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MSCT > MSCT Week 5: Cutaneous Infections > Flashcards

MSCT Week 5: Cutaneous Infections Flashcards

1
Q

Types of Cutaneous Infections and Infestations

5 Listed

A
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2
Q

Question 1

A

Impetigo (staphylococcus or streptococcus)

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3
Q

Impetigo Infection Type and Pathogen

A

Superficial Bacterial Infection

Staphylococcus aureus

Streptococcus pyogenes

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4
Q

Impetigo Location, morphology and description

A

commonly around the mouth or perineum

  • crusted
  • glazed
  • eroded papule to plaques
  • peripheral rim of scale
  • Honey Crusted
  • May be tender or asymptomatic
  • uncommonly bullous
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5
Q

“Honey Crusted” is descriptive of?

A

Impetigo

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6
Q

Impetigo Treatment

A

Topical or oral antibiotics

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7
Q

Impetigo Overview

A
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8
Q

Identify

A

Impetigo

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9
Q

Bullous
Impetigo

A

True Blistering Impetigo

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10
Q

Question 2

A

Cellulitis

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11
Q

Cellulitis Description

A

Common but serious bacterial skin and soft tissue infection

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12
Q

Cellulitis Morphology and appearance

5 listed

A
  • Edematous
  • erythematous
  • warm
  • sometimes taut/shiny localized plaque
  • usually unilateral
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13
Q

Cellulitis Etiology

A
  • May be initiated by a skin injury
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14
Q

Cellulitis Treatment

A
  • Rest
  • elevation
  • topical or systemic antibiotics
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15
Q

Cellulitis Overview

A
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16
Q

Question 3

A

Culture the Nasopharynx

because where is the problem and what is the bacteria doing to cause the problem

staph aureus toxin epidermolytic Toxin is coming from bacteria somewhere else

staph aureus lives in nasopharynx or perineum regions

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17
Q

Necrotizing Fasciitis Description & Pathogen

A
  • Rare “Flesh-eating bacteria”
  • deeper tissue injury
  • usually anaerobic bacteria or Grp A Streptococcus pyogenes
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18
Q

Necrotizing Fasciitis Crepitus

A

Creates Gas

Gas bubbles throughout the skin

crackling of gas upon palpation

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19
Q

Necrotizing Fasciitis Morphology and appearance

A
  • purple dusky necrotic color
  • can be ulcerous and bullae
  • crackling of gas upon palpation
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20
Q

Necrotizing Fasciitis Symptoms and treatment

A
  • Associated severe pain
  • systemic symptoms
  • Surgical emergency
  • IV antibiotics and other interventions
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21
Q

Necrotizing Fasciitis Overview

A
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22
Q

Staph Scalded Skin Syndrome (SSSS) Description and Pathogen

A

Epidermolytic-toxin produced by S. aureus

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23
Q

Staph Scalded Skin Syndrome (SSSS) caused by and seen in?

A
  • Cleavage/split of epidermis (basically just peels off)
  • Toxin comes from a bacteria somewhere else (usually nasopharynx or perneum)
  • Typically affects infants and younger children in immunocompromized and physiologically decreased renal function
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24
Q

Staph Scalded Skin Syndrome (SSSS) Pertinant negative

A

not affecting mucosa just perioral and eyes

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25
Q

Staph Scalded Skin Syndrome (SSSS) Diagnosis

A
  • Must culture the primary site like the nasopharynx or perianal
  • no true muscosal involvement
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26
Q

Staph Scalded Skin Syndrome (SSSS) Treatment

A
  • Systemic anti-staphylococcal antibiotic (PO or IV)
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27
Q

Identify

A

Staph Scalded Skin Syndrome

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28
Q

Question 4

A

Herpes Simplex Virus (HSV)

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29
Q

Herpes Simplex Virus Histology

A

individual keratinocytes infected by herpes simplex virus

have mutiple nuclei

have steely blue look with margination

molding nuclei fit together and mold together

3 Ms

Margination

Multinucleation

Molding

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30
Q

Herpes Simplex Virus Histology

A
  • individual keratinocytes infected by herpes simplex virus
  • have multiple nuclei
  • have a steely blue look to the nucleus with margination
  • molding nuclei fit together and mold together
  • 3 Ms
  • Margination
  • Multinucleation
  • Molding
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31
Q

Herpes Simplex Histology

A
  • individual keratinocytes infected by herpes simplex virus
  • have multiple nuclei
  • have a steely blue look to the nucleus with margination
  • molding nuclei fit together and mold together
  • 3 Ms
  • Margination
  • Multinucleation
  • Molding
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32
Q

