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Dermatology Crash Course > Infections and Infestations > Flashcards

Infections and Infestations Flashcards

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Dermatology Board Prep flashcards
1
Q

Describe change on skin of newborn baby in first few days of life?

A

Baby goes from sterile womb environment to non-sterile world.

Skin is colonised by 1000s of bacteria

Baby commonly gets rash called Pitorosporum

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2
Q

What are some common bacteria and funghi that normally live on our skin?

A

Staph Aureus

Staph Epidermis

Candida

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3
Q

Common signs of infection?

A

Remember classic signs

Rubor (Redness)

Dolor (Pain)

Calor (Heat)

Tumour (Swelling)

Pus

Blisters etc

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4
Q

How do you diagnose infection?

A

History

Exam

Investigations

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5
Q

What are some common investigations?

A

Swabs

Bloods (LFTs, U&Es etc)

Biopsy

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6
Q

What are the common infective agents of the skin?

A

Staph Aureus

Strep Pyogenes

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7
Q

What are the 4 bacterial infections to note?

A

Impetigo

Cellulitis

Oedema Blisters

Lipodermatosclerosis

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8
Q

What is Impetigo?

A

Most common bacterial infection in children

Honey crusted scabs (may also have Bulla) which are made worse by scratching

Caused by Staph Aureus and Strep Pyogenes

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9
Q

How do you treat Impitigo?

A

Topically -

Fusidic Acid 3/4 times a day for 5 days

Mupirocin 3/4 times a day for 5 days (if MRSA)

Orally (if systemic, severe or bullous) -

Flucloxacillin - 4x times daily for 7 days

Erythromycin - 4x times daily for 7 days

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10
Q

What is Cellulitis?

A

Bacterial infection caused by Staph Aureus and Strep Pyogenes

Causes red swollen lower limbs, may be hot

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11
Q

Where is cellulitis common?

A

Lower limb - below the knee

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12
Q

What are the symptoms of cellulitis?

A

Tender and hot

If the infection is extensive then fever as well

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13
Q

How do you diagnose Cellulitis?

A

Take swab and send to lab

Start on empirical Abx

IV Flucloxacillin every 6 hours

AND Benzylpenicillin every 6 hours

Review Abx after 48 hours and check bacterial swab results

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14
Q

If the Cellulitis isnt better in a week what might have happened?

A

Diagnosis wrong - think of differential diagnosis eg

Necrotising Fasciitis

Venous Eczema

DVT

Allergic Dermatitis

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15
Q

What is Ersypelas?

A

Acute, sometimes recurrent disease caused by a bacterial infection, characterized by large raised red patches on the skin.

More superficial than cellulitis

Caused by strep

Skin is raised and inflamed over infected area

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16
Q

What are Oedema Blisters?

A

Exacerbation of Oedema

Can be misdiagnosed as Cellulitis as affects lower limbs and dorsum of feet

Causes redness and swelling

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17
Q

What causes Lipodermatosclerosis?

A

Poor circulation in lower limbs causes inflammation of fat

Often hints at underlying venous issues

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18
Q

How do you treat Lipodermatosclerosis?

A

Compression stocking

Treat underlying venous disease or refer to specialist

Topical Steroids for inflamm

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19
Q

Name 2 common forms of Fungal infection

A

Tinea (Moulds) - Dermatophyte

Candidiasis (Yeasts) - red circles

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20
Q

Name some Tinea infections based on body area affected?

A

Tinea Corporis - Body (Ringworm)

Tinea Capitis - Head/Scalp

Tinea Cruris - Groin

Tinea Pedis - Foot

21
Q

How do you diagnose fungal infections?

A

Skin scraping, hair or nail sample

Incubate in lab - results can take weeks

22
Q

How do you treat tinea of scalp and nails?

A

Oral antifungals

23
Q

How do you treat Tinea of the body, hands, feet etc? (NOT scalp and nails)

A

Topical antifungals eg

Clotrimazole

Terbinafine

24
Q

What are the best agents to treat tinea pedis (dermatophyte fungi)?

A

Clotrimazole or terbinafine

25
Q

What happens when you use topical steroids on tinea?

A

Loss of scaly appearance

(tinea incognita)

26
Q

Who else besides the patient do you need to treat if Tinea infection is present?

A

Family and close contacts

27
Q

What common condition is Tinea sometimes mistaken for?

A

Eczema

28
Q

What is the most common yeast infection?

A

Candida albicans- grows on moist areas

(obese people who are unable to wash well)

29
Q

What is Candida Albicans?

A

Common yeast infection - likes warm, moist environments

30
Q

What does candida albicans look like?

A

Brick red erythema

Satellite pustules

(commonly foound underneath the breasts or inbetween the fingers of people who have a lot of wetness on their hands - occupation related)

31
Q

How do you treat Candida Albicans?

A

Topical antifungal eg

Miconazole

Ketoconazole

ZOLES

32
Q

What is Intertrigo and how is it linked to fungal infections?

A

Intertrigo is inflamm of skin folds eg areas where skin may rub more (under breasts etc)

This inflamm can be made worse by bacterial or fungal infections eg Candida Albicans commonly (warm and moist)

33
Q

What are some common viral infections you may see?

A

Viral Warts

DNA Pox Virus

Herpes Simplex Virus

Herpes Zoster Virus

34
Q

Describe Viral Warts

A

Common in children, often on hands

Resolve usually on their own within few years

Shouldnt limit child - plaster over them

If persist can freeze off

35
Q

Describe DNA Pox Virus

A

Papules with a central dent

Treat with 5% Potassium Hydroxide to papule - body will launch immune response and then recognise from then on

36
Q

Describe Herpes Simplex Virus

A

Type 1 = Coldsores

Type 2 = Genital Warts

Treat with Aciclovir

37
Q

What is the pathogenesis of the herpes simplex virus?

A

Primary infection

Latent period

Reactivation

38
Q

Who is likely to suffer from worse cinical episodes from the herpes simplex virus?

A

The immunosuppressed

Those with atopic eczema

39
Q

Describe the Herpes Zoster Virus

A

Chickenpox in children - usually build immunity to it

Can reactivate in adults as SHINGLES

Very harmful to others who havent had pox before so IPC measures very important

40
Q

What is the pathogenesis of the herpes zoster virus?

A

Primary exposure

Chicken pox

Latent infection

Reactivation

Shingles

(pain / constitutional symptoms)

about 4 days after - rash

The rash usually tracks around the body - however it does not cross the midline of the body

41
Q

Name a common INFESTATION

A

Scabies

42
Q

What is the main symptoms in scabies?

A

Itching - may also see red raised bumps which hints at burrows

43
Q

What causes the itching in scabies?

A

A protein in mite droppings

44
Q

Where does scabies normally infect?

A

Hands & Feet

Also areas of body hair eg genitals, breasts, belly button etc

45
Q

How is scabies spread?

A

Long skin-skin contact (about a minute), also bed sheets, clothing etc

46
Q

What causes the rash associated with scabies, describe the rash

A

Allergic rash is usually on the sides of the torso – lesions here do not have mites – they are the allergic manifestation of the mites

47
Q

How do we diagnose Scabies?

A

A) Skin scraping/swab and send to lab

B) Also useful to draw circle in ink around suspected burrow and wipe away ink - if some doesnt budge its because ink has entered the burrow

48
Q

How do we treat scabies?

A

PERMETHRIN CREAM - applied head to toe for 8 hours

Do again 7 days later

Also treat family/close contacts - wash bedding etc

Treat ongoing itch symptomatically with steroids for anti-inflammatory effects.

Dermatology Crash Course (11 decks)

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