, you need to ensure cleanliness skin, process various wounds and cracks, treat promptly pustular diseases. And also, during medical manipulations, observe asepsis and use only sterile instruments. Then the risk that a person will experience erysipelas is minimized.

Consequences of erysipelas

Besides the typical residual effects erysipelas, which include peeling of the skin and its pigmentation, more serious consequences may become lymphedema, that is, accumulation rich in protein fluids in the interstitial space. In this case it is necessary surgical intervention in combination with physical anti-edematous therapy.

Skin restoration after illness

Both cosmetology and independent fight against the consequences of the disease can help restore the skin after erysipelas. Before using any medications, it is better to consult a specialist.

Treatment of erysipelas at home - folk recipes

To combat the disease at home, they often use:

Pork fat . Apply it to the affected skin 2 times a day.
Kalanchoe juice . It is preserved with alcohol to a strength of no more than 20%, then a napkin is dipped in it and in a five percent novocaine solution, after which it is applied to the inflamed area.
Plantain. The plant is crushed and mixed with honey. After this, boil and apply a bandage with cooled ointment to the skin, changing it every 4 hours.

Important! Some of the remedies that people have been using at home to treat erysipelas for several centuries not only do not contribute to recovery, but can also cause further damage. more harm human health. These include, for example, injecting the affected area of skin with mercury salts.

Video: erysipelas in adults - causes and treatment.

How to treat erysipelas on the leg? This is far from an idle question. The infection enters the body through damaged skin: scratches, wounds, cracks, abrasions, abrasions, calluses. And such damage happens to everyone.

Erysipelas (or erysipelas)– serious illness. It is caused by a streptococcal infection (hemolytic streptococcus). The name comes from the French word rouge- "red". The Greek name for the disease is " erysipelas" means "red skin", which is completely consistent external condition skin during the acute stage.

The disease is characterized by local inflammation of the skin and mucous membranes, elevated temperature, and symptoms of intoxication of the body. Erysipelas most often affects the face and lower extremities. Due to the nature of infection, the legs belong to the zone increased risk. Cases of erysipelas on the legs are not uncommon in older people and people with limited mobility.

Causes of the disease

The presence of staphylococcus in the human body does not always lead to disease; bacteria begin to actively develop only under certain conditions.

Factors contributing to infection:

Diseases that cause damage and nutritional disorders of the skin: foot fungus, diabetes, excess weight, vein problems, alcoholism, tropical ulcers, immunodeficiency.
Permanent injuries caused by professional reasons: work activity associated with constant contamination of the skin, wearing rubber or uncomfortable shoes for a long time, etc.
Weakening of the body and decreased functions immune system as a result of surgery, long-term illness, hypovitaminosis, hypothermia, as well as in old age.
Presence in the body chronic infections(tonsillitis, otitis, caries).

Symptoms of erysipelas

The period from infection with streptococcus to the appearance of the first signs of illness can take up to ten days.

On initial stage felt:

general weakness
loss of strength, lethargy
headache
chills
muscle pain
poor appetite, nausea
digestive problems (vomiting, diarrhea)
high body temperature

The inflammation progresses rapidly, requiring surgical drug treatment, which is considered the most effective for this disease.

A day after the first symptoms of the disease appear, the affected area turns red and the skin becomes painful.

There is swelling, a feeling of skin tightness, and a burning sensation. Blisters filled with liquid (transparent or with blood), peeling and peeling of the top layer of skin may also appear.

In especially severe cases, patients experience: convulsions, fainting, loss of orientation, indicating disturbances in activity central nerve systems.

How to treat erysipelas on legs

This is unpleasant and painful and many people treat it at home. Apply medical supplies, traditional medicine, various ointments.

Visit to the doctor - required condition Successful disposal of this infectious disease! Acute course illness leads to mandatory hospitalization of the patient.

Therapeutic treatment with antibiotics

They carry out a course of antibiotic therapy and prescribe injections. In particularly severe and advanced cases, medications are administered intravenously. Minimum rate therapeutic treatment– 7 days; in case of complications, treatment – two weeks or more.

Patients may be prescribed erythromycin, penicillin, tetracycline, chloramphenicol or lincomycin. Which antibiotic is suitable in a particular case can only be determined by a doctor based on test results. Good results gives A complex approach when complex treatment: drugs that improve immunity and anti-inflammatory drugs are prescribed with antibiotics. Vitamins are also recommended.

Physiotherapy gives a good effect and relief in the treatment of erysipelas: electrophoresis and ultraviolet irradiation. If the lower extremities are affected, ozokerite applications or dressings with hot naphthalan ointment are indicated.