Herpes Simplex Virus Description morphology and appearance

A

Fever blisters

cold sores

genital erosions

the initial infection may be asymptomatic to fulminant stomatitis

individual lesions may last days to weeks

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33
Q

Herpes Simplex Virus Treatment

A
  • systemic antiviral if indicated
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34
Q

Herpes Simplex Virus Recurrence

A

once infected recurrence is common

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35
Q

Herpes Simplex Virus Overview

A
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36
Q

Question 5

A

Chicken Pox (Varicella)

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37
Q

Varicella Zoster Virus Symptoms, prevalence

A

Chicken Pox

can have systemic symptoms

Largely reduced via immunization

Very concerning in the immunocompromized

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38
Q

Varicella Zoster Lesion Description

A

Widespread disseminated papules and vesicles

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39
Q

Varicella Zoster Virus Lesion Morphology

A
  • widely distributed vesicles and papules that are discreet from one another (disseminated papules and vesicles
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40
Q

Varicella Zoster Virus Reactivation

A

Zoster or shingles

Dermatomal distribution of papules, vesicles, and plaques

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41
Q

Varicella Zoster Virus Concerning Presentations

2 listed

A
  • Ophthalmic involvement (can cause blindness)
  • Ramsay-Hunt Syndrome: Facial Palsy and Ear pain
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42
Q

Varicella Zoster Virus Histology

A

Identical to HSV

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43
Q

Varicella Zoster Overview

A
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44
Q

Question 6

A

Human Papilloma Virus (HPV)

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45
Q

Human Papilloma Virus (HPV) Description

A

Verruca (warts)

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46
Q

Human Papilloma Virus (HPV) Subtypes

4 listed but there are more

A
  • Vulgaris
  • Palmoplantar
  • Plana
  • Condyloma acuminata
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47
Q

Vulgaris means

A

Common

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48
Q

Plana means

A

Flat

49
Q

Condyloma acuminata

A

Genital

50
Q

Human Papilloma Virus (HPV) considerations

A

if extensive consider immunosuppression

51
Q

Human Papilloma Virus (HPV) Treatment

3 listed

A
  • Cryotherapy (freezing)
  • Chemical destruction
  • Topical immunomodulators or irritants
52
Q

Human Papilloma Virus (HPV) Overview

A
53
Q

Verruca Vulgaris Histology

A
  • Rete bends in towards the middle
  • papillomatous epidermal acanthosis
  • hyperkeratosis
  • hypergranulosis
54
Q

Verruca Vulgaris Histology

A

Church spires papilomatous architecture

hemorhage within the cornified layer

55
Q

Verruca Vulgaris Histology

A

Keratinocytes infected have HPV change called a koilocyte (keratinocytes have a white halo around them and granular cytoplasm) indicative of HPV infection

black dots are hemorrhage dried blood

56
Q

Koilocyte

A

keratinocytes have a white halo around them and granular cytoplasm Indicative of HPV infection

57
Q

Question 7

A

Molluscum Contagiosum

58
Q

Molluscum Contagiosum Histology

A
59
Q

Molluscum Contagiosum Pathogen

A

Pox Virus

60
Q

Molluscum Contagiosum Characteristic lesion description and location

A
  • dome shaped papules with a waxy surface
  • single or multiple
  • may be pruiritic
  • 5mm
  • trunk, face, axillae, genital area
  • spread by scratching
61
Q

Molluscum Contagiosum spread by?

A

scratching (self-inoculation)

62
Q

Molluscum Contagiosum center of lesion

A

a curd-like core can be expressed from center

63
Q

Molluscum Contagiosum Course

A

spontaneous remission 2-3 yrs

64
Q

Molluscum Contagiosum Treatment

A
  • watchful waiting
  • curetting after topical anesthetic
  • especially in poorly controlled eczema
65
Q

Question 8

A

Tinea Pedis (athlete’s foot) can be diagnosed by KOH Stain

66
Q

Tzanck Stain diagnoses

A

Herpes Simplex Virus

PCR is usually used now though

67
Q

Tinea Pedis AKA

A

Athletes foot

68
Q

Mollusca Contagiosum sources of contagion

A
  • SexuallTransmitteded
  • skin-on-skin
69
Q

Tinea Pedis Pathogen

A

Dermatophyte infection

40+ species of fungi that feed on dead skin

  • Trichophyton
  • Microsporum
  • Epidermopyton
70
Q

Tinea Pedis Diagnosis

A
  • KOH Stain
  • Fungal culture if inconclusive
71
Q

Tinea Pedis pathogen and diagnosis overview

A
72
Q

Tinea Pedis Histology

A
  • neutrophils sitting in the cornified layer
  • pink staining hyphae in the cornified layer
73
Q

