2/7/17 Dr. Florell Cutaneous Infection TEST #2 Flashcards
What does the stratum corneum prevent?
-Water loss and chemical entry
The dermis is tough and repels what?
-physical insults
What two layers are found in the dermis?
- Papillary dermis
- Reticular dermis
What is the Adnexa?
- Hair follicles
- Sweat glands
What are two types of bacterial cutaneous infections?
- Impetigo
- Follliculitis
What are three types of viral cutaneous infections?
- Herpes virus
- Molluscum contagiosum
- Verruca vulgaris
What type of cocci is on the normal skin flora?
-Aerobic cocci
What percent of outpaitient dermal visits are bacterial?
-20%
If you have impetigo what part of the skin does it affect?
-Epidermis
If you have Folliculitis what part of the skin unit does it affect?
-Appendages
What are three types of fungal cutaneous infections?
- Tinea versicolor
- Tinea corporis
- Deep fungal infection
What are two types of infestation cutaneous infections?
- Scabies
- Myiasis
What are most cutaneous infections caused by?
-Staph aureus
What are three bacteria causes of Impetigo?
- Staphylococcal
- Streptococcal
- Mixed infections
What is the main bacterial cause of Impetigo?
-Staphylococcal
How does impetigo manifest itself?
-Thin, straw colored discharge noted which dries to form golden’yellow crusts
What is impetigo most commonly found on people?
- Exposed areas
- Face
- Hands
- Neck
- extremities
What are the treatments for impetigo?
- Antibiotic ointment
- Systemic antibiotic
If a patient comes into your clinic with discrete, thin-walled vesicles that become pustular and rupture what might they have?
-Impetigo
If you see a hair coming straight from the center of a pustule what might that be indicative of?
-Some type of folliculitis
In folliculitis what are the shape of the pustules?
-Dome-shaped around hair follicles
In bacterial folliculitis what is the most common cause?
-Staph aureus
What are the treatments for folliculitis?
- Decrease bacterial load (antibacterial soap)
- Topical or systemic antibiotics
What type of parasite are viruses?
-Obligatory intracellular
What three viral infections involve the epidermis?
- Molluscum cotagiosum
- Herpesvirus
- Verruca
What type of viral infection involves the skin appendages (hair follicle)?
-Folliculitis (herpesvirus)
What does a positive interpretation require from a Tzanck smear for herpesvirus?
- Multi-nucleated keratinocytes
- Peripheral marginization of chromatin
After primary infection with Herpes (varicella) Zoster where does it remain latent at?
-Dorsal root ganglion cells
What is the treatment of Herpes (varicella) Zoster?
-Antiviral therapy
What type of Virus is herpesvirus infection?
-Double Stranded DNA
What type of virus is varicella virus?
-Double stranded DNA
What type of virus is cytomegalovirus?
-double stranded DNA
What type of virus is Epstein-Barr virus?
-Double stranded DNA
Where do you typically see oral herpes?
- Keratinized/masticatory mucosa
- palate
- gingiva
- tongue
What type of herpesvirus is a life threatening infection of a pre-existing skin rash, usually atopic dermatitis?
-Eczema herpeticum
What is oral hairy leukoplakia associated with?
-Epstein-Barr virus infection
Who does oral hairy leukoplakia occur most commonly in?
-HIV infected patients
What are three other groups of people besides HIV patients can you find oral hairy leukoplakia?
- Chemotherapy
- Organ transplant
- Leukemia
What is the treatment for oral hairy leukoplakia?
- Systemic antiviral therapy such as:
- Acyclovir
- Valacyclovir
- Famiciclovir
What is Molluscum contagiosum caused by?
-Poxvirus
What are three groups that you generally find molluscum contagiosum in?
- Young children
- Sexually active adults
- Systemic T-cell immunosupression (HIV)
How is Molluscum contagiosum transmitted?
-Direct skin to skin contact (especially if skin is wet)
If you see Hnderson-Paterson bodies in a histology side what does that indicate?
-Molluscum contagiosum
What is the treatment for molluscum?
-Spontaneous resolution within 2 yrs
If you see a thick granular cell layer with koilocytes what does that indicate?
-Verrucous epidermal
What are two types of fungal infections that effect the epidermis?
- Tinea versicolor
- Dermatophytosis
If a rash is scaly what type of preparation should you do?
-KOH preparation
If you have hyphae and yeast in the epidermis what is that indicative of?
-Tinea versicolor
What causes Tinea versicolor?
-Pityrosporum orbiculare
Where is the most common site of infection on a person with Tinea versicolor?
-Upper trunk
What are the treatments for Tinea versicolor?
-Topical or systemic antifungal agent
Where can Dermatophytes survive on?
-Only on dead keratin skin, hair and nails
T/F Dermatophytes can survive in the mouth or vagina where the stratum corneum does not form.
False
They can NOT
If you have hyphae present in largest numbers at the advancing annular edge what is that indicative of?
-Dermatophytes
What is the treatment of dermatophytes?
-Oral or topical antifungal
What is the mariners wheel found in a histo slide indicitive of?
-Paracoccidiodomycosis
What are most fungal infections a manifestation of?
-Systemic infections
T/F Primary infections of deep fungal pathogens are introduced directly into the skin via puncture, abrasion, trauma resulting in an ulcer or verrucous lesion
True
Who are most opportunistic fungal diseases seen in?
-Patients with leukemia or hematologic neoplasia
What are the two types of opportunistic deep fungal infections?
- Candidiasis
- Aspergillosis
T/F With scabies you will have intense itching
True
If you have pruritic papular lesion, excorations and burrows what might they have?
-Scabies
What is Myiasis?
-Infestation of human tissue by fly larvae
If you have a dermatophyte infection (annular scaling plaque) what should the next step be?
-KOH prep