Bactericidal ointments and solutions

The use of ointment gives a good result if it is necessary to destroy pockets of bacteria on the skin, reduce itching, reduce painful sensations that occur with erysipelas. Erythromycin ointment is used to treat erysipelas.

In the bullous form of the disease, the surgeon dissects the blisters and removes their contents. After the operation, a bandage is applied, which is soaked in a solution of furatsilin or rivanol.

For the erythematous-hemorrhagic form, dibunol liniment is applied twice a day, which actively stimulates skin regeneration processes.

Homemade ointments are used to treat erysipelas. For getting medicinal ointment chamomile or yarrow juice is mixed with fresh butter in a ratio of 1:4. The ointment is applied to the affected areas of the skin three times a day.

In the absence of complications, Vishnevsky’s ointment (balm) can be used to treat erysipelas on the leg. Apply it to a gauze bandage (bandage), and then apply it to the infected area of the leg and bandage it. The dressing should be changed every 12 hours. At severe forms This balm is not used for erysipelas.

Streptocide

Streptocide is used in the form of powder (powder), tablets, ointments. It is capable of destroying streptococcus. Use orally as prescribed by a doctor.
You can also use streptocidal ointment (10%).

For erysipelas, the ointment is applied to the affected skin of the leg or to a gauze bandage that is applied to the inflamed area. Very effective dusting of wounds with sterile streptocide powder.

Conclusion

Now you know how to treat erysipelas on your leg at home, but I want to say that conspiracies will not help. But don’t forget: erysipelas is enough insidious disease which requires specialist advice. If health care will not be provided on time or the treatment will not be correct, an infection can provoke serious complications which can cause health problems, disability and even death.

Doctors warn! Shocking statistics - it has been established that more than 74% of skin diseases are a sign of parasite infection (Accarida, Giardia, Toxocara). Worms cause enormous harm to the body, and the first to suffer is our immune system, which should protect the body from various diseases. The head of the Institute of Parasitology shared the secret of how to quickly get rid of them and cleanse your skin, it turns out that it’s enough...

Erysipelas, or erysipelas, is an infectious-allergic skin disease caused by group A beta-hemolytic streptococcus. It ranks fourth in prevalence among all infections, second only to intestinal and respiratory diseases, and viral hepatitis. Why is this disease so common? From erysipelas people with weakened immune systems suffer

Causes of erysipelas

Erysipelas is a very interesting infectious disease. It is distributed throughout the world, but it does not have a natural focus. Erysipelas is caused by group A beta-hemolytic streptococcus, a special microorganism that lives on human skin. It has been noted that people living in northern latitudes more often suffer from erysipelas. This trend is easily explained: streptococcus, which causes inflammation, does not like high temperatures and is not able to multiply when the thermometer is above 45 degrees.

Erysipelas is not very contagious, so epidemics of this disease has not been noted so far. Hemolytic streptococcus enters the body through the skin and mucous membranes, and this is what determines the main symptoms of erysipelas. The infection always develops in people with reduced immunity. People who do not have problems with the body's defense system become carriers of bacteria. Streptococcus is transmitted by airborne droplets from coughing and sneezing, as well as through household items. Even a simple handshake with someone with erysipelas can cause infection.

Constant stress inevitably lead to weakening protective barriers body

Risk factors

Most often, the disease develops in women over 50 years of age. Men are also susceptible to this infection, but among them the pathology occurs in more early age. Risk factors that provoke the appearance of erysipelas include the following conditions:

chronic diseases;
stress;
constant trauma to the skin;
bruises and fractures;
sudden temperature changes.

Regardless of the cause of the disease, erysipelas occurs against the background of reduced immunity. This is why symptoms of erysipelas are most often observed in pregnant women and elderly people whose protective system The body is unable to cope with an aggressive infection. The severity of symptoms and the incidence of complications do not depend on the location of the process.

Leg skin with erysipelas infection

Symptoms of inflammation

The infectious process can affect the upper and lower extremities, face, torso, and perineum. The most common inflammation of the leg is erysipelas. The disease always begins acutely with an increase in temperature to 38-40 degrees. The fever lasts about 10 days, accompanied by severe chills that shake the whole body. In some cases, there is a disturbance of consciousness, delirium, and convulsions. This patient’s condition is associated with the release of toxins produced by beta-hemolytic streptococcus into the blood.

