Ch 16 Infections

Question 1

Trichomycosis Folliculari

Answer 1

Diptheroids coat axillary hairs

Question 2

Pitted Keratolysis

Answer 2

Diptheroids, sweaty shoes

Question 3

Erythrasma

Answer 3

Diptheroids lead to porphoryn formation and color

Question 4

Impetigo

Answer 4

Staph aureus is bullous desmoglein 1
strep can be nonbullous and lead to glomerulonephritis
if recurrent think of head lice

Question 5

Ecthyma

Answer 5

Ulcer beneath wound/impetigo-full thickness, scar

Question 6

Furuncle

Answer 6

inflamed hair follicle, commonly staph aureus

• If recurrent expect aureus and maybe MRSA
• Tx is I&D and Abx

Question 7

Carbuncle

Answer 7

• Many coalescing furuncles

- Suspect MRSA

Question 8

SSS

Answer 8

Desmoglein 1

Question 9

Toxic Shock

Answer 9

Staph Aureus

-Desquemation of hands and feet

Question 10

Erysepilis

Answer 10

Rapidly expanding and often accompanied by fever

• Tx is IV peniciln
• Can be recurrent and commonly in same area, can lead to lymphangitis and obstruction

Question 11

Nec Facitiis

Answer 11

• Anaerobes and strep
• Aggressive debridement and IV abx
• Often presents as anesthetics area and deep infection

Question 12

Erysepiloid

Answer 12

-In fish mongers and buthers

Question 13

Cat scratch

Answer 13

-Granulomatous skin reaction at site and axillary LAD

Question 14

Meningococcal

Answer 14

-Petichiae and Purpura

Question 15

Syphilis

Answer 15

1-painless chancre
2-palms and hands have macular eythema, LAD, Condyloma, Patchy hairliss, mouth ulcers
3-Graunlomas

Question 16

Yaws

Answer 16

Cutaneous Syphilis

Question 17

Lyme

Answer 17

• Erythema Migrans

- Doxycycline is best, can also use amox

Question 18

Cutaneous Anthrax

Answer 18

Painless ulcer leading to eschar

Question 19

Gonococcal

Answer 19

-Arthritis and papulopustular

Question 20

TB

Answer 20

-Can cause lupus vulgaris which is scaly brown patch commonly around head

Question 21

Leprosy

Answer 21

• Transmitted nasally
• Tuberculoid is contained and often elads to small local hypopigmentation and anesthesia/thickening of nerves, not infectous
• Lempromatous-Disseminated, leione faces, anesthesia etc
• Type 1 - Borderline reversal reaction local erythema
• Type 2 - Lepromatous reversal reaction leading to systemic illness

Question 22

Mycobacteria Marinarum

Answer 22

• Sprothrichoid spreach

- Through water, commonly cleaning fish tank

Question 23

Leishmaniasia

Answer 23

• Discharge and skin reaction
• Donovani - Kalazar HSM, fever, skin darkening
• New world: Mucous membrane involvment

Question 24

Warts

Answer 24

• 1,2,4 are common. 3 is plane. 6, 11, 16, 18 are high risk for SCC
• Mosaic has many smaller ones and are often slower to heal
• Plantar can be painful and may need exision
• Be slow with warts and don’t over excise

Question 25

Wart Tx

Answer 25

-Topical salicylic etc, then to cryosurgery antigen ingectiosns to exisions last

Question 26

Epidermodysplasia veruciformis

Answer 26

-Disseminated HPV

Question 27

Varicella

Answer 27

- Respiratory spread - Centrifugal vesicular rash with erythematous base - Can treat with acyclovir/valciclovir - COmplications are pneumonitis, secondary infection

Question 28

Herpes Zoster

Answer 28

- Reactivation of varicells - Treat early in course (5days) - Dermatomal, multi think of immunodeficency

Question 29

Herpes Simplex

Answer 29

EM May follow - Initial and then dormant - Vesicular lesions

Question 30

Molluscum

Answer 30

- Pearly white umbilicated papules | - Most common on kids and don't need to treat, can treat in adults with destruction

Question 31

Orf

Answer 31

-Parapox virus from lambs

Question 32

AIDS

Answer 32

- Kaposi Sarcoma, violaceous vascular grwoths - Treat less than 200 - Folliculitis and seb derm from pytorosprum - Dry skin and florid infections

Question 33

Kawasaki

Answer 33

- Desquamation of hands and feet, conjunctivitis, strawberry tongue - Commonly follows parvovirus infection

Question 34

Gioncotti Crosti

Answer 34

- Symmetrical erythematous papules most common on the face | - Seen with Hep B

Question 35

Herpangina/Hand Foot and Mouth

Answer 35

-COxaskie viurs, | _kids have vesicular or eroded/ulcerated lesions

Question 36

Measles

Answer 36

-URI and falling rash

Question 37

Rubella

Answer 37

-fever and then falling rash

Question 38

FIfths

Answer 38

Parvo

Question 39

Dermatophytes

Answer 39

- Trichophyton - Common in hair - Microsporum and epidermosproin more common in skin - Infect only the stratum corneum, more sever if zoonotic - inflammation is from metabolic products - Treated with terbenafine and griseofulvin - Always get mycological proof before treatment

Question 40

Tinea Pedis/Onychomycosis/Hands

Answer 40

- Commonly rubrum | - Can treat with locals

Question 41

Capitis

Answer 41

- Trichphyton, tonsurans in AA - Treat with systemics - May cause hair loss or flaking

Question 42

Candida

Answer 42

- Infections usually signal some sort of underlying immunodeficency - Oral and angular stomatitis - Intertrigo - Genital - Paronychia - Chronic Mucocutaneous - Tx is with itraconzaole (not terb/gris), can also use nystatin if topical

Question 43

Pitaryasis Versicolor

Answer 43

- Caused by microsporum and has spaghetti and meatball appearance - Fungus - Tx with itraconazole because gris/terb don't work - areas of hypopigmentation

Question 44

Fungal

Answer 44

- Histo: Granuloma - Cocci: EN - Blasto: Veruccous hyperkeratotic - Sporptrichs: Lymphatic spread - Actinomyces: SUlphur graunles - Mycetoma: Foot rot

Question 45

Kerion

Answer 45

-Inflamed and bogy tinea infection

Question 46

Tinea Incognito

Answer 46

-spreading edge, steroids can hide symptoms