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Dermatology > Common skin infections > Flashcards

Common skin infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Which pathogen causes cold sores?

A

Herpes Simplex
(HSV-1, HSV-2)

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2
Q

Where does HSV-1 most commonly affect?

A

orofacial

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3
Q

Where does HSV-2 most commonly affect?

A

genital

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4
Q

How is Herpes simplex virus transmitted?

A

direct contact at a mucosal surface or on sites of abraded skin

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5
Q

Describe Herpes simplex lesions

A

grouped vesicles on erythematous base
crust and erosions form
painful

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6
Q

Genital Herpes simplex treatment

A

topical acyclovir 5% ointment (can use systemic acyclovir)

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7
Q

HSV prognosis

A

persists in sensory ganglia for life
tends to recur

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8
Q

HSV complications

A

erythema multiforme
eczema herpeticum
affect CNS

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9
Q

What causes shingles (Herpes zoster)?

A

Varicella zoster virus

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10
Q

How is shingles transmitted?

A

reactivation of latent VZV in sensory ganglia (previously had chicken pox)

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11
Q

Shingles symptoms and signs

A

pain in dermatomal or band-like pattern
followed by grouped vesicles on erythematous base
crusting
fever
malaise
can involve the eyes (ophthalmology referral needed)

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12
Q

How is Herpes zoster treated?

A

analgesics
acyclovir (needs to be within 24-72 hours of disease onset)

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13
Q

Herpes zoster complications

A

post-herpetic neuralgia
cranial nerve syndromes (eg. Ramset hunt syndrome)

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14
Q

What causes viral warts?

A

human papillomavirus (HPV)

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15
Q

Define viral warts

A

benign epithelial growths

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16
Q

Which HPV subtypes can cause cancers?

A

16 and 18 are most common (cervical cancer)

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17
Q

Describe a wart

A

hyperkeratotic flesh-coloured papule and/or plaque studded with small black dots (thrombosed capillaries)

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18
Q

Proper name for verrucae?

A

plantar warts

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19
Q

Warts treatment

A

no treatment
topical salicylic acid with paring
duct tape
cryosurgery

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20
Q

What causes molluscum contagiosum?

A

molluscum contagiosum virus (MCV) (poxvirus)

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21
Q

Describe molluscum contagiosum

A

benign self-limited papular eruption
often look like pearly papules
smooth flesh-coloured, dome-shaped, umbilicated papules
contain keratotic (cheesy) plug

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22
Q

Transmission of molluscum contagiosum

A

skin-to-skin contact

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23
Q

Which pathogens cause impetigo?

A

staphylococcus aureus > streptococcus pyogenes

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24
Q

Describe non-bullous impetigo

A

vesicles or pustules on erythematous skin –> erosions –> golden yellow crust

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25
Q

Describe bullous impetigo

A

flaccid bullae with clear yellow fluid (S.Aureus) –> erosions –> golden yellow crust

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26
Q

Bullous impetigo treatment

A

topical and/or systemic antibiotics (topical = mupirocin, systemic = beta lactams eg. penicillins)

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27
Q

Which pathogens cause folliculitis/furunculosis/carbunculosis?

A

Staphylococcus aureus
Pseudomonas aeruginosa

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28
Q

Describe folliculitis

A

follicular pustules

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29
Q

Describe furunculosis

A

tender, erythematous, fluctuant nodules that rupture with purulent discharge

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30
Q

Describe carbunculosis

A

larger and deeper inflammatory nodules often with purulent drainage (larger than furuncles)

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31
Q

Furunculosis/carbunculosis treatment

A

topical treatment 1% clindamycin or 2% erythromycin

systemic antistaphylococcal antibiotics

incision + drainage

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32
Q

Which pathogens cause ecthyma?

A

Staphylococcus aureus
Streptococcus pyogenes

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33
Q

Describe ecthyma

A

vesicles and bullae that progress to punched-out ulcerations with adherent crust which heals with scarring

often dark centre

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34
Q

Ecthyma diagnosis

A

clinical presentation
confirmation by culture

35
Q

Ecthyma treatment

A

oral antistaphylococcal antibiotics

36
Q

Which pathogens cause erysipelas and cellulitis?

A

Staphylococcus aureus
Streptococcus pyogenes

37
Q

Difference between erysipelas and cellulitis?

A

cellulitis affects deeper layers of skin

38
Q

How do you monitor if antibiotics are working in erysipelas and cellulitis?

A

draw around erythematous areas
area should shrink if antibiotics working

39
Q

Describe erysipelas

A

tender, well-defined erythematous patch

40
Q

Erysipelas and cellulitis treatment

A

beta lactam antibiotics

41
Q

Describe cellulitis

A

ill-defined erythematous and edematous patch

42
Q

Which pathogens cause necrotising fasciitis?

A

Streptococcus pyogenes
Group B and C streptococci
Vibrio vulnificus
Clostridium perfringens
Bacteroides fragilis
(mixed infections common)

43
Q

What is necrotising fasciitis?