The symptoms that occur during the development of erysipelas are associated with damage to the skin and subcutaneous fat. An infectious process affecting the lower extremities usually manifests itself in the form of erysipelas of the lower leg. IN in rare cases hips or feet are affected. The manifestations of erysipelas are quite specific, and diagnosis does not require any additional research. Let's list characteristic features erysipelas infection.

Hyperemia (redness) of the skin

This symptom appears 10-12 hours after the onset of fever. The skin is bright red, the color is uniform, without transitions. Hyperemia is associated with dilation of skin vessels due to their damage by streptococcus. The area of redness gradually grows, capturing new areas. Antibiotics used for erysipelas help stop the spread of infection. With timely treatment, the skin gradually turns pale, and after 7-10 days there is no trace of redness left. At the site of hyperemia, peeling appears and persists for two weeks.

Typical appearance changed skin

The inflamed area looks like flames or geographical map. A ridge forms around the focus of hyperemia, rising above healthy skin. It is worth noting that in this place the bacteria are most active and the patient feels severe pain at the edges of the inflammation. The skin at the site of the lesion is swollen. These symptoms allow special problems recognize erysipelas of the lower leg and prescribe antibiotics in time to stop the process.

Increase in regional lymph nodes

There's no such thing infectious process, which would not lead to changes in the lymph nodes at the site of the lesion. In erysipelas, the lymph nodes are painful, swollen, and fused together. In rare cases, the infection is complicated by lymphostasis - stagnation of lymph in the vessels.

Possible complications

Timely prescribed antibiotics allow you to cope with the disease within 7-14 days. If therapy was not started in the first days or the drugs selected to treat the infection were not effective, the following complications develop:

hemorrhages in the skin and subcutaneous fat;
the formation of large blisters filled with clear or purulent contents;
spread of the process over the entire surface of the lower extremities, transition to abdominal wall and crotch.

Erysipelas of the legs with this option is much more severe and very often leads to relapse of the disease. In this case, new foci of infection may appear in the same place or choose a different affected area.

Penicillin is most often used to treat erysipelas.

Treatment of inflammation

Erysipelas is infectious pathology, and are actively used for its treatment antibacterial agents. Only properly selected antibiotics can cope with streptococcus and reduce the likelihood of complications. How is the treatment of a dangerous infection carried out?

Treatment of erysipelas begins with the choice of antibiotics. Drugs commonly used penicillin series. They destroy the cell wall of bacteria, acting on both mature forms of streptococcus and those that reproduce. Antibacterial drugs prevent the spread of infection, reduce pain and swelling of the skin. They are administered intramuscularly, the course of treatment ranges from 7 to 14 days.

If you are intolerant to penicillins, antibiotics from the group of tetracyclines or macrolides are prescribed. The mechanism of action is the same, the duration of therapy depends on the degree of damage and the presence of complications. Unlike penicillins, these drugs are better tolerated by patients and are less likely to cause adverse reactions.

To prevent relapses of the disease and restore general condition, additional drugs are prescribed:

antihistamines (antiallergic) agents that reduce skin swelling;
glucocorticosteroids - in case of risk of developing lymphostasis (stagnation of lymph in the affected organ);
immune system stimulants that restore skin regeneration;
vitamins and enzymes to maintain general tone body.

Local treatment of erysipelas

How to treat erysipelas on the leg other than using oral medications? To treat the skin at the site of the lesion, a 50% dimexide solution is most often used. This drug helps relieve inflammation, reduces pain and swelling, and also has good antimicrobial effect. Bandages with antiseptic solutions (for example, furatsilin) that can fight bacteria in the subcutaneous tissue are actively used. Enteroseptol powder applied to clean, dry skin twice a day has proven itself well.

Important!

When treating erysipelas, it is prohibited to use any ointment dressings! This method only worsens the patient’s condition and can cause the development of an abscess - purulent complication at the site of inflammation.

A compress of grated potatoes will help alleviate the disease.

Treatment of erysipelas on the legs with folk remedies

Many patients are concerned about the question: is it possible to cure erysipelas at home? This is not surprising, because the use of antibiotics does not always have a good effect on the body, and many people want to avoid unpleasant side effects from exposure to penicillin. Doctors say that erysipelas can be treated with folk remedies only if the process is uncomplicated. This means that the temperature should not rise above 39 degrees. Convulsions, confusion and other signs of severe inflammation are unacceptable. With the development of hemorrhages, joining purulent infection Trying to cure erysipelas at home should be abandoned.

good folk remedy A compress using raw potatoes. To do this, the vegetable should be finely grated, wrapped in a cloth and applied to the affected area of the leg. A good effect was noticed when using cabbage leaves. To lubricate the shins, you can use tincture of valerian, eucalyptus or chaga. These drugs are available at any pharmacy without a prescription.
Famous the folk way To get rid of erysipelas on the legs, use juniper infusion. Two tablespoons of the plant are poured with boiling water, cooled and applied to the sore limb several times a day. Similar effect can be achieved using an infusion of a mixture of chamomile, sage, plantain and St. John's wort.

