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Niesztowica – groźna choroba skórna

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Niesztowica to choroba skórna o podłożu bakteryjnym. Jej charakterystycznym objawem są krostne zmiany skórne, które prowadzą do powstawania owrzodzeń. Jaka jest etiologia choroby, jak wygląda jej przebieg oraz kto znajduje się w grupie podwyższonego ryzyka zachorowania?

Etiologia i epidemiologia niesztowicy

Czynnikiem etiologicznym niesztowicy jest zazwyczaj mieszane zakażenie bakteriami z grupy gronkowców i paciorkowców.

Ryzyko zakażenia niesztowicą jest powiązane z zaniedbaniami w zakresie higieny. Mocniej predysponowane do zakażenia tą chorobą są osoby niedożywione, wyniszczone, z występującymi upośledzeniami odporności. Ze względu na to, że do zakażenia dochodzi za pośrednictwem mikrourazów skórnych, do grupy zwiększonego ryzyka należą także osoby cierpiące na inne schorzenia, w przebiegu których występują zmiany skórne, takie jak świerzb, atopowe zapalenie skóry, ospa wietrzna.

Zakażenia niesztowicą często obserwuje się u osób bezdomnych oraz u turystów powracających z krajów sfery tropikalnej.

Objawy niesztowicy

Wczesnym objawem niesztowicy są pęcherze i krosty ze współistniejącym rumieniem, które łatwo ulegają uszkodzeniom. Zmiany mają charakter penetrujący i prowadzą do uszkodzenia skóry właściwej. W wyniku tego procesu dochodzi do miejscowej martwicy skóry i wykształcenia owrzodzeń. Zmiany wrzodowe pokrywają są grubymi żółtawymi strupami i wytwarzają blizny w procesie gojenia.

Zmiany skórne najczęściej są zlokalizowane w obrębie kończyn dolnych i pośladków. Towarzyszą im objawy takie jak powiększenie węzłów chłonnych i zapalenie lokalnych naczyń chłonnych. Wtórne powikłanie choroby może również stanowić kłębuszkowe zapalenie nerek.

W diagnostyce różnicowej niesztowicy należy uwzględnić skórną postać błonicy, rumień stwardniały, kiłę wtórną i trzeciorzędową, wąglik, a także leukocytoklastyczne zapalenie naczyń skóry.

Leczenie niesztowicy

W terapii niesztowicy stosuje się ogólną antybiotykoterapię w połączeniu z leczeniem miejscowym polegającym na regularnym oczyszczaniu i odkażaniu wykwitów skórnych. Zmiany, na których doszło do wykształcenia strupów, są pozostawiane do samoistnego wygojenia.

Źródła:  http://niesztowica.pl/, http://www.interna.com.pl/, https://www.medonet.pl/

Przeczytaj także: „Medycyna to schody ruchome, które jadą w dół. Musimy walczyć, żeby się na nich utrzymać” – rozmowa z dr. n. med. Grzegorzem Krasowskim

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