skin infections

Question 1

tinea corporis

Answer 1

Human to human transmission : fomite transmission or auto inoculation from T. pedis or T. Capitis

Animal to human (domestic animals)
Well-defined, annular, scaly, itchy, lesions with active border

mostly in exposed skin

Question 2

tinea mannum

Answer 2

Human to human & animal to human transmission

Associated with T pedis +/- toenail infection

Diffuse hyperkeratosis of the palm, with accentuation of flexural creases.

Question 3

tinea cruris

Answer 3

Auto infection from T pedis & sharing towels/clothes

More common: in adult males, obesity, hyperhidrosis
sweaty old men

Unilateral or bilateral area of itchy erythema with an advancing scaly border (active edge)

rringworm of the groin

Question 4

what differentiates T.cruris from other infections of the groin ?

Answer 4

T. cruris spares the scrotum

Question 5

tinea pedis

Answer 5

infection of the soles & interdigital web spaces

Ways of infection:
Moist environment created by occlusive shoes
From gyms, basins & locker rooms where walking bare feet is common.

athletes foot

Question 6

types of tinea pedis ?

Answer 6

interdigital T.pedis
inflammatory T.pedis
moccasin T.pedis

Question 7

other naming for tinea versicolor

Answer 7

pityrasis versicolor

Question 8

tinea versicolor

Answer 8

Variably pigmented patches, mostly truncal
More common in hot, humid climates than in cool, dry climates
It may clear in the winter months and recur each summer

Question 9

organism in tinea versicolor

Answer 9

malassezia spp

Question 10

Tx of tinea

Answer 10

topical antifungal : ketoconazole
Systemic antifungal - terbinafine
Antibiotic for associated secondary bacterial infection Ketaconazole shampoo
Selenium sulphide (Selsun Shampoo)
Avoid predisposing factors:
* Obesity,
* Hyperhidrosis,
* Do not exchange personal equipment, clothes

Question 11

types of cutaneous candidiasis

Answer 11

Intertrigo
Genital Candidiasis
Nappy dermatitis
Nails
Chronic mucocutaneous candidiasis

Question 12

what is intertrigo ?

Answer 12

inflammatory skin condition associated with skin to skin friction

Question 13

candidal intertrigo

Answer 13

triggered by a combination of the following factors:

• The hot and damp environment of skin folds (under breast in females)
• Increased skin friction
• Immunocompromised

Question 14

gential candidiasis

Answer 14

Candidal balanitis
Vulvovaginal Candidiasis

Question 15

candida off the nails

Answer 15

Candidal Paronychia : infection of the nail fold, becomes swollen & red, painful & tender. Sometimes, thick pus may discharge.

Candidal onychomycosis : infection of the nail plate. The plate loses it’s colour and becomes brittle & thickened

Question 16

Chronic muco-cutaneous candidiasis (CMC)

Answer 16

T cell deficiency
recurrent candida infection of thee skin, nails, mucous membranes

Question 17

Bacterial Infections with cutaneous manifestations

Answer 17

• Impetigo
• Folliculitis
• Abscess
• Cellulitis & erysipelas
• Secondary infection

Question 18

impetigo

Answer 18

characterised by pustules and honey-coloured crusted erosions

bullous impetigo :
caused by Staphylococcus aureus
affecting the trunk

Question 19

predisposing factors of impetigo

Answer 19

atopic dermatitis
destructed skin barrier
secondary infection - eg chicken-pox
scabies

Question 20

folliculitis

Answer 20

Inflamed hair follicles, commonly due to S. aureus

Question 21

result of infection of deep part of the follicle

Answer 21

boil forms

Question 22

treatment for folliculitis

Answer 22

• Topical : Potassium Permanganate Soaks
  Topical Antibiotics
• Systemic : Flucloxacillin
  Penicillin

Question 23

most common sites presenting with abscess ?

Answer 23

under the arms
at the base of the spine (pilondial)
around thee genital (bartholin cysts )
Anus

Question 24

what is cellulitis

Answer 24

bacterial skin infection of the lower dermis and the subcutaneous tissue

Question 25

similar presentation to cellulitis but a more superficial infection

Answer 25

erysipelas

Question 26

who is more at risk of developing cellulitis

Answer 26

1- someone with previous episodes of cellulitis
2- fissuring of thee toes or heels
3- venous disease
4- current or prior injury
5- immunodeficiency or immuno-suppressant
medication
6- diabetes
7- Alcoholism

Question 27

signs associated with cellulitis

Answer 27

signs include:
* Dimpled skin (peau d’orange)
* Blistering
* Erosions and ulceration
* Abscess formation

Question 28

complications of cellulitis

Answer 28

• Necrotizing fasciitis
• Gas gangrene
• Severe sepsis (blood poisoning)
• Infection of other organs, e.g. pneumonia, osteomyelitis, meningitis
• Endocarditis

Question 29

how should cellulitis be treated ?

Answer 29

1- bed rest and elevation of the affected limb
2- involved area off swelling should be marked to monitor it
3- MDT approach