Tinea Pedis Histology Fungal Hyphae

A
74
Q

Tinea Infections Examples

7 listed

A

+

Scalp

Nails

Versicolor

75
Q

Annular Eruption should remind of

A

Ringworm Tinea Corporis

76
Q

Tinea infections of the scalp and nails

A
77
Q

Tinea Versicolor

A
  • Pityosporum not feeding on dead skin but sebum and oils neck chest and back
  • see hypopigmented round or cersinate well demarcated
  • can be hypopigmentation or hyper or pink
78
Q

Question 9

A

Secondary Syphilis (Treponema pallidum)

79
Q

Syphilis description and pathogen

A
  • Sexually Transmitted Disease
  • Treponema pallidum
  • have primary, secondary and teritary syphilis
80
Q

Primary Syphilis Presentation

A

solitary or multiple painless genital “Chancres”

81
Q

Secondary Syphilis

A

Rash & condyloma lata, systemic symptoms (febrile, fatigued etc.)

82
Q

Tertiary Syphilis

A
  • Gummas
  • Aortitis
  • neurosyphilis
83
Q

Congenital Syphilis

A
  • Stillbirth
  • Acral bullae/erosions
  • Rhinitis
  • Rhagades
  • Deafness
  • wet moist white epidermis lifting off erosive change
84
Q

Condyloma lata definition

A

is a cutaneous condition characterized by wart-like lesions on the genitals

85
Q

Syphilis histology

A

Plasma cells in the skin are big indicator because they’re not usually found there

86
Q

Identify

A

Syphilis Plasma cells in the skin not usually seen in the skin

87
Q

Identify

A

Syphilis Plasma cells in the skin which aren’t usually found there

88
Q

Identify

A

Secondary Syphilis

89
Q

Secondary Syphilis Histological Characteristics

A
90
Q

Question 10

A

Scabies

91
Q

Scabies Etiology

A
  • Skin infestation by human itch mite (Sarcoptes scabiei)
  • Adult female burrows into epidermis & lays eggs
92
Q

Scabies transmission

A

Transmitted by close skin-skin contact

93
Q

Scabies lesion description

A

Moth-eaten papules, burrows on hands, feet, waistline, genitals

94
Q

Scabies diagnosis

A

Mineral Prep oil and scraping to remove papule

95
Q

Scabies Transmission

A

Extremely itchy

Self-innoculation

transmitting to others

96
Q

Scabies treatment

A

Permethrin Cream Topically

&

again in 7 days when eggs have had a chance to hatch

97
Q

Scabies Histology

A
98
Q

Scabies Overview

A
99
Q

How does permethrin cream work?

A

Permethrin is not ovicidal so it kills the mites but the eggs survive and treated again in 7-10 days to kill all new mites that were born

100
Q

Overview

A
101
Q

MSSA

A

methicillin-susceptible S. aureus (MSSA) infections

102
Q

MRSA

A

methicillin-resistant S. aureus (MSSA) infections

103
Q

HPV

A

Human Papilloma Virus

104
Q

HSV

A
105
Q

Dermatophytes

A
106
Q

Cellulitis Symptoms

A
  • fever/afrebile
  • edema
  • erythematosus
  • warm
  • red
  • shiny tight skin with an abscess
  • pain and tenderness
107
Q

Mollusca Contagiosum Most common in?

A

Children

108
Q

Herpes Simplex Virus Types

A
  • Type 1 is more common orally
  • Type 2 is more common on the genitals
109
Q

Tinea Pedis AKA

A

Athlete’s Foot

110
Q

Tinea Corporis AKA

A

Ring Worm

111
Q

Tinea Manuum AKA

A

Fungal infection of the hands

112
Q

Tinea Cruris AKA

A

Jock Itch

113
Q

Tinea Onychomycosis

A

Dermatophytosis of the nails

114
Q

Tinea Capitis AKA

A

Dermatophytosis or fungal infection of the Scalp

115
Q

Tinea Versicolor Pathogen

A

Pityrosporum orbiculare

116
Q

Pathology?

A

Chancre

Primary Syphilis

117
Q

Scabies Lesion in Children

A
  • palms and soles pinpointer ovoid white vesicle
  • look moth-eaten ill-defined raggedy pink and brown hemorrhagic crusting
118
Q

Scabies lesion in adults

A

slightly scaly papules in the web space in adults

MSCT (30 decks)

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