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Dermatology > Skin Infections > Flashcards

Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What virus cause skin infections

A

HPV
Herpes simplex ( HSV)
Herpes Zoster (HZV)
Molluscum contagiosum

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2
Q

What bacteria cause skin infection

A

Normal skin flora protect but if skin damage micro-organism can penetrate
S.aureus
Strep
Corynebacterium minitissimum in acne

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3
Q

What fungi cause skin infection

A 
Tinea
Candida albican
Yeast 
Piturosporium
True fungi
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4
Q

What ectoparasites cause skin infection

A

Scabies

Cutaneous leishmaniasis

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5
Q

What does HPV lead too

A 
Warts on body
Hyperkeratotoic papules or nodules
Most common at sites of trauma 
Incubation = 4 months
Transferred by direct skin contact
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6
Q

How do you Rx

A

Consider if painful, unsightly or persist
Should resolve 24 months
Chemical paint
Cryotherapy
Imiquidmod for genital - usually sexual transmission

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7
Q

What does primary exposure to HSV cause

A

1st clinical episode
Most severe
Virus becomes latent in neural tissue in DRG

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8
Q

What can reactivate virus

A 
Trauma
Menstruation
Sunlight
Fever
Virus then tracts down nerves
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9
Q

How does HSV present

A 
Closely tinny packed vesicle / pustule
Monomorphic - same 
May only see erosions if skin is fragile e.g. genitals 
May see ulcers on thick skin
Often proceeded by burning or itching
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10
Q

If recurrent vesicles what should you suspect

A

HSV

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11
Q

Who is at risk of severe infection

A

Immunosuppressed

Atopic tendency

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12
Q

How do you Rx

A

Acyclovir - oral or topical

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13
Q

What does primary exposure to HZV lead too

A

Chicken pox
Then becomes latent
When reactivated = shingles

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14
Q

What are features of shingles

A

Pain in dermatome region as virus tracks down nerves
Rash after 4 days of pain
Dermatomal
Vesicular
If in ophthalmic devision of 5th CN = urgent referral

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15
Q

What are complications

A

Scarring
Post-shingles neuralgia
Meningnitis
Encephalitis

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16
Q

How do you Rx

A

Opthamologist if in eye area
Oral acyclovir if immunocompromised, >50, eye involvement
IV if severe

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17
Q

When are you non-infective

A

When vesicles dry up

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18
Q

Who gets shingles vaccine and what type

A

All elderly 70-79 SC

Live attenuated so CI if immunosuppressed

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19
Q

What is molluscs contagiosum

A

Common skin infection caused by MCV virus
Transmission via close contact
Very common in children, immunocompromised, atop eczema

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20
Q

What are the features

A 
Pinky pearly white papules
Central umbilication 
Up to 5mm in diameter
Appear in clusters
Common on trunk and flexure
May get lesions on genitalia if sex
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21
Q

How do you Rx

A 
Self limiting within 18 months
Do not share towels as contagious 
Cryotherapy if lesion troublesome
GUM if on genitals + STI screen
Ophthalmology if eye lid
HIV if +Ve
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22
Q

What are complications and how do you treat

A

Eczema or inflammation so Rx
Emollient or steroid if itch
Ax if bacterial infection on top - topical fusidic or fluclox

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23
Q

What is pityriasis Rosea

A

Acute self-limiting rash
Herald patch - usually on trunk to start
Followed by erythematous oval scaly patches
CHaracterisitc distribution
Longitudinal line

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24
Q

What causes and how do you treat

A

Viral-predrome
Lasts 6-12 weeks - self limiting
Symptomatic treatment of itch wit antihistamine, emollients, steroid

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25
Q

What is impetigo and what causes

A

Superficial bacterial skin infection that occurs when bacteria enter through a break in the skin
S.aureus = 70%
Strep A
Can be primary or secondary to eczema / scabies / bite

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26
Q

How does it present

A

Golden crusted lesion

Tend to be on face and flexures

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27
Q

How do you Rx

A

Topical fusidic acid = 1st line if local
Fusabet = Ax + steroid
Flucloxacillin if extensive
Oral erythromycin if allergic

