Streptococcal impetigo muaj nyob txhua qhov chaw ntawm cov neeg uas muaj tawv nqaij mos thiab rhiab heev. Tus kab mob no feem ntau yog tshwm sim los ntawm kev tu cev tsis zoo, yog li nws feem ntau tshwm sim hauv cov menyuam yaus, tshwj xeeb tshaj yog thaum lub caij sov.
Definition
Streptococcal impetigo (ICD 10 L01) yog kab mob sib kis ntawm daim tawv nqaij uas tshwm sim los ntawm cov kab mob ntawm pawg streptococcal. Nws yog manifested los ntawm kev tsis sib haum xeeb (me me blistering pob) nrog o thiab liab. Nyob rau hauv pab pawg, cov npuas sib koom ua ke thiab nce, thiab tom qab cov pob khaus dhau lawm, cov pob liab liab tseem nyob ntawm daim tawv nqaij rau qee lub sijhawm.
Daim tawv nqaij tshwm sim tau hloov kho txhua tsib mus rau rau hnub. Tus kab mob kis sai sai rau thaj chaw noj qab haus huv, thiab cov txheej txheem pib dua. Kev kho thiab kev tiv thaiv tsis raug tuaj yeem ua rau muaj kev puas tsuaj rau thaj tsam loj ntawm daim tawv nqaij. Feem ntau qhov chaw: ntsej muag, tes, xub pwg thiab lwm yam tawv nqaij raug.
Nyob rau hauv dermatology, cov nram qab no ntau yam ntawm streptococcal impetigo yog txawv: bullous, annular, slit-zoo li, raws li zoo raws li tourniole (tus kab mob ntawm tus ntsia thawv quav), streptococcal diaper pob thiab posterosive syphilis.
Ua rau impetigo
Cov kab mob tseem ceeb ntawm tus kab mob yog suav tias yog streptococcus thiab staphylococcus aureus. Txoj kev sib kis yog kev sib cuag, los ntawm cov tes qias neeg, cov khoom ua si, khaub ncaws thiab lwm yam khoom siv hauv tsev. Kev nkag mus ntawm cov kab mob los ntawm cov mucous membranes tsuas yog ua tau yog tias lawv puas lawm, xws li tawg lossis khawb.
Streptococcal impetigo nyob rau hauv cov menyuam yaus tshwm sim tawm tsam keeb kwm ntawm atopic dermatitis, eczema, allergic contact dermatitis, txij li thaum lub cev tsis muaj zog lawm. Maceration ntawm daim tawv nqaij, hyperhidrosis (hws tawm), rhinitis los yog otitis nrog profuse tawm kuj yog qhov zoo rau qhov pib ntawm tus kab mob. Cov niam txiv ntawm cov menyuam yaus hu ua streptococcal impetigo "fireworm" vim nws kis tau tus nqi zoo heev hauv cov menyuam yaus hauv zej zog.
Symptoms of disease
Nws tag nrho pib nrog cov tsos ntawm cov pob liab liab me me ntawm daim tawv nqaij. Ob peb teev tom qab, npuas tshwm nyob rau hauv lawv qhov chaw, tab sis hyperemia tsis mus qhov twg - cov no yog tsis sib haum xeeb. Nyob rau theem no, cov npuas yog nruj, cov kua uas nyob hauv lawv yog pob tshab. Tab sis dhau sij hawm, lawv lub dome nyob, thiab cov ntsiab lus ua pos huab thiab tig mus ua kua paug. Txij li lub sijhawm no, ob qhov xwm txheej tuaj yeem ua tau: cov kua paug dries, thiab daj lossis xim av crusts nyob rau ntawm daim tawv nqaij, los yog cov npuas qhib spontaneously, kua paug tawm, tawm qhov txhab. Tom qab txhua yam zoo los yog cov crusts tev tawm, lilac me ntsis nyob ntawm daim tawv nqaij rau qee lub sijhawm.
