Ectima

Ectima Ectima is an ulcerative pyoderma of the skin caused by beta-hemolytic streptococci group A. Since ectima extends into the dermis is about a deeper form of impetigo disease. Ectima rarely lead to systemic symptoms or bacteremia. The lesions are painful and may have associated lymphadenopathy. Limfangita secondary and cellulite can occur. Ectima heal with scarring. Poststreptococice glomerulonephritis rate is 1%. It is characterized by a vesicle or pustule which becomes inflamed intro dermal ulceration with crust formation. Lesions are 0. 5-3 cm in diameter and appear on the legs in children, diabetics and neglected older people. Ectima are hard to heal and leave scars.
Treatment depends on lesion progression. Hygiene is important. It will use antibacterial soaps will remove the crust and will apply antimicrobial ointments. Leziuni8le require more extensive oral antibiotics for several weeks. Ectimei is suitable for treating penicillin. The lesion may require surgical debridement of the crust.
Ectima rarely produce symptoms. Complications of invasive streptococcal skin infections include cellulitis, erysipelas, gangrene, limfangita, suppurative lymphadenitis and bacteremia. Nesupurative complications of streptococcal infections of the skin include scarlet fever glomerulonephritis. Prompt antibiotic therapy appears to reduce the rate of poststreptococica glomerulonephritis. Ectima lesions heal slowly and do not respond to antibiotics for several weeks. The prognosis is favorable.
Pathogenesis and causes
Ectima begins superficially similar to impetigo. Betahemolitici group A streptococci can initiate injury or preexisting wounds may become secondarily infected. Altering preexisting tissue (excoriations, insect bites, dermatitis), immunocompromised state (diabetes, neutropenia) predispose patients to dezvltarea ectimei. Streptococci Extension is augmented by poor hygiene and scratching. Ectima can be observed in areas with underlying tissue damage and immunocompromised.
Important factors that contribute to the development of streptococcal or ectimei piodeemitei include: High-temperature and humidity Promiscuous life-conditions -Poor hygiene. Untreated impetigo evolves in ectima occurs most often in people with poor hygiene.
Signs and symptoms
Ectima shows predilection for children and elderly. It usually occurs on the legs in children, diabetics, elderly neglect. His debut as a vesicle or pustule on an inflamed area of skin that is deep in the dermis with ulceration and crustificare. Gray-yellow crust is thick and tough crust from the impetigo. When the crust is removed adherence ulceration is observed. Deep skin ulcer is elevated and indurated borders. Ectimei lesions may remain fixed in size and can range from 0 gradually. 5-3 cm. Ectima heal slowly and cause scarring. Regional lymphadenopathy is common even in solitary lesions.
Ectima rarely produces symptoms. Complications of invasive streptococcal skin infections include cellulitis, erysipelas, gangrene, limfangita, suppurative lymphadenitis and bacteremia. Nesupurative complications of streptococcal infections of the skin include scarlet fever glomerulonephritis. Prompt antibiotic therapy appears to reduce the rate of poststreptococica glomerulonephritis. Possible sequelae of untreated secondary piodermitei cellulitis include Staphylococcus aureus, limfangita, bacteremia, ostemielita, acute infective endocarditis. Some strains of S. aureus to produce exotoxin can lead to scalding skin syndrome and toxic shock syndrome. Nesupurative complications of streptococcal infections of the skin include glomerulonephritis and scarlet fever. Prompt antibiotic therapy appears to reduce the rate of poststreptococica glomerulonephritis. Ectima lesions heal slowly and do not respond to antibiotics for several weeks.
Diagnosis
Laboratory studies: Gram-stain and culture of the lesion shows samplers gram-positive cocci are beta-hemolytic streptococcus group A with or without golden staph. Histological examination showed dermal necrosis and inflammation. There is a superficial and deep perivascular granulomatous infiltrate with endothelial swelling. A hard crust covers the surface ectimei ulcer.
The differential diagnosis is made with the following conditions: ectima gangrenosum, insect bites, papuloza limfomatoida, tubeculidele papulonecrotice, pyoderma gangrenosum, sporotrichoza, cutaneous diphtheria.
Treatment
Medical treatment depends on lesion progression. Hygiene is very important. Maintaining clean ulcer by use of antibacterial soaps and change sheets and clothing. Removal of crusts by soaking and soft pads and applying antibiotic ointment daily. Therapy is indicated for the topical ointment ectima mucirocin located. More extensive lesions require oral antibiotics. Duration varies because trataemntului ectima therapy may require several weeks to resolve completely. Penicillin is adequate to treat ectima. Antistafilococicele Oral dicloxacillin, cephalexin, erythromycin, clindamycin have been used to cover possible secondary infection with streptococci. Systemic antibiotic therapy is indicated if lesions are extensive.