Skin conditions

Question 1

Impetigo

Answer 1

• Highly infectious
• Bacteria- a beta haemolytic streptococci and staphylococci
• Honey colour exudate round motuth
• Treatment is topical ointment (muciprin)
• More severe require ABs

Question 2

Cellulitis

Answer 2

• Infection of deep subcutaneous layer of skin
• Got and sometimes tender spreading redness
• Likely in people with sedimentary lifestyle
• Common in lower limb and at site of trauma
• Penicillin
• Refer if suspected

Question 3

MRSA

Answer 3

• Methicillin-resistant staphylococcus aureus
• Super bug- Caused by staph and AB use
• Vancomycin
• Enters through cuts and wounds
• Community and hospital acquired
• Small red bumps, quicky turn to painful abscesses, swelling, redness, pus
• Risks- recent hospitalisation, recent AB use, young age, contact sports, sharing towels, weak immune system
• Dx- tissue sample
• Tx- trial and error with strong ABs
• Prevention- wash hands, surfaces, cover wounds

Question 4

Boils

Answer 4

• Deep seated infection of skin
• P, red, swelling
• Recurrent boils common in diabetics and teenagers
• Oral ABs
• Drainage for severe cases, warm compress for milder cases

Question 5

Folliculitis

Answer 5

• Painful inflammation of hair follicle
• Tender papules and pustules
• More common in humid enviros
• sycosis barbae occurs as beard area variant, more common in black African populations
• Extensive in upper trunk and limns- refer due to possibility of HIV

Question 6

Hidradenitis suppurativa

Answer 6

• Rare, more common in females, family Hx
• Painful discharging inflammation of skin at sites of apocrine gland
• Presents post puberty with abscesses which progresses to scarring and sinus formation
• Treatment- weight loss, ABs, oral retinoids

Question 7

Fungal disease

Answer 7

• Aka mycosis
• Common in humans
• Prevalence inc with immunosuppression
• Dermatophytes cause a characteristic ring worm lesion, which varies with site, congestion and host response

Question 8

Tinea corporis

Answer 8

Ring worm
- Asymmetrical scaly patches
- Usually raised edge
- May itch after UV exposure

Question 9

Tinea cruris

Answer 9

• Fungal infection- Jock itch
• Red/scaly rash on inner thigh
• Common in obese Px + athletes in tight fitting clothes
• Common in humid weather
• Antifungal cream

Question 10

Tinea pedis

Answer 10

• Athletes foot
• Rash presents on sole of foot as well as between toes
• Examine scraping under microscope
• Antifungal cream, keep foot dry

Question 11

Tinea capitis

Answer 11

• Fungus spreads by close contact
• More common in children
• More common in black Africans, skin and hair susceptibility

Question 12

Toenail fungus

Answer 12

• Yellow, thick nails, P, brittle
• Lamsil, vicks, takes 6-12 months
• Oregano oil for 2-3 months

Question 13

Pediculosis

Answer 13

• Lice, six-legged wingless insect
• Nits are gelatinous white colour
• Can be found in head, body and pubic hair
• Pierce skin and secrete saliva which causes itching, lay eggs close to scalp
• Shampoo, fine tooth comb

Question 14

Scabies

Answer 14

• Ver contagious
• Intense itchy rash with linear burrows
• Kwell or elimite
• Wash bedding/clothing in hot water, store for 2-3 days

Question 15

Herpes simplex

Answer 15

• Viral infection either type 1 or 2
• May cause fever, lymph node enlargement, burning P
• Lesions will crust over in 5-14 days
• Analgesics for P, oral antiviral, naturopathic- diluted tea tree oil in olive oil topically applied

Question 16

Herpes zoster

Answer 16

• Shingles, reactivation of varicella zoster virus
• Remains in cells of nerve roots in an inactive state after exposure from youth
• Unknown reasons for reactivation- re-exposure to virus, immunosuppressant tissue, some drugs
• Results in vesicles on a red base in band-like distribution
• Painful rash, prickly nerve P
• Tx- symptomatic, calamine lotion
• Neuropathic- diluted lemon-balm topically

Question 17

Malignant melanoma

Answer 17

• Most serious form skin cancer
• Metastases can occur early and cause death in old and young people
• Incidence inc with UV exposure
• Childhood and intermittent sun exposure are implicated in etiological development
• Surgery to remove

Question 18

Melanoma characteristics

Answer 18

Asymmetry
Border- ragged or irregular edge
Colour- varies throughout
Diameter- larger than pencil rubber

Question 19

Basal cell carcinoma

Answer 19

• Most common malignant skin tumour
• Usually related to excessive UV exposure and present on areas of exposure
• Slow growing palpate which eventually erodes local tissue
• Marginal excision

Question 20

Squamous cell carcinoma

Answer 20

• More aggressive than basal cell carcinoma
• Keratic lesion +/- ulceration
• More likely to metastasize
• Related to UV exposure
• Rapid growth- inspect lymph system
• Excision +/- radiotherapy