Staphylococcal impetigo kav yam tsis muaj kev kho mob (ib lub voj voog ntawm kev tsis sib haum xeeb) rau xya hnub. Pob tshab,Raws li txoj cai, nws nyob ntawm qhov chaw qhib ntawm lub cev: ntsej muag, caj npab, plab thiab nraub qaum. Kev tsis sib haum xeeb yog nyob rau hauv conglomerates thiab nyiam sib koom ua ke. Txij li thaum tus menyuam khaus, nws tus kheej kis tus kab mob thoob plaws hauv nws lub cev. Nrog rau kev kho mob kom txaus, tus kab mob no ploj mus hauv ib hlis thiab tsis muaj qhov cuam tshuam rau kev kho kom zoo nkauj.
Diagnosis
Tus kws kho mob dermatologist tuaj yeem txheeb xyuas cov tsos mob ntawm tus kab mob streptococcal impetigo. Daim duab ntawm daim tawv nqaij (dermatoscopy) thiab kev tshawb fawb ntawm nws cov acidity tsuas yog lees paub qhov kev kuaj mob. Txhawm rau txiav txim siab qhov etiology ntawm tus kab mob, cov ntsiab lus ntawm cov vesicles tau sown rau hauv cov khoom noj khoom haus, thiab thaum cov kab mob loj hlob tuaj, nws cov microscopy tau ua.
Yog tias tus kab mob no rov tshwm sim dua, nws ua rau kev kuaj xyuas los ntawm tus kws tshuaj tiv thaiv kab mob kom tsis txhob muaj qhov ua txhaum loj. Kab mob kab mob ntawm daim tawv nqaij yog thawj lub tswb qhia qhov ntsuas qhov teeb meem.
Tus kws kho mob, nyob rau hauv tus txheej txheem ntawm kev sau cov ntaub ntawv hais txog tus kab mob, yuav tsum sib txawv ntawm folliculitis, ostiofolliculitis, impetigo vulgaris, epidemic pemphigus, herpes simplex, Duering's dermatitis. Clinically, lawv txhua tus zoo li streptococcal impetigo. Daim duab loj loj ntawm daim tawv nqaij puas pab kom paub qhov txawv ntawm ib leeg.
Txhua xyoo impetigo
Tus kab mob no pib nrog cov tsos ntawm cov hlwv me me uas muaj cov kua hauv huab. Lawv loj hlob sai nyob rau hauv dav, kis mus rauchaw noj qab haus huv, tab sis nyob rau tib lub sij hawm qhuav nyob rau hauv qhov chaw nrog tsim ntawm ib tug xim av crust. Yog li ntawd, thaum kawg ntawm tus kab mob, kev tsis sib haum xeeb muaj daim ntawv ntawm cov nplhaib. Qee zaum, tus qauv ntawm pob khaus zoo li lub garland.
Txhua lwm yam, tus kab mob feem ntau zoo li streptococcal impetigo. Cov kws kho mob tshwj xeeb txawv daim ntawv no los ntawm herpes zoster, exudative erythema thiab Dühring's dermatitis.
Bullous impetigo
Tus neeg ua haujlwm ua rau yog streptococcus, tab sis qee zaum staphylococcus kuj tau cog rau hauv cov neeg mob. Cov kab mob nkag mus rau hauv lub cev los ntawm daim tawv nqaij macerated. Feem ntau qhov no tshwm sim thaum lub caij ntuj sov. Cov ntaub ntawv piav qhia txog kev kis tus kabmob no hauv cov tub rog.
Cov cim qhia uas paub qhov txawv ntawm bullous thiab streptococcal impetigo feem ntau yog ib hom pob khaus. Cov npuas ntawm qhov loj (txog li ob centimeters) muaj cov duab hemispherical thiab tau ntim nrog cov kua dej sib xyaw nrog cov ntshav. Qhov nyiam tshaj plaws hauv cheeb tsam ntawm cov kev tsis sib haum xeeb no yog ob txhais tes thiab shins. Nyob ib ncig ntawm thaj chaw cuam tshuam, muaj qhov o thiab mob ntawm cov hlab ntsha lymphatic. Cov tsos mob hauv zos tau nrog cov tshuaj tiv thaiv ntawm lub cev: kub taub hau, mob taub hau, nce leukocytes thiab ESR (erythrocyte sedimentation rate) hauv kev kuaj ntshav.