Interesting fact: although erysipelas is considered infectious disease, but at the same time responds quite well to treatment with traditional methods. Traditional medicine explains this by the fact that during treatment with herbs, stress is relieved, which causes a decrease in immunity and the development of pathology. The main thing is not to get too carried away with healing and carefully monitor general condition. If your health worsens and complications develop, you should seek help from a qualified doctor.

Patients with erysipelas are less contagious. Women get sick more often than men. In more than 60% of cases, erysipelas occurs in people aged 40 years and older. The disease is characterized by a distinct summer-autumn seasonality.

Symptoms of erysipelas

The incubation period of erysipelas ranges from several hours to 3-5 days. In patients with a relapsing course, the development of the next attack of the disease is often preceded by hypothermia and stress. In the vast majority of cases, the disease begins acutely.

The initial period of erysipelas is characterized rapid development general toxic phenomena, which in more than half of patients precede the occurrence of local manifestations of the disease by several hours to 1-2 days. Marked

headache, general weakness, chills, muscle pain
25-30% of patients experience nausea and vomiting
already in the first hours of illness the temperature rises to 38-40°C.
In areas of the skin in the area of future manifestations, a number of patients develop a feeling of fullness or burning, and mild pain.

The height of the disease occurs within a period of several hours to 1-2 days after the first manifestations of the disease. General toxic manifestations and fever reach their maximum. Characteristic local manifestations occur.

Most often, erysipelas is localized on the lower extremities, less often on the face and upper limbs, very rarely only on the torso, in the area of the mammary gland, perineum, and in the area of the external genitalia.

Skin manifestations

First, a slight red or pink spot, which within a few hours turns into a characteristic erysipelas. Redness is a clearly demarcated area of skin with uneven boundaries in the form of teeth, “tongues”. The skin in the area of redness is tense, hot to the touch, moderately painful when touched. In some cases, a “marginal ridge” can be detected in the form of raised edges of redness. Along with redness of the skin, swelling develops, spreading beyond the redness.

The development of blisters is associated with increased effusion at the site of inflammation. If the bubbles are damaged or spontaneously rupture, fluid leaks out, and in place of the bubbles, superficial wounds. While maintaining the integrity of the blisters, they gradually shrink to form yellow or brown crusts.

The residual effects of erysipelas, which persist for several weeks and months, include swelling and pigmentation of the skin, dense dry crusts in place of the blisters.

Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Diagnosis of erysipelas

Diagnosis of erysipelas is carried out by a general practitioner or infectious disease specialist.

Definite diagnostic value have increased titers of antistreptolysin-O and other antistreptococcal antibodies, detection of streptococcus in the blood of patients (using PCR)
Inflammatory changes in general analysis blood
Disturbances of hemostasis and fibrinolysis (increased blood levels of fibrinogen, PDP, RKMP, increase or decrease in the amount of plasminogen, plasmin, antithrombin III, increased level of platelet factor 4, decrease in their number)

Diagnostic criteria for erysipelas in typical cases are:

acute onset of the disease with severe symptoms of intoxication, increased body temperature to 38-39°C and above;
preferential localization of local inflammatory process on the lower extremities and face;
development of typical local manifestations with characteristic redness;
enlarged lymph nodes in the area of inflammation;
absence of severe pain in the area of inflammation at rest

Treatment of erysipelas

Treatment of erysipelas should be carried out taking into account the form of the disease, the nature of the lesions, the presence of complications and consequences. Currently, the majority of patients with light current erysipelas and many patients with a moderate form are treated in a clinic. Indications for mandatory hospitalization in infectious diseases hospitals(branches) are:

severe course;
frequent recurrences of erysipelas;
the presence of severe common concomitant diseases;
old age or childhood.

Antimicrobial therapy occupies the most important place in the complex treatment of patients with erysipelas. When treating patients in a clinic or at home, it is advisable to prescribe antibiotic tablets:

erythromycin,
oletethrine,
doxycycline,
spiramycin (course of treatment 7-10 days),
azithromycin,
ciprofloxacin (5-7 days),
rifampicin (7-10 days).

