Infections

Question 1

staph aureus

Answer 1

bullous impetigo: 2-3cm blisters; rare
scalded skin: rare; widespread;
toxic shock

erysipelas (less than strep)
cellulitis (less than strep)
ecthyma (mixed)
impetigo
folliculitis
furunculosis/carbuncle (boils)
infected eczema

Question 2

strep/GAS

Answer 2

erythema nodosum
erythema multiforme
guttate psoriasis
vasculitis
glomerulonephritis

scarlet fever
STSLS

cellulitis
erysipelas
impetigo
necrotising fasciitis
infected eczema/ulcers

Question 3

Pseudomonas

Answer 3

ulcers/burn infection
parnychia
folliculitis (gram neg)
green skin discolouration

Rx: flamazine, acetic acid, PO ciprofloxacin

Question 4

corynebacterium

Answer 4

erythrasma

pitted keratolysis: soles; smelly white punched-out pits; Rx: soaks, dry, top ABx

Question 5

mycobacteria

Answer 5

cutaneous TB/lupus vulgaris: red/brown defined plaque; Rx: RIPE
leprosy: TB = hypopig/hypoaesth, local; lepromatous = widespread, ‘leonine’; Dapsone, rif, clofazimine
Fish tank granuloma (hand nodule); tetracycline

Question 6

spirochaete

Answer 6

syphilis: 1o aSx non-painful Chancre; 2o generalised macpap rash incl. palms/soles

lyme disease: borrelia (ticks); migrating annular rash + neuro + organs; doxycycline

Question 7

impetigo

Answer 7

golden crusted papules; mouth/nose/limbs

usually staph (Can be strep), may have toxin blisters

Rx: topical mupirocin + PO Fluclox

Question 8

ecthyma

Answer 8

indurated non-healing ulcer
thick crust
deep strep infection - long course (2-4/52) ABx PO (erythro/fluclox)
RF: DM/immunosuppression
may scar

Question 9

cellulitis

Answer 9

erythema, swelling, shiny/taught, poorly defined; inflam 4
systemic

subcutaneous staph/strep
systemic ABx (PO/IV benpen/fluclox)

Question 10

erysipelas

Answer 10

acute severe onset; systemic
‘beefy red’ circ’d unilateral cheek plaque
inflamm 4

GAS cellulitis
PO/IV benpen 10-14d

Question 11

staph scolded skin syndrome

Answer 11

erosions on face and body, esp. flexures
blisters/peeling
widespread erythemna
systemic upset

IV fluclox/erythro + IVF + analgesia + emollients

Question 12

toxic shock syndrome

Answer 12

fever, vom, dd, circulatory collapse

widespread macular erythema, desquamation (10-21d), oedema, ulceration

IV fluclox/erythro

Question 13

scarlet fever

Answer 13

fever, tonsilitis, painful cervical LA;
rash spreads from trunk to limbs, ‘sunburn’ then scaling and desquamation

Rx: benpen + support

Question 14

necrotising fasciitis

Answer 14

high fever, intense pain
rapid progression;spread; empysema, erythema, blistering and necrosis

deep infection, staph and strep

Rx: IV ABx + debride

Question 15

superficial folliculitis

Answer 15

pustules around hairs

staph aureus - fluclox

Question 16

pseudofolliculitis

Answer 16

trapped hairs

emollients + steroids

Question 17

furuncle and carbuncle

Answer 17

fluclox
deep (and multiple) follicle infection

drainage sites

Question 18

viral warts (HPV)

Answer 18

common, mosaic, plane, filiform, plantar, anogenital

Question 19

viral warts - Rx

Answer 19

cryotherapy or curettage most common
may resolve sponataneously

paints, formalin soak, podophyllin

Question 20

molluscum contagiosum

Answer 20

asymptomatic self-limiting pox virus
kids and atopic
umbilicated papules

no Rx needed

Question 21

HSV

Answer 21

cold sores
genital lesions
gingivo: painful oral lesions/uclers

Rx: top/PO aciclovir if prompt

Question 22

HSV complications

Answer 22

gingivostomatitis: oral, vesicles, pain, fever
keratoconjunctivitis: ulcer
Bell’s palsy
eczema herpeticum
erythema multifome (65% of cases)
herpetic whitlow (local infection)
disseminated infection

Question 23

shingles

Answer 23

dermatomal, herpetiform clusters
shiny vesicles, some pustules, some haemorrhagic/scaly/dirty grey necrosis
erythematous base
pain and paraesthesis (PHN), palsy, uveitis, keratinitis, conjunctivitis
*RHS!

Question 24

hand/foot/mouth

Answer 24

vesicles

epidemics

Question 25

pityriasis rosea

Answer 25

herald patch
small macules
annular + scaling edge

Question 26

commensals

Answer 26

staph
micrococci
corynebacteria
proprionbacteria (acne)
yeasts, mites

Question 27

eczema herpeticum

Answer 27

crusted primary papules, puncatate erosions
itchy, sore monomorphic vesicles
systemic upset

Rx: aciclovir +/- ABx +/- steroids (for eczema)

Question 28

chicken pox

Answer 28

14-17 day incubation
infectious: 2 days before until 7 days after rash

erythema, intense puritus
papules, vesicles, crusting

Question 29

erythrasma

Answer 29

corynebacteria
dry erythema with fine scaling
no annular/ring scaling, or itching
wood’s light: coral pink

Rx: erythromicin