Other skin and soft tissue infections

Question 1

Superficial Thrombophlebitis:

What is it?

Where?

Risk factors?

Answer 1

Inflammation of superficial vein

Long saphenous vein
IV access sites, cannulas, IVDU

Varicose veins
Hypercoagulability
Stasis
Obesity

Question 2

Superficial Thrombophlebitis:

S+S

Management

When are Ab’s needed?

Answer 2

Red
Tender
Along vein

Topical anti-inflammatory

Signs of infection

Question 3

Skin abscess:

Define

Presentation

What might you find on the overlying skin?

Answer 3

Localized collection of pus within dermis or subcutaneous tissue

Painful swelling of the skin
Fluctuant though may initially be firm

Overlying cellulitis

Question 4

Skin abscess:

Management of:

• small abscesses
• larger ones
• when AB’s needed?

Answer 4

Self-resolve

Incision and drainage - culture fluid

Abscess over 2cm
Multiple
Systemically unwell
High risk - DM, immunocomprimised

Question 5

Define:

Folliculitis
Furuncles - aka boils
Carbuncles

Management:

Folliculitis

Furuncles and Carbuncles

Answer 5

Superficial infection of hair follicle causing itchy pustule

Abscess which results from deep infection of hair follicle

Larger furuncles with multiple openings - a cluster of furuncles

Conservative + antiseptics
Topical antibiotics or oral flucloxacillin

Incision and drainage +/- oral antibiotics

Question 6

Onychomycosis

What is it?

Causes

Risk factors

Answer 6

Fungal nail infection

Dermatophyte
Non-dermatophyte moulds or years

Age
DM
PVD
Psoriasis 
Eczema
Other fungal skin infection

Question 7

Onychomycosis

Presentation

How is it diagnosed?

Answer 7

Yellow/white streaks
Scaling
Thickening
Cracking and destruction

Microscopy and culture of nail clipping/scrapings

Question 8

Onychomycosis

Management

Self-care
What if superficial
What is more extensive?

Answer 8

Keep nails short
Keep it dry and clean

Topical amorolfine 5% nail polish
6 months for fingers
12 months for toes

Terbinafine
Itraconazole