Pyoderma is not a primary disease. It can be caused by a disorder of the immune system, by other primary diseases, by skin infections but also by streptococci or staphylococci, respectively.
What is pyoderma?
Pyoderma is a burning and purulent skin inflammation that can affect different layers of the skin. Triggers in most cases are β-hemolytic streptococci and staphylococci known as pus bacteria. Three types are distinguished:
- The surface pyoderma (surface pyodermia).
Here, only the uppermost layers of the epidermis are affected. There are four special forms: Intertrigo (a skin fold dermatitis), pyotraumatic dermatitis (hot spot), bacterial overgrowth syndrome and mucocutaneous pyoderma.
- The superficial pyoderma
Especially in the area of hair follicles, deeper layers of the epidermis are also affected. The infection, however, remains above the basal lamina. Three special forms are known here: Impetigo (highly contagious), bullous impetigo and folliculitis (superficial and bacterial).
- The deep pyoderma
Infection also occurs in the dermis or even the subcutis. Possible are a: Folliculitis (most common form), furunculosis (hair follicle is infected and can be destroyed), cellulitis (the subcutis is also infected).
Causes
Bacteria, which are also found on healthy skin, together with malassezia (yeast fungi) form the normal flora of the skin. If the body’s defense system is healthy and thus functional, the bacteria and yeasts also cannot multiply pathologically. Penetration into deeper layers of the skin and infection also do not occur in this case. If, however, the skin is injured or damaged by a disease, the bacteria causing the infection have an easy time of it. The result is the formation of pus, pyoderma. Pyoderma is therefore not only triggered by infection, but also by a malfunctioning immune system. Another trigger for pyoderma are different diseases. For example, a hormonal disorder such as thyroid disease or kidney hyperfunction (cuching) may be responsible. In any case, the triggering factor must be found, since pyoderma is not a primary disease. Another cause may be allergic skin reactions. For example, flea bite allergy, food allergy or even atopy. If there is a previous disease of the skin, for example neurodermatitis, the risk of infection is increased many times and the course of pyoderma is often more severe.
Symptoms, complaints and signs
The symptomatology of pyoderma is very complex. Itching, scaling and redness as well as crusting are among the typical symptoms, as is skin discoloration. The abdomen, the inner side of the thighs and the flanks are particularly frequently affected. The head and legs (not the spaces between the toes) are less frequently affected. In children, especially young children and kindergarteners, impetigo contagiosa is usually present, which is an inflammation of the epidermis. Transmission by staphylococci or streptococci results in skin blisters of varying sizes with a reddened fringe and a purulent opacity. The small blisters burst very easily and quickly. As a result, honey-yellow crusts develop and the foci of infection spread. Transmission to other areas of the skin or even other people occurs through the fingers that have come into contact with the infected areas.
Diagnosis and course of the disease
Usually, a clinical examination including laboratory analysis is performed with or without a skin smear. If deeper inflammation is present, a bacterial culture is obtained. This is possible with or without skin biopsy. If the bacteria causing the infection penetrate into the deeper layers of the skin, the general condition may be impaired and nausea may occur. Not only the skin, but the entire organism is then affected. For a diagnosis, transmission by other persons can also be considered. This is because it is not uncommon for small and kindergarten children to have staphylococci or streptococci that have been transmitted from the throat of another child by droplet infection. Complications are less frequently observed.However, infection by streptococci can cause the secondary streptococcal diseases that also occur in scarlet fever. Infection by staphylococci carries the risk of Lyell’s syndrome (immune system reaction to a staphylococcal infection on another area of the skin).
Complications
Usually, pyoderma is already a complication of another underlying disease. In this case, the affected person suffers from various complaints, which, however, always occur on the skin. As a rule, there is severe itching and reddening of the skin. The skin itself is severely dried out and irritated. In many cases, patients are ashamed of the symptoms of pyoderma and therefore also suffer from inferiority complexes and reduced self-esteem. Depression or other psychological upsets may also occur as a result of the disease. Furthermore, blisters may form on the skin. The blisters themselves are painful and can easily burst open. Likewise, pyoderma can spread to other regions of the skin. Due to the relatively high risk of infection, contact with other people should also be avoided. Furthermore, pyoderma not infrequently leads to nausea or a general feeling of illness in the affected person. Treatment of pyoderma is carried out without complications with the help of antibiotics. The patient’s life expectancy is not affected by pyoderma.
When should you go to the doctor?
Pyoderma should always be treated by a physician. Only proper treatment can prevent further complications and discomfort. Early diagnosis and treatment of pyoderma always have a positive effect on the further course. A doctor should be consulted if the affected person suffers from various skin complaints that do not disappear on their own and usually occur without any particular reason. The main symptoms are severe itching and redness in the affected areas. The entire body can be affected by the symptoms of pyoderma. Likewise, blisters on the skin may indicate pyoderma and should be examined by a doctor. Since the disease can also be transmitted to other people through skin contact, skin contact should be avoided for the time being. Pyoderma can be treated by a general practitioner or by a dermatologist. There are usually no particular complications, and the life expectancy of the affected person is not reduced.
Treatment and therapy
Since, as already mentioned, pyoderma is not a primary disease, it is essential to clarify the triggering disease. If this can be successfully treated, recurrence of the skin infection can usually be prevented. Pyoderma in itself is treated with antibiotics. It is important to take antibiotics at least one week beyond the healing stage. When this stage is reached is again determined by laboratory tests. In most cases, the treatment period is three to four weeks. After the first half of the treatment period, a control examination should be performed. This allows for an individual determination of the intake of an antibiotic. In addition, there is the use of sprays and rinses. They can be used not only to reduce odor, but also to accelerate healing. Particularly susceptible areas can also be treated specifically. The therapeutically applied shampoos are highly antibacterial and must be massaged in for at least ten minutes. This is the only way to best ensure that the contact time with the skin is sufficient to kill the bacteria. Thorough rinsing is also very important.
Prevention
It is important to use age-appropriate skin care that does not attack the skin’s natural acid mantle and protects and, if necessary, restores and maintains the skin’s natural moisture content. Ph-neutral ointments or lotions containing urea are considered very beneficial. The gel of the aloe vera plant also supports the natural protective mechanism and thus also the maintenance of healthy skin. Surfactants should not be used, as they damage the skin in its natural healthy function. In addition, the body’s own fat is drawn out. The skin dries out. Those who have a rather dry skin by nature should only take short and not so hot showers.
Aftercare
After successful treatment of pyoderma, the most important thing is to prevent recurrence of pyoderma. For this purpose, regular and intensive personal hygiene is very important. In addition, it is recommended to prevent the occurrence of serious, sometimes fatal secondary diseases (especially sepsis and acne inversa). Intensive body hygiene is also necessary for this purpose. In addition to washing with soap and disinfecting hands, especially after visiting public toilets, showers should be taken daily. Intensive skin care is also beneficial to prevent the recurrence of pyoderma. This should consist of regular rinsing of the skin with ph-neutral cleansers and a skin-healthy vitamin A-rich diet. In addition to this, the inflammation levels in the blood should be checked regularly by the responsible general practitioner or specialist in order to detect the recurrence of pyoderma and the occurrence of secondary diseases at an early stage. In addition, long-term therapy with antibiotics may be indicated even after successful treatment of pyoderma. This is particularly the case if secondary diseases have already occurred. Here, too, blood values should be checked regularly. In the case of acne inversa, additional surgery of the skin may be necessary in which the inflamed tissue is removed.
