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Dermatology Year 2 > Infections > Flashcards

Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Folliculitis?

A

Follicular erythema, sometimes pustular
Infectious or non-infectious
Eosinophilia folliculitis associated with HIV
Recurrent may arise from Staph a

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2
Q

Which staph a can cause recurrent folliculitis?

A

Panton-Valentine leukocidin (PVL)

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3
Q

Folliculitis treatment?

A

Antibiotics (flucloxacillin or erythromycin)
Incision and drainage for furunculosis

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4
Q

Furnuncle vs carbuncle?

A

Furuncle - deep folicular abscess

Carbuncle - involvement with adjacent follicles, more likely to lead to complications like cellulitis and septicaemia

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5
Q

Staph a infections - immunodeficiency?

A

Hypogammaglobulinaemia
HyperIgE syndrome
Chronic Granulomatous disease
AIDS
Diabetes mellitus

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6
Q

Panton Valentin Leukocidin Staph a?

A

Beta-pore-forming exotoxin, leukocyte destruction and tissue necrosis
Higher morbidity, mortality and transmissibility

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7
Q

Panton Valentin Leukocidin Staph a? Skin

A

Recurrent and painful abscesses, folliculitis, cellulitis
Often painful, more than 1 site, recurrent, present in contacts

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8
Q

Panton Valentin Leukocidin Staph a? Extracutaneous

A

Necrotising pneumonia
Necrotising fasciitis
Purpura fulminans

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9
Q

Panton Valentin Leukocidin Staph a risk of acquiring? 5 Cs.

A

Close contact
Contaminated items
Crowding
Cleanliness
Cuts and grazes

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10
Q

Panton Valentin Leukocidin Staph a? Treatment

A

ABx (tetracycline)
Decolonisation - chlorehexidine body wash for 7 days, nasal application of mupirocin ointment 5 days
Treatment of close contacts

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11
Q

Cellulitis? What, symptoms + treatment

A

Infection of lower dermis and subcutaneous tissue
Tender swelling with ill-defined, blanching erythema or oedema
Most cases - strep p + staph a
Oedema predisposing factor
Treatment - systemic ABx

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12
Q

Impetigo?

A

Superficial bacteria infection, stuck on, honey-coloured crusts overlying an erosion
Causes by strep (non-bullous) or staph (bullous)
Often affects face
Treatment with topical +/- systemic ABx

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13
Q

Streptococci vs staphylococci impetigo?

A

Strep - non-bullous

Staph - bullous, caused by exfoliative toxins A & B, split epidermis by targeting desmoglein I

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14
Q

Impetiginisation?

A

Occurs in atopic dermatitis
-gold crust
-staph aureus

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15
Q

Borreliosis? Meaning

A

Lyme disease
Annular erythema develops at site of bite of a borrelia-infected tick
Bite form Ixodes tick infected with Borrelia burgdorferi

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16
Q

Lyme disease initial cutaneous manifestation?

A

Erythema migrans (in 75%):
-erythematosus papule at bite site
-progression to annular erythema of >20cm

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17
Q

Lyme disease 1-30 days after infection, fever and headache?

A

Multiple secondary lesions develop - similar but smaller to initial
Neuroborreliosis
Arthritis (knee)
Carditis

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18
Q

Neuroborreliosis?

A

-facial palsy
-aseptic meningitis
-polyradiculitis

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19
Q

Syphilis? Primary

A

Primary infection Chancre - painless ulcer with a firm indurated border
Painless regional lymphadenopathy one week after primary chancre
Chancre appears within 10-90 days

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20
Q

Secondary syphilis?

A

Begins around 50 days after chancre
Malaise, fever, headache, Pruritus, loss of appetite, iritis
Rash, alopecia (moth eaten), mucous patches, lymphadenopathy, residual primary chancre, condylomata lata, hepatosplemomegaly

21
Q

Syphilis - lues maligna?

A

Rare manifestation of secondary syphilis
Pleomorphic skin lesions with pustules, nodules and ulcers with necrotising vasculitis
More frequent in HIV manifestation

22
Q

Tertiary syphilis?

A

Gummy skin lesions - nodules and plaques
Extended peripherally while central areas heal with scarring and atrophy
Mucosal lesions extend to and destroy nasal cartilage
CVD
Neurosyphilis - general pareses or tabes dorsalis

23
Q

Syphilis treatment?

