Pyoderma

1. Pyoderma

2. Pyoderma is usually caused by staphylococcal, streptococcal, or combined infection. • Pyoderma is a group of cocci infections in the skin, including impetigo, ecthyma, folliculitis, furuncle, carbuncle, erysipelas and cellulitis. • The quantity and the toxicity of the bacteria • The resistance of the body

3. Impetigo • Occur most frequently on the exposed parts of the body • Contagious • Occur most frequently in childhood • Mostly during summer

4. Pathogen • Coagulasepositive Staphylocuccus aureus Group A beta-hemolytic streptococci • Group A beta-hemolytic streptococci and the phage type 71 and 80/81 S. aureus skin infections are sometimes followed by glomerulonephritis. • Enviroment: humid weather • Body: itching skin diseases

5. Clinical Type • Impetigo vulgaris • impetigo bullosa • Impetigo neonatorum • Granuecthyma

6. Impetigo vulgaris • Highly contagious • Age: preschool age or school age • Season: summer and autumn • Locus: exposed parts of the body: perioral, paranasal and vulval regions

7. Impetigo vulgaris • Feature of the lesion: erythematous macula or papula, pustula, erosion, crusts • Subjective symptom: itching seriously • Course of disease: about one week • Systemic symptom: fever and lymphangitis may occur in serious disease, and more seriously septicaemia and acute glomerulonephritis may occur in disease.

8. Impetigo vulgaris

9. Impetigo bullosa • Childhood, Summer • Impetigo often complicates miliaria, hidradenitis and insect bites • Bullae:pellucid to turbid exudate, like half bottle of water, after these lesions rupture, the exudate dries to form crusts and hyperpigmentation. • Impetigo circinata

11. Impetigo neonatorum • Phage type 71 coagulasepositive S. aureus or a related group 2 phage type • Rapidly evolving, highly contagious • pellucid to turbid exudate, Nikolsky’s sign (+) • dries to form loosely stratified golden yellow crusts • The disease evolves rapidly • Systemic symptom is serious: septicaemia,toxemia and die

12. Impetigo neonatorum

13. Granuecthyma • Deep and inflammatory vesicle or vesicopustule, ruptures to form ulcer and dark brown crusts • Causalgia, regional lymphonodi swell • Autoinoculation infection • The lesions tend to heal after 2-4 weeks, leaving scars or granulomatous lesions

14. Granuecthyma

15. Treatment • 1. Clean the skin and cure the wound and itching skin diseases

16. Treatment 2. Systemic treatment: sulfanilamide antibiotics or other antibiotics Serious Impetigo neonatorum: • Topical therapy • High dose and sensitive antibiotics • General suppotive measures

17. Treatment 3. Topical therapy: Principle: sterilize, diminish inflammation, astringe and desiccate 1% camphor、5% sulfurcalamine lotion, 0.5% novobiocin ointment Impetigo neonatorum Diers astringents and antiseptics Granuecthyma Remove the crusts, topical antibiotics ointment

18. Treatment • Isolation and disinfection

19. Thank you