If antibiotics are intolerant, furazolidone is indicated (10 days); delagil (10 days).

It is advisable to treat erysipelas in a hospital setting with benzylpenicillin, a course of 7-10 days. At severe course diseases, the development of complications (abscess, phlegmon, etc.), a combination of benzylpenicillin and gentamicin, and the prescription of cephalosporins are possible.

For severe skin inflammation, anti-inflammatory drugs are indicated: chlotazol or butadione for 10-15 days.

Patients with erysipelas need a vitamin complex for 2-4 weeks. In case of severe erysipelas, intravenous detoxification therapy is carried out (hemodez, rheopolyglucin, 5% glucose solution, saline solution) with the addition of 5-10 ml of 5% solution ascorbic acid, prednisone. Cardiovascular, diuretic, and antipyretic drugs are prescribed.

Treatment of patients with recurrent erysipelas

Treatment of recurrent erysipelas should be carried out in a hospital setting. It is mandatory to prescribe reserve antibiotics that were not used in the treatment of previous relapses. Cephalosporins are prescribed intramuscularly or lincomycin intramuscularly, rifampicin intramuscularly. Well antibacterial therapy- 8-10 days. For particularly persistent relapses, two-course treatment is advisable. Antibiotics that have an optimal effect on streptococcus are consistently prescribed. The first course of antibiotic therapy is cephalosporins (7-8 days). After a 5-7-day break, a second course of treatment with lincomycin is carried out (6-7 days). For recurrent erysipelas, immune correction (methyluracil, sodium nucleinate, prodigiosan, T-activin) is indicated.

Local therapy for erysipelas

Treatment of local manifestations of erysipelas is carried out only in its cystic forms with localization of the process on the extremities. Erythematous form of erysipelas does not require use local funds treatment, and many of them ( ichthyol ointment, Vishnevsky balm, ointments with antibiotics) are generally contraindicated. IN acute period if there are intact blisters, they are carefully incised at one of the edges and after the fluid comes out, bandages with a 0.1% solution of rivanol or a 0.02% solution of furatsilin are applied to the site of inflammation, changing them several times during the day. Tight bandaging is unacceptable.

In the presence of extensive weeping wound surfaces in place of opened blisters local treatment start with manganese baths for the limbs, followed by the application of the bandages listed above. To treat bleeding, 5-10% dibunol liniment is used in the form of applications in the area of inflammation 2 times a day for 5-7 days.

Traditionally, in the acute period of erysipelas, ultraviolet irradiation is prescribed to the area of inflammation, to the area of the lymph nodes. Ozokerite applications or dressings with heated naphthalan ointment (on the lower extremities), paraffin applications (on the face), lidase electrophoresis, calcium chloride, and radon baths are prescribed. Shown high efficiency low-intensity laser therapy of local inflammation. Dose used laser radiation varies depending on the condition of the lesion and the presence of concomitant diseases.

Complications

Complications of erysipelas, mainly of a local nature, are observed in a small number of patients. TO local complications include abscesses, cellulitis, skin necrosis, suppuration of blisters, inflammation of the veins, thrombophlebitis, inflammation lymphatic vessels. TO general complications, which develop in patients with erysipelas quite rarely, include sepsis, toxic-infectious shock, acute cardiovascular failure, thromboembolism pulmonary artery etc. The consequences of erysipelas include persistent lymph stagnation. By modern ideas, lymph stagnation in most cases develops in patients with erysipelas against the background of already existing functional failure lymph circulation of the skin (congenital, post-traumatic, etc.).

Prevention of recurrence of erysipelas

Prevention of recurrence of erysipelas is integral part comprehensive dispensary treatment patients suffering from a recurrent form of the disease. Preventive intramuscular injection bicillin (5-1.5 million units) or retarpen (2.4 million units) prevents relapses of the disease associated with reinfection with streptococcus.

At frequent relapses(at least 3 per Last year) continuous (year-round) bicillin prophylaxis is advisable for 2-3 years with an interval of bicillin administration of 3-4 weeks (in the first months the interval can be reduced to 2 weeks). In case of seasonal relapses, the drug is started to be administered a month before the start of the morbidity season in a given patient with an interval of 4 weeks for 3-4 months annually. If there are significant residual effects after suffering from erysipelas, bicillin is administered at intervals of 4 weeks for 4-6 months.

Forecast and course

With adequate treatment of mild and moderate forms, complete recovery is possible.
Chronic lymphedema (elephantiasis) or scarring in a chronic relapsing course.
In the elderly and weakened, there is a high incidence of complications and a tendency to frequent relapses.