A

IM benzylpenicillin or oral tetracycline

24
Q

Herpes Simplex Virus? What, where and how

A

Primary and recurrent vesicular eruptions
Favour orolabial and genital regions
Transmission can occur even during asymptomatic periods of viral shedding
Replicates at mucocutaneous site of infection
Travels by retrograde axonal flow to dorsal root

25
Q

HSV 1 vs 2?

A

HSV-1 - direct contact with contaminated saliva/other infected secretions
HSV-2 - sexual contact

26
Q

HSV symptoms?

A

Symptoms within 3-7 days
Preceded by tender lymphadenopathy, malaise, anorexia +/- burning, tingling
Painful rouped vesicles on erythematosus base -> ulceration/pustules/erosions with scalloped border
Crusting and resolution within 2-6 weeks

27
Q

HSV orolabial lesions?

A

Often asymptomatic

28
Q

HSV genital involvement?

A

Orfeo excruciatingly painful - urinary retention

29
Q

HSV systemic manifestations?

A

Aseptic meningitis in up to 10% of omen

30
Q

HSV reactivation?

A

Spontaneous, UV, fever, local tissue damage, stress

31
Q

Eczema herpeticum?

A

Emergency
Monomorphic, punched out erosions (excoriated vesicles)

32
Q

Herpes whitlow?

A

HSV (1>2) infection of digits - pain, swelling and vesicles
Misdiagnosed as paronychia or dactylitis
Often in children

33
Q

Neonatal HSV?

A

Exposure to HSV during vaginal delivery - risk higher when HSV acquired near time of delivery
1 or 2
Onset from birth to 2 weeks
Localised usually - scalp or trunk
Vesicles - bullae erosions
Encephalitis
Requires IV antivirals

34
Q

Severe or chronic HSV?

A

Immunocompromised patients
Most common presentation - chronic, enlarging ulceration
Multiple sites or disseminated
Often atypical
Involvement of resp or GI tract possible

35
Q

HSV diagnosis and treatment?

A

Swab for PCR
Oral valacyclovir or acyclovir

36
Q

Fungal infections subclassifications?

A

Superficial
Deep/soft tissue
Disseminated

37
Q

Superficial fungal infections? Pityriasis versicolor

A

Hypo/hyper pigmented or erythematosus macular eruption +/- fine scale
Begins during adolescence (when sebaceous glands become active)
Flares when temperatures and humidity are high
Topical azole

38
Q

Dermatophytes?

A

Fungi that live on keratin

39
Q

What causes the most fungal infections?

A

Trichiphyton rubrum

40
Q

Kerion?

A

An inflammatory fungal infection that may mimic a bacterial folliculitis or an abscess of the scalp - scalp is tender and patient usually has posterior cervical lymphadenopathy
Frequently secondary to staph a

41
Q

Superficial fungal infections signs

A

Tinea pedis
Onychomycosis
Maceration between toes
Kerion formation

TOM K

42
Q

Id reaction? Superficial fungal infections

A

Dermatophytid reactions
Inflammatory reactions at sites distant from associated dermatophyte infection
May include urticaria, hand dermatitis, or erythema nodosum

43
Q

Candidiasis? (Superficial fungal infections)

A

Candida albicans
Predisposition - occlusion, moisture, warm temp, DM
Most sites show erythema oedema, thin purulent discharge
Usually intertriginous infection (skin folds) or of oral muscosa
Common cause of vulvovaginitis
Can become systemic

44
Q

Opportunistic fungal infections? Mucormycosis

A

Oedema, then pain, then eschar
Fever, headache proptosis, facial pain, orbital cellulitis +/- CN dysfunction
Associations - DM, malnutrition, uraemia, neutropenia, steroids ABx, burns, HIV

45
Q

Mucormycosis (opportunistic) treatment?

A

Aggressive debridement and anti fungal therapy amphoteracin

46
Q

Scabies?

A

Caused by Sarcoptes species
Female mates, burrows into upper epidermis, lays eggs then dies after one month
Insidious onset - red to flesh coloured Pruritic papules
Affects interdigital areas of digits, volar wrists, axillary areas and genitalia
diagnostic burrow consisting of fine white scale

47
Q

Crusted or ‘Norwegian’ scabies?

A

Hyperkeratosis
Often asymptomatic

48
Q

Scabies treatment?

A

Permethrin, oral ivermectin
2 cycles required

Dermatology Year 2 (3 decks)

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