Skin infections

Question 1

What is Eczema Herpeticum?

Answer 1

Rare and serious skin infection caused by Herpes Simlex Virus Many possible complications so treated as an emergency

Question 2

How does Eczema Herpeticum present? How would you manage it?

Answer 2

Systemically unwell with extensive crusted papules/blisters/erosions Antivirals (Acyclovir)

Question 3

What is Necrotising Fasciitis?

Answer 3

Rapidly progressing infection of the deep fascia causing necrosis of subcutaneous tissue

Question 4

How does Necrotising Fasciitis present?

Answer 4

Severe pain, Erythema, Tachycardia, Crepitus (Subcutaneous Emphysema)

Question 5

How would you manage Necrotising Fasciitis?

Answer 5

Extensive Surgical Debridement IV Antibiotics

Question 6

Define Cellulitis

Answer 6

Spreading bacterial infection of the skin involving the deep subcutaneous tissue and dermis

Question 7

What is the difference between Cellulitis and Erysipelas?

Answer 7

Erysipelas is a more superficial form Erysipelas has more sharply demarcated borders than Cellulitis

Question 8

Give 5 risk factors for Cellulitis/Erysipelas

Answer 8

IVDU Elderly Venous Insuffiency Lymphoedema Alcoholism

Question 9

Erysipelas is mainly caused by Strep Pyrogenes, name the causative organisms of Cellulitis.

Answer 9

Staph Aureus Post Op - Strep Pyogenes, Closdtrodium Perfringes (crepitus)

Question 10

How would you manage Cellulitis/Erysipelas?

Answer 10

Rest, Elevation and Analgesia Uncomplicated - Flucloxacillin 500mg QTS Facial Involvement - Co _ Amoxiclav

Question 11

What is Staphylococcal Scalded Syndrome?

Answer 11

Scald appearance seen in infancy and early childhood Caused by epidermolytic strain of toxigenic STaph Aureus

Question 12

How might Staphylococcal Scalded Syndrome present?

Answer 12

Scald appearance followed by large bullae Painful lesions Lesions on buttocks/hands/feet/face

Question 13

How would you manage Staphylococcal Scalded Syndrome?

Answer 13

Flucloxacillin (or Vancomycin for MRSA) Analgesia Petroleum Jelly

Question 14

Describe Tinea Corporis and Tinea Cruris

Answer 14

Corporis - Fungal infection of Trunk/Limbs, ittchy circular lesions with raised edges Cruris - same as corporis but in groin and natal cleft

Question 15

Describe Tinea Manuum and Tinea Pedis

Answer 15

Tinea Manuum - Fungal infection of hands Tinea Pedis - Athlete’s Foot Scaling and fissuring dryness

Question 16

Describe Tinea Capitus and Tinea Unguium

Answer 16

Capitis - Scalp Ringworm (patches of broken hair, scaling and infammation) Unguium - Fungal infection of the nail causing yellowed discoloration/thickened/crumbly nail

Question 17

What is Tinea Incognito?

Answer 17

Due to inappropriate treatment of fungal infection with steroid creams Ill defined and less scaly

Question 18

What is Ptyriasis/ Tinea Versicolor?

Answer 18

Cutaneous infection with the yeast Malassezia Causes scaly brown patches on upper trunk that fail to tan on sun exposure

Question 19

How would you manage fungal skin infections?

Answer 19

Topical treatment - Terbinafine cream If severe - Oral antifungals such as Itraconazole

Question 21

Scabies is an itchy rash caused by a parasitic mite, give four risk factors.

Answer 21

Overcrowding Poverty Homelessness Poor Hygiene

Question 22

How does Scabies present?

Answer 22

Signs and symptoms don’t develop for 3-4 weeks Widespread itching (worse at night and when warm) Papular/Vesicular lesions at burrow sites

Question 23

How do you investigate Scabies?

Answer 23

Usually just clinical Ink Burrow Test - Ink rubbed over burrow and wiped with an alcohol wipe, ink should track the burrow sites

Question 24

Describe four management points for Scabies

Answer 24

All close contacts should be treated on the same day to avoid reinfestation Topical Parasiticidal Cream (Permethrin) applied head to toe once a week Wash clothes/towels/bedding Antihistamines for itching