Cutaneous Infection/Soft tissue infection Flashcards
What is impetigo?
Superficial bacterial infection caused by S.aureus or S.pyogens. Commonly occurs as a complication of of eczema, scabies or insect bites
What are the features of impetigo?
Common in paeds. Occurs in the face, flexures and limbs.
Presents with golden crusted lesions around the moth and is very contageous
What is the treatment for impetigo?
1% hydrogen peroxide cream first line for non-bollous impetigo.
Can also use fusidic acid, topical mupirocin
What treatment is used in impetigo if there is extensive disease?
Oral flucloxacillin or erythromycin if pen allergic
How long should children be excluded from school for impetigo?
Until lesions are crusted and healed or 48 hours after starting antibiotics
What is Tinea and its features
Superficial fungal infections of the skin/nails.
Caused by microsporum, epidermophyton and other fungi.
Diagnosed via skin scrapings
Treatment of non-severe cases - topical clotrimoxazole or terbinafine cream. Systemic therapy required in severe cases and this can be terbinafine
What are soft tissue abscesses?
Infection within dermis/fat layers with development of walled off infection and pus.
Limited antibiotic penetration into abscess so best treatment is surgical drainage with Abx use if not fully drained/surrounding cellulitis.
Describe features of cellulitis
Infection involving the dermis, commonly caused by S. aureus and group A strep (beta-haemolytic strep)
Often tracks through lymphatic system and may be associated with systemic upset
What is the classification of cellulitis
Ero classification:
Class I - No signs of systemic toxicity or uncontrolled comorbidities.
Class II - Person is systemically unwell or has comorbidities.
Class III - Person has severe systemic upset or unstable comorbidities.
Class IV - Person has severe infection/sepsis
What is the treatment for cellulitis?
Eron class 1 - Oral fluclox. Erythromycin in pregnancy. Clari as second line
Eron Class 2 - IV fluclox
Eron class 3/4 - IV co-amoxiclav, IV clindamycin
What is the management of orbital cellulitis?
IV antibiotics. Important to differentiate from preseptal cellulitis. Orbital cellulitis presents with reduced visual acuity, opthalmoplegia/pain with eye movements
What does the following image show and what are its features?
Molluscum contagiosum. It is caused by the pox virus and is transmitted via close personal contact or contaminated surfaces/objects. Commonly occur in children.
WHat is the advice for molluscum contagiosum?
Self limiting condition which should resolve in 18 months. Lesions are contagious and should not scratch but exclusion from school is not necessary.
If lesions are trouble some then can do cryotherapy.
What does the following infection show and what are its features?
Pityriasis versicolor. It is a cutanrous fungal infection caused by malassezia furfur.
Commonly affects trunk and can be hypopigmented, pink or brown, Scale is common and there may be mild pruritus
What is the treatment for pityriasis versicolor?
Topical antifungal - ketoconazole shampoo. If fails to respond then consider alternative diagnosis, take skin scrapings and try itraconazole
What is the following?
A boil. It is an infection of the hair follicle where there is purulent extension into subcut tissue where a small abscess forms.
Most commonly caused by S. aureus
What is the following
A carbuncle - several boils join beneath the skin.
