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2A week 3 - eczema, psoriasis and infections > common skin infections > Flashcards

common skin infections Flashcards

1
Q

4 common viral skin infections

A
  1. herpes simplex;
  2. herpes zoester/shingles;
  3. viral warts;
  4. molluscum contagiosum
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2
Q

who might get multi-dermal shingles

A

immunocompromised; diabetes; elderly

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3
Q

herpes simplex usual presentation

A

cold sore (around mucosa e.g. mouth, genitals); grouped vesicles on erythmatous base; severe pain; often recurrent in same dermatoses (location)

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4
Q

treatments for herpes simplex

A

topical acyclovir (delicate areas e.g. eyelinds); systemic acyclovir (200mg,5x a day, 5 days)

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5
Q

herpes simplex prophylaxis

A

acyclovir 200mg TDS for 6-12mo

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6
Q

when is prophylaxis given for herpes simplex

A

recurrent episodes (>2 per year)

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7
Q

where does HSV lie dormant

A

sensory ganglia

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8
Q

what can occur in those who have eczema herpeticum (infected eczema) post treatment

A

flare up

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9
Q

what can be given alongside to reduce eczema flare up

A

steroids

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10
Q

erythema multiforma classic presentation

A

red, raised circles - secondary to infection/drugs

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11
Q

shingles presentation

A

usually dermatomal/ band like pattern - pain; grouped vesicles on erythematous base -> crusting; malaise; fever; Hx of past shingles of chicken pox

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12
Q

why are herpes simplex/zoesta confined to dermatomes usually

A

they lie dormant in the ganglia of sensory neruons and so affect which ever dermatome is innervated by the nerve

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13
Q

herpes zoester treatment

A

analgesics; acylovir

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14
Q

3 complications of herpes zoster

A

post-herpetic neuralgia; cranial nerve syndromes - ramsey hunt syndrome (CN VII), optic involvement (CN II)

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15
Q

what HPV subtypes can cause cancers

A

16, 18

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16
Q

what HPV subtypes can cause genital warts

A

6, 11

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17
Q

warts presentation

A

very variable - may be crusted, hyperkeratotic or can be flat, flesh coloured papule, plaque studded with small black dots (thrombosed capillaries); single or multiple present

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18
Q

treatment for warts

A

no treatment - self limiting (some quickly, some take longer); topical salicylic acid post filing down; cryotherapy

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19
Q

why is filing down a wart beneficial

A

microtrauma (esp if bleeds) caused allows for stimulaiton of inflammatory response and for penetration of salicylic acid to root of wart

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20
Q

when should a wart be biopsied

A

rapidly growing, painful, bleeding

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21
Q

what is molluscum contagiosum

A

a benign pox virus commonly seen in children or on genital skin

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22
Q

molluscum contagiosum presentation

A

“pearly papule” with umbilication; often multiple; contain keratotic plug

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23
Q

how is molluscum contagiosum transmited

A

skin to skin contact - advise to reduce contact with others

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24
Q

5 bacterial skin infections

A
  1. impetigo;
  2. follicultitis/furanculosis;
  3. ecthyma;
  4. erysipelas/cellulitis;
  5. necrotising facitis
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25
Q

necrotising fascitis treatment

A

emergency - call surgeon for debridement, IV Abx

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26
Q

what organisms cause impetigo

A

S.aureus; S.pyogenes

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27
Q

impetigo presentation

A

classicaly a yellow/golden crust to the area; NO visible vesicles;

28
Q

what is bullous impetigo

A

impetigo with large pus filled blisters that can rapidly spread -> can grow cultures to confirm

29
Q

when is Abx given for bullous impetigo

A

systemically unwell, usually a B-lactam

30
Q

what can be given as treatment for bullous impetigo

A

topical abx - mupirocin

31
Q

what is folliculitis

A

inflammation of hair follicles

32
Q

what organisms cause folliculitis

A

S.aureus; P.aeruginosa

33
Q

where might p.aeruginosa causing folliculitis be acquired from

A

hot tub/ pool - wet environment

34
Q

folliculitis vs furunculosis vs carbunculosis

A

folliculitis - pustules
furinculosis - nodules, purulent discharge, tender
carbunculosis - larger and deeper inflammaotry nodules with purulent drainage -> plastic surgeon may be needed

35
Q

treatment for furunculosis

A

topical Abx - 1% clindamycin OR 2% erythromycin; or incision and drainage

36
Q

what is ecthyma

A

deep infection of the skin - down to dermis (usually deeper than cellulitis)

