Integumentary 3 Flashcards
carbuncles are
several boils that coalesce to form a large boil or abscess
several boils that coalesce to form a large boil or abscess
carbuncle
carbuncles are usually treated with what
systemic abx
purulent cellulitis organism
S. aureus (gram positive)
non-purulent form of cellulitis is usually due to ____ but may also be ____
streptococci; staphylococcal
people with liver disease, immunocompromised status, or those who are pregnant should avoid eating what
raw or undercooked oysters or clams d/t to possibility of Vibrio vulnificus infection
cellulitis classic case
acute onset of diffused pink to red colored skin that is poorly demarcated with advancing margins
cellulitis - abscess (boils) are usually due to
staphylococcus or MRSA
cellulitis labs
2
C&S
CBC if fever or signs of systemic illness (refer to ED)
non-purulent cellulitis tx options with no risk factors for MRSA
4
dicloxacillin
flucloxacillin
cephalexin
cefadroxil
purulent cellulitis tx w/o severe sepsis but with risk factors for MRSA
3
trimethoprim-sulfamethoxazole
amoxicillin w/ doxycycline
linezolid
for immunocompetent patients with purulent cellulitis w/o severe sepsis but with a risk factor for MRSA, give what
trimethoprim-sulfamethoxazole
atopic dermatitis/eczema mild to moderate disease - what are first line tx
2
topical steroids
emollients
eczema mild disease topical steroids
2
low potency - classes V and VI (e.g. hydrocortisone)
eczema mod disease steroid potency
classes III and IV (e.g. triamcinolone)
eczema - face and skin folds tx
recommend topical calcineurin inhibitors, which are at higher risk for skin atrophy
eczema of ear canal tx
corticosteroid based ophthalmic solutions
contact dermatitis tx
topical steroids 1-2 x day for 1-2 weeks; use high potency steroid (triamcinolone, halcinonide), calamine lotion, or oatmeal baths
tinea infections - labs
2
fungal culture of scales/hair/nails or skin lesions
potassium hydroxide KOH slide microscopy reveals pseudohyphae and spores
tinea capitis tx
systemic tx only - topicals are not effective
asymptomatic scaly patch that gradually enlarges; hairs inside the patch break off easily by the roots =
tinea capitis
tinea capitis - LFTs
determine baseline LFTs and repeat 2 weeks after initiating systemic antifungal treatment
tinea capitis gold standard tx
oral antifungal therapy with griseofluvin, terbinafine, fluconzaole, and itraconazole
early lyme disease two step testing
- first step is enzyme immunoassay EIA; if negative no further testing
- if positive the second test is the indirect immunofluorescence assay (IFA, or western blot test)
EIA and IFA are to
lyme disease tests
western blot test aka
IFA
lyme disease - if what two things are positive, patient likely has lyme disease
both EIA and IFA
treatment - early lyme disease only
3
doxy BID x 10 days (first line)
amoxicillin 500 mg TID or feuroxime axetil 500 mg BID x 14 days (alternative)
erysipelas
a subtype of cellulitis involving the upper dermis and superficial lymphatics that is usually caused by group A streptococcus
sudden onset of one large, hot, indurated red skin lesions that has clear demarcated margins; accompanied by fever, chills, severe malaise, and HA
erysipelas
