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Bacterial infections of the skin Flashcards

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Dermatology Board Prep flashcards
1
Q

What are two bacteria that commonly cause bacterial infections of the skin?

A

Staph Aureus, Streptococcus

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2
Q

How does staph aureus express its virulence factors?

A

Binding to cell fibrin, found in abundance in wound surfaces such as ulcers and jt dermatitis

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3
Q

Virulence factors expressed by Staph A.

A

Haemolysin
Leukocidin
a-toxin
exfoliative toxin
PVL

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4
Q

What types of conditions can staph aureus cause?

A

Ecthyma,
Impetigo,
Cellulitis,
Folliculitis,
SSSS (Staph scalded skin syndrome)
Superinfects other skin conditions e.g. herpes

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5
Q

How does streptococcus express its virulence factors?

A

Attaches to cell epithelium (lipoteichoic acid) using M protein (anti-phagocytic) and hyaluronic acid capsule

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6
Q

What virulence factors does streptococcus express?

A

Erythrogenic Exotoxins, gives skin red appearance
Streptolysins S and O, causes cells to break apart

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7
Q

What types of conditions can streptococcus cause?

A

Ecthyma,
Impetigo,
Cellulitis,
Erysipelas
Scarlet Fever,
Necrotising Fasciitis

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8
Q

Folliculitis

A

Inflammation of the hair follicle

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9
Q

How does folliculitis manifest

A

Follicular erythema, redness around the follicle
sometimes pustular, pus producing

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10
Q

What is another term for non-infectious folliculitis?

A

Eosinophilic Folliculitis
associated with HIV

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11
Q

How can recurrent cases of folliculitis arise?

A

Reservoir of Staph A. esp in nasal cavity.
(especially panton-valentine leukocidin - PVL - expressing strains)

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12
Q

What is the treatment for folliculitis?

A

Antibiotics - erythromycin
incision and drainage for furunculosis

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13
Q

Furuncle vs Carbuncle

A

Furuncle is a deep follicular abscess
Carbuncles are clusters of multiple boils, when the abscess involves multiple follicles

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14
Q

What are carbuncles likely to lead to?

A

Cellulitis and Septicaemia

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15
Q

Why are staph aureus infections so recurrent?

A

Microbial abundance in nasal flora
Immune deficiency (AIDS, DM)

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16
Q

What is a strain of staph aureus that has a higher morbidity, mortality and transmissibility?

A

Panton Valentine Leukocidin Staphylococcus Aureus
PVL

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17
Q

What is PVL staph A. characterised by

A

Leukocyte destruction
tissue necrosis

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18
Q

What are the skin signs of PVL Staph Aureus?

A

Recurrent painful abscesses, folliculitis and cellulitis (in multiple sites)

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19
Q

What are the extracutaneous signs of PVL Staph Aureus?

A

Necrotising Pneumonia,
Necrotising Fasciitis,
Purpura Fulminans - patches of dark purple skin, due to haemorrhage and thrombosis

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20
Q

What are the 5 risks for acquiring PVL Staph Aureus?

A

5 Cs:
Contact,
Contamination,
Crowding,
Cleanliness,
Cuts

21
Q

What are the treatments for PVL Staph Aureus?

A

Antibiotics, (tetracycline)
Decolonisation (chlorhexidine body wash, nasal antibacterial ointment, to remove the strain from the body)
treat close contacts

22
Q

What is a type of folliculitis associated with hot tubs?

A

Pseudomonal Folliculitis (from pseudomonas aerugionsa)

23
Q

What is cellulitis?

A

Infection of lower dermis and subcutaneous tissue

23
Q

presentation of pseudomonal folliculitis

A

1-3d post exposure
diffuse truncal eruption of follicular erythematous papules (red spots)
usually mild tho can be treated with AB if severe

24
Q

What are the characteristic signs of cellulitis?

A

oedema, tender swelling with ill defined blanching erythema

25
Q

What are the main bacteria that cause cellulitis?

A

Strep P, Staph A

26
Q

What is the treatment for cellulitis?

A

Systemic Antibiotics

27
Q

What is impetigo?

A

Superficial bacterial infection

28
Q

What is impetigo characterised by?

A

Honey-Coloured Crusts overlying an erosion

29
Q

What are the two causes for impetigo?

A

Strep, Staph

30
Q

Difference between impetigo caused by strep and staph

A

Strep - non blistering
Staph - blisters, exfoliative toxin split epidermis

31
Q

Where does impetigo usually target?

A

Face - oral, ears

32
Q

How do you treat impetigo?

A

Topical and or systemic antibiotics

33
Q

What is impetiginization?

A

Impetigo with atopic dermatitis,
superficial infection of eczema skin

34
Q

What is primary syphilis characterised by?

A

Painless ulcer with firm indurated border + painless localised lymph node swelling

35
Q

What is a chancre and when does it appear in syphilis?

A

Painless genital ulcer, 10-90 days post exposure

36
Q

When does secondary syphilis start?

A

~50 days after chancre

37
Q

What is secondary syphilis characterised by?

A

rash, alopeica, lymphadenopathy, hepatosplenomegaly

38
Q

What are the name of orogenital lesions in secondary syphilis?

A

Condylomata lata

39
Q

What is a rare manifestation of secondary syphilis?

A

Lues maligna
Skin lesions with pustules (due to blocked blood vessels)

40
Q

When is lues maligna more frequently found?

A

HIV manifestation

41
Q

What are the cutaneous signs of tertiary syphilis?

A

Gumma Skin Lesions (extend peripherally w/ central scarring)
- can destroy cartilage, CNS (neurosyphilis) and blood vessels -> CVD

41
Q

What is the treatment of syphilis?

A

Intramuscular Benzylpenicillin or Oral Tetracycline
1/2º syphilis can look similar to other conditions

42
Q

What is the other term for Lyme disease?

A

Borreliosis

43
Q

What is borreliosis caused by?

A

Borrelia-infected ticks

44
Q

What is the cutaneous manifestation of borreliosis?

A

Annular erythema - erythematous papule

44
Q

What are the secondary effects of borreliosis?

A

Secondary lesions,
Neuroborreliosis (CN/facial palsy),
Arthritis, painful and swollen jts
Carditis

45
Q

What are the problems with diagnosing borreliosis?

A

Serology not sensitive and histopathology non specific
.: High index of suspicion (keep high on checklist when seeing patient)

derm (4 decks)

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