37
Q

what organisms cause ectyma (2)

A

S.aureus; S.pyogenes

38
Q

ecthyma presentation

A

vesicles/bullae that progress to punched-out ulcerations with adherent crust -> heals w scaring

39
Q

echyma treatment

A

oral antistaphylococcal abx (flucoxacillin)

40
Q

cellulitis presentation

A

UNILATERAL, red ,hot, swollen (leg), ill-defined

41
Q

what is erysipelas

A

a superficial form of cellulitis - tender and well defined

42
Q

how is cellulitis treated

A

abx - B-lactams

43
Q

what can cause nectrotizing fascitis

A

S.pyogens; group B/C streptococci; clostridium perfringens

44
Q

symptoms of necrotising fascitits (6)

A
  1. severe pain unresponsive to analgesia;
  2. erythema; skin becomes dusky;
  3. formation of bullae followed by necrosis;
  4. gangrene;
  5. fever;
  6. systemic toxicity
45
Q

3 parasitic skin infections

A
  1. scabies;
  2. leishmaniasis
  3. cutaneous larva migrans
46
Q

what is scabies

A

an infection of the skin caused by S.scabiei burrowing into the epidermis; transmitted by skin-skin contact

47
Q

scabies symptoms (4)

A
  1. intense itching especially at night;
  2. involvement of the finger webs, wrists, elbows, armpits, lower buttocks, thighs etc.
  3. vesicles, papules, pustules
  4. burrows
48
Q

how to diagnoses scabies

A

look for mites/eggs in a skin scraping sample

49
Q

treatment for scabies

A

treat ALL family member/close contacts - permethrin; repeat after 7 days

50
Q

what is the vector for leishaniasis and where is it normally seen

A

sand fly; often seen in south america

51
Q

leishmaniasis presentation

A

skin lesions with erythema, inflammation, ulceration;

depends on type - if mucocutaneos then lesions of nasal/oral mucosa; if Diffuse Cutaneous - multiple deep skin lesions

52
Q

treatment of leishmaniasis

A

amphotericin B

53
Q

what is cutaneous larva migrans

A

larva of cat or dog hookworm

54
Q

presentation of cutaneous larva migrans

A

cutaneous erythmatous erruption confined to skin of feet, arms or buttocks; rash may be seen moving slowly (movement of the parasite); Hx of walking barefoot abroad (brazil)

55
Q

treatment of cutaneous larva migrans

A

antifungals - thiabendazole, albendazole, mebendazole etc.

56
Q

6 fungal infections of the skin

A
  1. tinea corporis
  2. tinea capitis
  3. tinea pedis
  4. tinea cruris
  5. candidal intertrigo
  6. pitytiasis versicolor
57
Q

what is tinea

A

infectious disease of the skin caused by fungi

58
Q

tinea general presentation

A

peripheral scaling discoid lesions; itch

59
Q

tinea treatment

A

topical anti-fungals e.g. miconazole, clotrimazole; sytemic antifungals for nails or scalp involvement e.g. terbinafine

60
Q

what is seen in tinea under a microscope and with wood’s light

A

micro - branching hyphae
wood’s light - green fluorescence

61
Q

what is candidal intertrigo

A

a superficial mycotic infection of the skin that affects moist occluded skin folds (e.g. under breasts, obese folds); yeast

62
Q

candidal intertrigo presentation

A

erythematous macerated patch with satellite macules of pustules extending beyond the flexure; may be itchy or painful

63
Q

what is a macule

A

a flat, distinct, discolored area of skin

64
Q

candidal intertrigo treatment

A
  1. topical antifungals e.g. clotrimazole, terbinafine;
  2. antifungal + weak steroid e.g. daktacort;
  3. keep area dry;
  4. weight loss
65
Q

what is pityriasis versicolor

A

a fungal (yeast) skin infection

66
Q

pityriasis versicolor presentation

A

fine scaly, well-demarcated, hypopigmented or hyperpigmented plaques (area of skin slightly raised)

67
Q

pityriasis versicolor treatment

A
  1. selenium sulfide shampoo or kertoconazole shampoo (lather hair then allow it to wash down the body), may be lifelong treatment;
  2. antifungal with weak steroid (daktacort)
  3. if resistant then oral antifungals (usually immunocomprismised e.g. HIV)

2A week 3 - eczema, psoriasis and infections (6 decks)

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