A

infection of subcutaneous tissue and fascia

44
Q

Transmission necrotising fasciitis

A

after injury
idiopathic

45
Q

Describe necrotising fasciitis + symptoms

A

erythema
pain
extends to deep underlying fascia
skin becomes dusky and bullae forms followed by necrosis, gangrene
rapid progress
fever
systemic toxicity, organ failure, shock, death

46
Q

Necrotising fasciitis treatment

A

biopsy for histology
gram stain and culture to identify pathogen

47
Q

Necrotising fasciitis treatment

A

surgical debridement or amputation
antibiotics (gentamicin, clindamycin)

48
Q

Which pathogen causes scabies?

A

Sarcoptes scabiei var.hominis (human itch mite)

49
Q

What is scabies?

A

infectious disease of skin causes by S.scabiei burrowing into epidermis

50
Q

Scabies symptoms

A

itching (especially at night)

51
Q

Describe scabies

A

burrows, vesicles, papules and pustules
common in finger webs

52
Q

How is scabies diagnosed?

A

looking for mites
look for eggs under microscope (skin scrapings)

53
Q

Scabies treatment

A

skin lotions containing permethrin
all family members
all over body
repeat treatment in 7 days (as more eggs may have hatched)

54
Q

What are the 3 subtypes of leishmaniasis?

A

Cutaneous leishmaniasis
Mucocutaneous leishmaniasis
Diffuse cutaneous leishmaniasis

55
Q

Which pathogens cause each subtype of leishmaniasis?

A

CL = leishmania tropica
MCL = leishmania braziliensis
DCL = leishmania mexicana, leishmania aethiopia

56
Q

Cutaneous leishmaniasis symptoms

A

skin lesions with erythema, inflammation and ulceration

57
Q

Mucocutaneous leishmaniasis symptoms

A

lesions of nasal and/or oral mucosa

58
Q

Diffuse cutaneous leishmaniasis symptoms

A

multiple deep skin lesions

59
Q

Transmission of mucocutaneous leishmaniasis

A

bites of infected sandflies

60
Q

Leishmaniasis treatment by subtype

A

CL = self-healing, antibiotics
MCL, DCL = pentavalent antimony, amphotericin B

61
Q

What pathogen causes cutaneous larva migrans (creeping eruption)?

A

larva of dog and cat hookworm (Ancylostoma braziliensis)

62
Q

What is cutaneous larva migrans?

A

cutaneous eruption usually confined to skin of feet, arms or buttocks caused by migrating larva

63
Q

Transmission of cutaneous larva migrans

A

active penetration of the skin by larva

64
Q

Cutaneous larva migrans symptoms

A

erythematous, pruritic, serpiginous (wavy margin) lesions that advance several mm/day

65
Q

Cutaneous larva migrans treatment

A

thiabendazole (topical or oral)
albendazole
mebendazole
ivermectin
antibiotics

66
Q

What is tinea?

A

fungal infection of skin
usually peripheral scaling discoid lesions

67
Q

How is tinea diagnosed?

A

skin scrapings
direct microscopy (may see branching hyphae)
woods light = green fluorescence

68
Q

Tinea main symptom

A

itch

69
Q

Tinea treatment

A

topical antifungals (imidazoles)
systemic antifungals for nails, scalp, widespread or chronic infections

70
Q

Which tinea subtype affects the body?

A

Tinea Corporis

71
Q

Which tinea subtype affects the head?

A

Tinea Capitis

72
Q

Which tinea subtype affects the feet?

A

Tinea Pedis

73
Q

Which tinea subtype affects the groin?

A

Tinea Cruris

74
Q

What causes candidal intertrigo?

A

yeast - usually candida albicans

75
Q

What is candidal intertrigo?

A

superficial mycotic infection of skin
tend to affect moist occluded skin folds

76
Q

Describe candidal intertrigo

A

erythematous macerated patch with satellite macules or pustules extending beyond the flexure

77
Q

Candidal intertrigo diagnosis

A

skin scrapings or swab

78
Q

Which 2 conditions can predispose someone to candidal intertrigo?

A

Diabetes mellitus
HIV

79
Q

Candidal intertrigo treatment

A

topical antifungals (eg. clotrimazole)
or antifungal with weak steroid (eg. daktacort)
keep area dry (eg. lose weight, loose clothing)
oral antifungals if severe (eg fluconazole)

80
Q

What causes pityriais versicolor?

A

yeast - Malassezia furfur

81
Q

What is pityriasis versicolor?

A

superficial mycotic infection of skin

82
Q

Describe pityriasis versicolor

A

confluent, fine, scaly, well-demarcated, hypo/hyper-pigmented plaques

83
Q

Pityriasis versicolor diagnosis

A

skin scrapings or swab

84
Q

Pityriasis versicolor treatment

A

selenium sulfide shampoo
ketoconazole shampoo
topical antifungals

Dermatology (23 decks)

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