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Curs Piodermite

Curs Piodermite

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Published by Leonard D
Cursuri dermatologie, anul VI, UMF "Carol Davila"
Spitalul Clinic Colentina
Cursuri dermatologie, anul VI, UMF "Carol Davila"
Spitalul Clinic Colentina

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Published by: Leonard D on Jan 30, 2011
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08/17/2013

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PIODERMITEPIODERMITE
 
Def Def 
.. ± ±procese supurativeprocese supurative PiodermitePiodermite --
primitiveprimitive
--
secundaresecundare
--suprainfecfiisuprainfecfii--r. de hipersensibilizare la distanfar. de hipersensibilizare la distanfa--vasculita la distantavasculita la distanta
Rezistenta cutanataRezistenta cutanata
--strat comosstrat comos--pH cutanat (aprox. 5,5)pH cutanat (aprox. 5,5)--secretia sebacee (rol antibacterian)secretia sebacee (rol antibacterian)--relativa uscaciune a pieliirelativa uscaciune a pielii--interferenta bacterianainterferenta bacteriana--anticorpi, imunitate celularaanticorpi, imunitate celulara
Euflora tegumentaraEuflora tegumentara
--bacterii rezidente: C. acnes, difteroizi aerobi, C. minutissimum (eritrasma), S.bacterii rezidente: C. acnes, difteroizi aerobi, C. minutissimum (eritrasma), S.epidermidis (102epidermidis (102 --106 / cm2), bacili G106 / cm2), bacili G--(E.coli, Proteus,...)(E.coli, Proteus,...) --flora tranzitorie: bacili Gflora tranzitorie: bacili G--, S. auriu., S. auriu. Zone expuse (fata, gat) au % microbian >Zone expuse (fata, gat) au % microbian >--umede (axila, perineu): Gumede (axila, perineu): G--
Factori patogenici:Factori patogenici:- 
patogenitatea microorganismuluipatogenitatea microorganismului--potential invaziv (multiplicare si rezistenta la fagocitoza)potential invaziv (multiplicare si rezistenta la fagocitoza)--elaborarea de toxine si enzime (det manifestari locale si generale).elaborarea de toxine si enzime (det manifestari locale si generale).--poarta de intrare: sol. de continuitate cu afectarea peretelui vascular poarta de intrare: sol. de continuitate cu afectarea peretelui vascular --raspunsul inflamator al gazdei (r. supurativa locala / si r.la distanta)raspunsul inflamator al gazdei (r. supurativa locala / si r.la distanta)
Diagnostic Diagnostic 
::
--ex. direct pe lama, coloratia Gramex. direct pe lama, coloratia Gram--culturiculturi--teste serologice, RFC, Ac. fluorescenti, etc.teste serologice, RFC, Ac. fluorescenti, etc.
 
S
TAFILOCOCII
S
TAFILOCOCII
S.
auriu
S.
auriu
--la purtatori cronici (vestibul nazal, scalp, axile, perineu, tub digestiv)la purtatori cronici (vestibul nazal, scalp, axile, perineu, tub digestiv)--G+; exotoxine (hemolitice, vasospastice, necrotizante);G+; exotoxine (hemolitice, vasospastice, necrotizante);enzime (catalaza, epidermolizina, termonucleaza, coagulaza, etc)enzime (catalaza, epidermolizina, termonucleaza, coagulaza, etc)--tipuri fagice: 80/81, D77 si D71.tipuri fagice: 80/81, D77 si D71.--infectii grave la batrani, anergici, diabetici, copii, etc.infectii grave la batrani, anergici, diabetici, copii, etc.
ClinicClinic
: pilo: pilo--sebacee; gl. sudoripare; unghii; piele glabra;sebacee; gl. sudoripare; unghii; piele glabra;
S
TAFILOCOCII
 
PILO
S
EBACEE
S
TAFILOCOCII
 
PILO
S
EBACEE
1.1.
Foliculita pustuloasaFoliculita pustuloasa
(ostiofoliculita)(ostiofoliculita)2.2.
Sicozis vulgar Sicozis vulgar 
(Folliculitis simplex barbae)(Folliculitis simplex barbae) --foliculita profunda + inflam.perifol.foliculita profunda + inflam.perifol. 3.3.
Sicozis lupoid Sicozis lupoid 
(Folliculitis decalvans faciei)(Folliculitis decalvans faciei) --infectie pana la papila firului de par infectie pana la papila firului de par  cicatrici.cicatrici.4.4.
 Acnee cheloidiana Acnee cheloidiana
--foliculita fibrozanta cronica a cefeifoliculita fibrozanta cronica a cefei--cicatrici cheloide + alopecie cicatricialacicatrici cheloide + alopecie cicatriciala5.5.
 Acnee necrotica Acnee necrotica
--necroze ce lasa cicatrici varioliformenecroze ce lasa cicatrici varioliforme--pare o reactie de hipersensibilizare la Ag. microbienepare o reactie de hipersensibilizare la Ag. microbiene6.6.
 Acnee conglobata Acnee conglobata
--forma cronica, supurativa de acnee, cu abcese si cicatrici.forma cronica, supurativa de acnee, cu abcese si cicatrici.7.7.
Furuncul Furuncul 
--stafilococie profunda, necrozanta, a foliculului pilos + glanda sebacee +stafilococie profunda, necrozanta, a foliculului pilos + glanda sebacee +tesutui conjunctiv perifolicular tesutui conjunctiv perifolicular --forme grave:forme grave: --stafilococia maligna a feteistafilococia maligna a fetei --furuncul antracoidfuruncul antracoid--furunculoza reddivantafurunculoza reddivanta--furuncul de spital; F.conduct auditiv externfuruncul de spital; F.conduct auditiv extern

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