Chapter 15 - Localized Erythema Flashcards
pus filled nodules in the dermis, S. aureus is the usual pathogen; often begin as hard tender red nodules that become more fluctuant an dmore painful with time
abscessess and furuncle
Abscesses or furuncles:
Which one arises from traumatic inoculation of bacteria into the skin?
abscesses
abscesses or furuncles:
which ones arises from infected hair follicles?
furuncles
Abscesser or furuncles?
Which one tends to be larger and deeper than the other?
abscesses are larger and deeper than furuncles
during physical examination of abscess and furnaces, you may find these two things associated?
regional lymph nodes enlarged, fever RARELY present
How do you diagnose an abscess or furuncle?
usually done clinically; MRSA should be checked y requesting a culture and sensitivity
What is the principal therapy of abscesses and furuncles?
incision and drainage
how does the bacteria usually enter dermis to form an abscess verses furuncles?
abscess - usually trauma such as puncture wound, laceration, or surgical incision
furucles- usually through hair follicle
deep infection of the skin, localized erythema, caused by Group A streptococci (streptococcus progenies) and Staphylococcus aureus are organisms most responsible
cellulitis
what are the two presenting symptoms of cellulitis that patients normally complain with?
feeling ill and febrile
saphenous venectomy for coronary bypass surgery can predispose patients to recurrent _______ of the legs. Buccal _______ in children often accompanies otitis media/
cellulitis
what can you expect to see on examination of cellulitis?
all four signs of inflammation:
- redness *rubor
- warmth *calor
- swelling *tumor
- tenderness and pain *dolor
where does cellulitis more often affect adults?
in the legs, especially if lymphatic obstruction is present.
When severe, contact dermatitis can mimic the erythema and swelling of cellulitis. How can you tell the difference?
contact dermatitis is more marked epidermal involvement with vesicles, the symptom of itch rather than of tenderness, and the absence of fever
Stasis dermatitis is often confused with cellulitis. How can you tell the difference?
Stasis dermatitis is chornic, bilateral involvement, epidermal involvement with crust and scale, and absence of fever.
Facial cellulitis in children can sometimes be confused with the “slapped cheek” appearance of erythema infeciosum. How can you tell the difference?
erythema infectious, is bilateral and usually non tender and the patients condition does not appear toxic
inflammatory reaction in subcutaneous fat, tender noodles on lower legs, hypersensitivity response to a remote focus of infection or inflammation
erythema nodosum
what would u expect to see when doing a physical exam finding an erythema nodosum?
erythematous, localized, extremely tender, deep nodules that are 1-5 cm in diameter, and have indistinct borders. as lesions evolve they become yellowish - purple & look like bruises.
how can you tell the difference between subcutaneous fat necrosis and erythema nodosum?
subcutaneous fat necrosis is a rare condition and occurs in the setting go fpancreatitis or pancreatic carcinoma. Patients usually have raised serum amylase and lipase levels, and a diagnostic skin biopsy.
associated with cutaneous flushing erythema, common the face, the clinical feature becomes apparent only after hepatic metastases have occurred or when the primary tumor is in the lung (the venous drainage bypass the liver).
Carcinoid Syndrome
appears as sharply demarcated red plaques that late take on a dusky hue. these recur after each exposure
fixed drug eruption
the lesion appears in 1-2 weeks with first exposure to drug in a fixed drug eruption. upon subsequent re-exposures, the lesions appear within _____.
24 hours
what are the most common offenders causing fixed drug eruptions?
NSAIDS, sulfonamides, tetracyclines, and carbamazepine.