Tawm tsam keeb kwm ntawm lwm yam kab mob ntawm daim tawv nqaij, bullous impetigo tseem hnyav dua.
Streptogenic congestion
Qhov no yog streptococcal impetigo uas tsim nyob rau hauv cov ces kaum ntawm lub qhov ncauj nrog tsim cov hlwv me me, ua ntej sauserous kua thiab tom qab ntawd kua paug. Vim muaj kev puas tsuaj tas mus li (thaum noj mov, tham), kev tsis sib haum xeeb qhib, thiab cov kab nrib pleb tshwm hauv lawv qhov chaw. Yog tias tus kab mob tsis quav ntsej, ces cov kab nrib pleb no tob heev thiab mob heev. Thaum menyuam yaus, qaug dab peg feem ntau tshwm sim. Qhov no yog vim kev tu cev tsis zoo thiab tsis muaj cov vitamins B, thiab muaj cov kab mob xws li ntshav qab zib.
Sib txawv qaug dab peg nrog cov tawv nqaij tawv tawv, mob plab thaum ntxov, Plummer-Vinson syndrome. Thawj ob kab mob yog cov yam ntxwv zoo ntawm cov tshuaj tiv thaiv kab mob syphilis thiab muaj lwm cov tsos mob, thiab Plummer-Vinson syndrome yog nrog los ntawm hypochromic anemia, dysphagia, glossitis thiab stomatitis, uas tsis muaj nyob rau hauv streptococcal qaug dab peg.
Surface panaritium (tourniol)
Tus kab mob no yog ib hom bullous impetigo thiab tshwm sim nyob rau hauv lub periungual folds. Nws tshwm sim yog provoked los ntawm kev raug mob, burrs thiab khawb, uas kis tau tus kab mob streptococcus thiab suppurate. Npuas yog nyob rau hauv daim ntawv ntawm horseshoe, nyob ib ncig ntawm cov ntsia hlau daim hlau ntawm ob txhais tes thiab taw. Nws tuaj yeem yog qhov mob sib cais ntawm ib tus ntiv tes, lossis ib qho dav, npog tag nrho tes.
Npuas nce hauv qhov dav thiab muaj cov ntsiab lus serous lossis purulent. Yog hais tias lub hau ntawm lub vial puas lawm, erosion tseem, uas nws thiaj li yuav npog nrog crusts. Yog hais tias tus kab mob ua tau zoo, ces tag nrho cov mob zoo, tab sis nyob rau hauv tsawg zaus, tus kab mob nkag mus tob rau hauv tus ntsia thawv, mus txog rau nws tsis kam. Cov kab mob ces kis mus rau cov lymphatics thiab cov hlab ntsha.
Tus neeg phem tshaj plaws yuav tsum paub qhov txawv ntawm chancre-felon, candidiasis ntawm tus ntsia thawv quav thiab Allopo dermatitis. Chancre yog ib qho kev tshwm sim ntawm thawj tus mob syphilis, yog li ntawd, cov tsos mob tshwm sim muaj nyob rau hauv nws: ib tug ntom liab-bluish nce nrog ib tug rwj nyob rau hauv qhov chaw. Tsis tas li ntawd, tus neeg mob muaj lwm cov tsos mob ntawm tus mob syphilis. Candidiasis ntawm tus ntsia thawv quav yog ib qho kev tshwm sim ntawm kev txo qis hauv kev tiv thaiv kab mob. Nyob rau hauv tas li ntawd, tsis muaj o ntawm cov ntiv tes cov ntaub so ntswg, cov rau tes yog qias neeg-xim av nyob rau hauv cov xim, thiab muaj fungi pom nyob rau hauv cov paug tawm los ntawm yaig.
Posterosive syphiloid
lossis lwm tus kab mob Svestre-Jacquet. Nws yog feem ntau tshwm sim hauv cov menyuam mos liab. Vim tias muaj ntau qhov quav, cov niam txiv tsis tas yuav tswj xyuas lawv zoo, yog li thaj chaw ntawm maceration thiab irritation tshwm sim ntawm daim tawv nqaij.
