Skin Infections Flashcards
What are features of Chickenpox?
Caused by VZV
Itchy rash beginning on face/head/trunk then spreads to limbs
Small erythematous macules that progress into papules/vesicles and pustules
Crust over after 5 days
Quarantine until all vesicles have crusted over
What are features of shingles?
Reactivation of VZV from dorsal ganglion
Prodromal dermatomal burning pain or abnormal sensation
Dermatomal rash then develops as maculopapular lesions before clusters of vesicles appear
Do not cross midline
T1-L2 most commonly affected- torso
What is the management of shingles?
Admit if immunocompromised or complications or opthalamic involvement
Oral aciclovir within 72 hours of rash if
- immunocompromised
-non-truncal shingles
- moderate- severe rash or pain
- Age >50
What is the management of herpetic pain/neuralgia?
1) Paracetamol with NSAID or codeine
2) Consider amitriptyline/gabapentin etc if not infected
3) Severe pain- consider prednisolone within first 2 weeks if not immunosuppressed
What are features of measles?
RNA Paramyxovirus
Prodrome
- irritable, tearful, conjunctivitis
Koplik spots on buccal mucosa
Morbilliform rash- starts behind ears and spreads to rest of body and becomes blotchy
Quarantine for 4 days after start of rash
What are features of Rubella?
Caused by Togavirus
Pink maculopapular rash on face and spreads to rest of body
Fades rapidly
Lymphadenopathy
Quarantine for 6 days after rash exposure
What are features of Erythema Infectiosum (slapped cheek)
Parvovirus B19
Rose red rash on cheeks- later spreads to arms and body
May reappear after resolution when bathed in warm water
Not necessary for quarantine
What is the management of slapped cheek?
Supportive measures
Inform pregnant women if exposed to see midwife
- risk of foetal anaemia, hydrops fetalis, foetal death
- blood test for IgM or IgG
- IgM positive- specialist review for close monitoring
- IgG positive and IgM negative- reasssure immune already
- IgG and IgM negative- not immune but susceptible to infection
What are features of Scarlat Fever?
Caused by Strep Pyogenes (Group A strep)
Sore throat
Strawberry Tongue
Sandpaper rash- starts on torso and spreads, then desquamates
Circumoral pallor
Pastia’s lines- redness in flexor creases
Treat with Pen V for 10 days
Quarantine for 24 hours after starting abx
What are features of Hand Foot and Mouth Disease?
Coxsackie A16 and Enterovirus 71
Sore throat
Fever
Anorexia
Macular lesions on palms and soles which evolve into red blisters and peel 7-10 days later
Painful mouth ulcers
Treatment is supportive
What are features of impetigo?
Caused y staph aureus or strep pyogenes
Macule develops into pustule/vesicle which ruptures and forms golden, honey coloured crust
Lesions itchy and can be painful
Can become bullous
What is the management of impetigo?
Non bullous
- 1) Hydrogen peroxide 1%
- If unsuitable then Fusidic acid or mupirocin
If extensive disease then oral
Bullous or unwell/high risk
1) Flucloxacillin or clarithromycin in pen allergy (erythro in pregnancy)
Quarantine for 48 hours or until lesions have crusted
What are features of Molluscum Contagiosum?
Dome shaped pearly white/flesh coloured papules with central umbilication
Occur in clusters anywhere on the body
Treatment is conservative- should resolve within 12-18 months
What are features of Scabies?
Intensely itchy rash
Worse at night
Families affected
Erythematous papules in interdigital spaces, periumbilical areas, hands, wrists, axilla
Thin grey lines may be seen as burrows and tracks
Treatment
1_ Permethrin 5% once weekly to whole body for 2 doses, treat family
2) Malthion
Can return to school after first treatment
What are features of head lice?
Pediculus humanus capitis
Itching scalp
Treat with
- wet combing removal
- Dimeticone 4% gel/spray
Malathion
What are features of Pityriasis rosea?
Viral infections
Herald patch appears first- single pink/red patch wtih scale
1-2 weeks later more widespread rash develops characterised with well demarcated oval lesions
Lesions normally on trunk or limbs
Self limiting- resolves within 6-12 weeks
