Chapter 15 - Localized Erythema

Question 1

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

Answer 1

abscessess and furuncle

Question 2

Abscesses or furuncles:

Which one arises from traumatic inoculation of bacteria into the skin?

Answer 2

abscesses

Question 3

abscesses or furuncles:

which ones arises from infected hair follicles?

Answer 3

furuncles

Question 4

Abscesser or furuncles?

Which one tends to be larger and deeper than the other?

Answer 4

abscesses are larger and deeper than furuncles

Question 5

during physical examination of abscess and furnaces, you may find these two things associated?

Answer 5

regional lymph nodes enlarged, fever RARELY present

Question 6

How do you diagnose an abscess or furuncle?

Answer 6

usually done clinically; MRSA should be checked y requesting a culture and sensitivity

Question 7

What is the principal therapy of abscesses and furuncles?

Answer 7

incision and drainage

Question 8

how does the bacteria usually enter dermis to form an abscess verses furuncles?

Answer 8

abscess - usually trauma such as puncture wound, laceration, or surgical incision
furucles- usually through hair follicle

Question 9

deep infection of the skin, localized erythema, caused by Group A streptococci (streptococcus progenies) and Staphylococcus aureus are organisms most responsible

Answer 9

cellulitis

Question 10

what are the two presenting symptoms of cellulitis that patients normally complain with?

Answer 10

feeling ill and febrile

Question 11

saphenous venectomy for coronary bypass surgery can predispose patients to recurrent _______ of the legs. Buccal _______ in children often accompanies otitis media/

Answer 11

cellulitis

Question 12

what can you expect to see on examination of cellulitis?

Answer 12

all four signs of inflammation:

1. redness *rubor
2. warmth *calor
3. swelling *tumor
4. tenderness and pain *dolor

Question 13

where does cellulitis more often affect adults?

Answer 13

in the legs, especially if lymphatic obstruction is present.

Question 14

When severe, contact dermatitis can mimic the erythema and swelling of cellulitis. How can you tell the difference?

Answer 14

contact dermatitis is more marked epidermal involvement with vesicles, the symptom of itch rather than of tenderness, and the absence of fever

Question 15

Stasis dermatitis is often confused with cellulitis. How can you tell the difference?

Answer 15

Stasis dermatitis is chornic, bilateral involvement, epidermal involvement with crust and scale, and absence of fever.

Question 16

Facial cellulitis in children can sometimes be confused with the “slapped cheek” appearance of erythema infeciosum. How can you tell the difference?

Answer 16

erythema infectious, is bilateral and usually non tender and the patients condition does not appear toxic

Question 17

inflammatory reaction in subcutaneous fat, tender noodles on lower legs, hypersensitivity response to a remote focus of infection or inflammation

Answer 17

erythema nodosum

Question 18

what would u expect to see when doing a physical exam finding an erythema nodosum?

Answer 18

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.

Question 19

how can you tell the difference between subcutaneous fat necrosis and erythema nodosum?

Answer 19

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.

Question 20

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).

Answer 20

Carcinoid Syndrome

Question 21

appears as sharply demarcated red plaques that late take on a dusky hue. these recur after each exposure

Answer 21

fixed drug eruption

Question 22

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 _____.

Answer 22

24 hours

Question 23

what are the most common offenders causing fixed drug eruptions?

Answer 23

NSAIDS, sulfonamides, tetracyclines, and carbamazepine.