Cov tsos mob tseem ceeb ntawm tus kab mob yog qhov tshwm sim ntawm pob pob tw, uas, tom qab qhib, tawm erosions ncig los ntawm halo ntawm cov tawv nqaij desquamated. Hauv cov xwm txheej siab, kev tsis sib haum xeeb tuaj yeem nyob rau sab nraub qaum thiab sab hauv ncej puab, sib koom ua ke, tsim cov duab arched txawv txawv.
Tom qab qee lub sijhawm, qhov chaw yaig tau nkag mus, thiab papules tshwm hauv lawv qhov chaw. Tom qab qhov kev daws teeb meem ntawm cov pob liab liab, uas yog, kho ntawm rwj, hnub nyoog me ntsis feem ntau nyob twj ywm. Vim muaj ntau ntawm cov ntsiab lus morphological, nws tsis tuaj yeem kuaj pom tus kab mob hauv lub sijhawm.
Kev kuaj mob sib txawv yog ua nrog papular syphilis thiab microbial eczema. Nyob rau hauv thawj rooj plaub, muajIb qho zoo Wasserman cov tshuaj tiv thaiv, thiab nyob rau hauv lub thib ob - tsis muaj redness nyob rau hauv lub polymorphic ntsiab ntawm cov pob liab liab. Tsis tas li ntawd, papules thiab vesicles hauv microbial eczema tsis sib koom ua ke.
Kev kho mob
Muaj cov ntsiab cai dav dav rau kev kho mob streptoderma, uas yuav pab tshem tawm streptococcal impetigo. Kev kho mob yog nqa tawm nrog tshuaj tua kab mob thiab tshuaj tua kab mob hauv zos. Yog hais tias cov pob liab liab yog ib leeg, ces lawv tuaj yeem kho nrog aniline dyes: ci ntsuab lossis fucorcin. Kuj tseem muaj txiaj ntsig zoo yog kev siv tshuaj pleev nrog tshuaj tua kab mob ("Oxycort", "Dermazolone", "Neomycin" thiab lwm yam). Thaum tsis sib haum xeeb kis mus rau thaj chaw loj ntawm daim tawv nqaij, streptococcal impetigo tuaj yeem kho nrog resorcinol lotions.
Tableted tshuaj tua kab mob yog pom zoo nyob rau hauv tshwj xeeb tshaj yog mob hnyav thiab nquag rov tshwm sim ntawm tus kab mob. Tsis tas li ntawd, cov tshuaj ntxiv dag zog tau muab sau ntxiv. Streptococcal impetigo hauv cov menyuam yaus tsis yog qhov txawv. Cov kev kho mob tseem zoo li qub, tab sis ua ntej siv cov tshuaj pleev, koj yuav tsum tau tos kom lub npuas qhib, thiab xyuas kom tus menyuam tsis khawb daim tawv nqaij.
Cov Lus Qhia thiab Kev Tiv Thaiv
Raws li kev tiv thaiv, kab lis kev cai ntawm kev nyiam huv yuav tsum tau tsim. Cov menyuam yaus thiab cov neeg laus raug qhia kom tsis txhob ntub cov chaw cuam tshuam thaum lub sijhawm kho tag nrho. Txhua yam hauv qab no yuav tsum tau ua raws:
- zam kev sib cuag nrog lwm tus menyuam;
- siv cov khoom siv da dej cais thiab hloov txaj thiab ris tsho hauv qab tsis tu ncua;- qhov tseem ceebmob cov tais diav.
Yog tias koj ua raws li cov cai no, tsis yog hauv tsev neeg, lossis hauv pab pawg menyuam yaus, tus kabmob yuav tsis kis. Txhawm rau tiv thaiv kev kis kab mob, tsis txhob tso tseg kev tu tus kheej, ua tib zoo kho cov tawv nqaij thiab khawb thiab sim tsis txhob khawb ntawm daim tawv nqaij thaum muaj pob khaus. Recurrent streptococcal impetigo yog ib qho teeb meem uas tshwm sim vim qhov txo qis hauv lub cev tsis kam. Tsis txhob hnov qab txog nws thiab saib xyuas koj txoj kev noj qab haus huv.
