Infections & Infestations

Question 1

Describe the progression of HSV?

Answer 1

1st exposure causes the first clinical episode or goes straight to latency.

Lies latent in your DRG

New episodes occur due to certain stimuli

Question 2

What can cause a flare up of HSV?

Answer 2

• Trauma
• Menstruation
• Sunlight
• Fever
• Stress
• random?

Question 3

So if a patient presents with small closely grouped vesicles/pustules that come and go in the same place?

Answer 3

Herpes simplex virus

Tends to return to the same spot as the first exposure e.g. hands/genital/mouth

Question 4

How do we treat HSV?

Answer 4

Aciclovir

Question 5

What patients suffer badly with HSV?

Answer 5

Immunocompromised or atopic patients

Question 6

How does Herpes Zoster Virus appear?

Answer 6

Closely grouped vesicles in a dermatomal distribution

Question 7

What conditions are caused by HZV?

Answer 7

Chickenpox on primary exposure

Shingles later

Question 8

How do you trat HZV and what are its complications?

Answer 8

Aciclovir

Extensive Scarring and Post-herpetic Neuralgia

Question 9

If a patient tells you they had a small number of papules/vesicles on their hands and after 6 weeks broke out in itchy excoriations and pustules on their chest what do you think they have?

Answer 9

SCABIES!!

Mites transferred from person to person burrow under you skin and shit. after 6 wks or so you get allergic to the faeces and break out in the itchy rash

Question 10

How is Scabies transmitted?

Answer 10

Person to person.

Its slow, you have to hold someones body for around a minute for the mites to pass over. (so think loved ones)

Question 11

What can you look for to confirm scabies?

Answer 11

Visible burrows in the skin, mainly the hands.

Question 12

How do you treat scabies?

Answer 12

Liclear cream
Patient has to cover their whole body in it, wait 8 hours, wash it off and repeat in 1 wk

Ensure you treat all their contacts simulatenously to prevent re-infection

Question 13

What virus causes warts?

Answer 13

Human Papilloma Virus (HPV)

has a 4 month incubation period

Question 14

What are the types of Warts?

Answer 14

Common
Plantar
Genital
Other - Plane/filiform/mosaic

Question 15

How do you treat warts?

Answer 15

Largely let them regress themselves
Chemical paints e.g. salicylic acid
Cryotherapy e.g. Liq Nitrogen
Imiquimod (genital warts)

Question 16

What are the main bacterial species causes skin infections?

Answer 16

Staph Aureus
Streptococci

They can cause Impetigo, Ecthyma/Cellulitis, Erysipelas and boils (Furuncle)

Question 17

How do we treat bacterial infections?

Answer 17

Antibiotics
IV for Erysipelas

Drain pus from a boil

Question 18

Whats the most common fungal infection and how do you get it?

Answer 18

CAndida Yeast

Wet, unclean areas like under breasts. nails or between fingers get infected if you don’t keep them clean

Question 19

How does candida present and how do we get ris of it?

Answer 19

Erythema rash with satellite pustules

Oral or topical antifungals (e.g. fluconazole)

Question 20

What infections can dermatophyte fungi cause?

Answer 20

Tinea Pedia (Athlete’s Foot)
Tinea Corpuris
Tinea Cruris (akak Tinea Incognito)
Tinea Barbea

Question 21

How do Tinea infections appear?

Answer 21

Flaky red rings with scaly bits around the edge

Tinea Pedis has white lacerated flaky skin between toes

Tinea Incognito loses the scaly appearance, often just being a large reg patch expanding from the inguinal creases

Question 22

How do we test for Tinea infection?

Answer 22

Skin scrape from the edge of the scaly rings for a fungal culture

Question 23

What is Kerion?

Answer 23

A fungal scalp infection, mainly in kids whos scalps dont make much sebum (grease).
Looks like honeycomb oozing raw part of the scalp

Question 24

How do we test for kerion?

Answer 24

Hair sample from affected area for a fungal culture