Skin Infection Flashcards
What is tinea?
Dermatophyte fungal infection
What is this a presentation of?
Prepubertal child, scaly area with broken hair on scalp, may have scarring alopecia.
Tinea capitis
What happens to tinea capitis if left untreated?
Raised, spongy/boggy mass called a kerion may form.
Which organism commonly causes tinea capitis?
Trichophyton tonsurans
How is tinea capitis diagnosed and treated?
- Scalp scrapings
2. Oral antifungal terbinafine and ketoconazole shampoo
What is this a presentation of?
Well defined, round, scaly, itchy lesion. Edge is more inflamed than centre. Trunk and limbs commonly.
Tinea corporis (ringworm)
How is tinea corporis diagnosed and treated?
- Skin scrapings of ring edge
2. Topical antifungal terbinafine/imidazole BD for 2 weeks/oral fluconazole.
What is this a presentation of?
Itchy, peeling skin between toes.
Tinea pedis (athletes foot)
What is the treatment for tinea pedis (athletes foot)?
Topical imidazole/terbinafine
What causes candida albicans?
Commensal yeast in mouth and gastrointestinal tract.
What is this a presentation of?
Pink, moist skin +/- satellite lesions in mouth, vagina, glans penis, and skin folds.
Candida albicans
How is candida albicans treated on the skin?
Imidazole cream
How is candida albicans treated in the mouth?
Nystatin oral suspension/miconazole gel
How is candida albicans treated in the vagina?
Imidazole cream and pessary (Canesten combi)
Which organisms are commonly responsible for impetigo?
Staphylococcus aureus or Streptococcus pyogenes
What is this a presentation of?
3-5 year old, golden crusted skin lesion around nose and mouth. Can occur on limbs not covered by clothing.
Impetigo
How contagious is impetigo?
Highly contagious, can spread through toys and clothing.
What is the treatment for limited/localised impetigo?
Topical fusidic acid
What is the treatment for extensive impetigo?
Oral flucloxacillin
How long should children be excluded from school for if they have impetigo?
- Until lesions are crusted and healed
Or - 48 hours after starting antibiotics
What causes warts?
Human papilloma virus
What is a verruca?
A plantar wart
When should you treat warts?
If they are painful, unsightly, or persisting (90% disappear within 2 years without treatment)
What is the treatment for warts?
- Topical salicylic acid gel daily for 12 weeks
2. Cryotherapy once per month for 4 cycles
What is the treatment for genital warts?
- Topical podophyllum for multiple
2. Cryotherapy for solitary, keratinised
What causes molluscum contagiosum?
Molluscum contagiosum virus (pox virus)
What is this a presentation of?
1-4 years old, pinkish/pearly white papules with central umbilication, up to 5mm in diameter.
Molluscum contagiosum
What is the curative treatment for molluscum contagiosum?
- Treatment NOT recommended (resolves within 18 months)
2. Cryotherapy in older children/adults if painful/unsightly
What is the symptomatic treatment for molluscum contagiosum?
- If itchy - emollient and hydrocortisone
2. If infected (oedema and crusting) - topical fusidic acid
What is this a presentation of?
Severe gingivostomatitis, cold sores, or painful genital ulceration.
Herpes simplex virus infection
How is gingivostomatitis (HSV-1) treated?
PO acyclovir and chlorhexidine mouth wash
How is genital herpes (HSV-2) treated?
PO acyclovir
Which virus causes herpes zoster?
Varicella zoster virus
What is this a presentation of?
Acute, unilateral, painful, blistering rash in a dermatomal pattern.
Herpes zoster infection
How is herpes zoster treated?
PO acyclovir
How is herpes zoster infection protected against in the elderly population?
Live-attenuated SC shingles vaccine offered to all ages 70-79.
What is this a presentation of?
Child/young adult, widespread pruritus affecting fingers, interdigital webs, flexor aspect of wrist, axillae.
Scabies (infestation)
Who should be treated when someone is diagnosed with scabies?
All members of the household and close contacts regardless of symptoms.
What is the management for scabies?
- Permethrin 5% cream 1st line (malathion 0.5% 2nd line)
- Clean all clothing, bedding, towels.
- Warm both, soap skin, scrub fingers and nails with brush, cream body, wash off after 24 hours, repeat every 7 days.
What may worsen in treatment of scabies and how is this mitigated?
- Pruritus
2. Crotamiton cream
How do headlice spread and what is the recommendation for exclusion from school?
- Head to head contact (lice can’t jump)
2. No school exclusion advised
What is the management for headlice infection?
- Regular combing of hair with fine-tooth comb
2. Malathion/Dimeticone