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28
Q

Do you exclude from school

A

Yes till lesions crust or 48 hours on Ax

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29
Q

What is erysipelas and what causes / RF

A

Form of cellulitis but only in dermis and upper SC tissue
Strep pyogene
S.aureus

RF 
Wounds
Local ulcer
Immunosuppression
Minor skin injury
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30
Q

What are the features

A 
Most common in LL 
Swelling
Erythema
Warm
Painful 
May have associated lymphangitis 
Systemically unwell - fever / rigors 
Raised plateau into erythema

Differentiated from cellulitis as well defined red raised border

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31
Q

How do you Rx

A

IV Ax - fluclox or benpen
Rest
Leg elevation
Analgesia

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32
Q

What is a furuncle

A

Abcess in hair follicle

Known as boil

33
Q

What do you do if recurrent

A

Dip urine to check for glucose

34
Q

How do you Rx

A

Drain pus then Ax

35
Q

What is carbuncles

A

Lots of furuncles together

36
Q

What is ecthyma

A

Minature cellulitis
Much more localised
Crust + rim of erythema

37
Q

How do you Rx

A

Oral Ax to cover staph and strep

38
Q

What is cellulitis and features of cellulitis and what can it lead too

A

Bacterial infection involving deep subcutaneous tissue
Diffuse swollen
Red
Tender
Hot
Fever and rigors
Can lead to necrosis, abscess + septicaemia
Infection enters through trauma e.g. ulcer or athletes foot

39
Q

What does corynebacterium minutissiumum cause

A

Erythrasma

Pitted keratosis

40
Q

What is erythrasma

A

Asymptomatic flat, scaly pink or brown rash
Affects groin or axillae
Similar to athletes groin

41
Q

How do you Rx

A

Topical anti-fungal

Ax - erythromycin topical or oral if extensive

42
Q

What types of superficial fungal infection

A

Dermatophyte - tine / ringworm
Yeast - candida/ Malazzeia
Moulds - aspergillus

43
Q

What does candida yeast cause

A 
Thrush
Balantitis
Angular stomatisis
Nappy rash
Chronic paronyhia - inflammation of nail fold
44
Q

How do you Rx

A

Canistan

45
Q

What is a typical candida infection

A

Affects moist areas such as breast / mucosal
Brick red erythema with satellite pustules in flexures
White plaque on mucosal

46
Q

What is tinea

A

Dermatophyte fungal infection

47
Q

What is tinea pedis

A 
Athletes foot
White macerated rash
Scaling
Flaking
Itching
Fissuring
48
Q

What is tinea corporis

A 
Ring worm 
Well defined annular, erythematous lesions
Scaly 
Itchy 
Papules and pustules
Flakey skin around
49
Q

How do you Dx

A

Skin scrapings sent for microscopy and culture

50
Q

What is tinea cruris

A

Infection round the crotch

51
Q

What makes fungal infections worse

A

Steroid

Can cause tinea incognito (ill defined and less scaly)

52
Q

How do you Rx

A 
Correct predisposing where possible
- Moist area
- Immunosuppression 
Topical anti-fungal - terbinafine 
Anti-Fungal shampoo 
Oral anti-fungal if doesn't improve / severe / widespread or nail infection - itranazole
53
Q

What is tinea capitis and what is tinea manuum

A

Capitas
Fungal infection in the scalp
Itchy, dry erythematous scalp
Patches of broken hair

Manuum
Scaling and dryness / white of palmar creases of hand

54
Q

What can it lead too

A

Scarring alopecia

55
Q

How do you Rx

A

Oral anti-fungal + topical anti-fungal shampoo

56
Q

When do you think fungal

A

If not gone away with Ax

57
Q

What are typical fungal skin infections

A

Circular patch
Flaky skin around erythematous ring
Steroids worsen

58
Q

What causes fungal nail infection (onychomycosis)

A

Dermatophytes - tinea
Candida yeast
Non-dermatophye mould (aspergillus)

59
Q

What are RF

A

Age

DM

60
Q

What are features

A

Thick, rough, opaque nal
Tinea unguium
- Yellow discoluration
- Thickened nail

61
Q

What is DDX

A

Psoriasis
Trauma
Lichen planus
Yellow nail

62
Q

How do you Dx superficial fungal infection

A

Nail clipping or scrapping before Rx

Skin swab for yeasts

63
Q

If caused by dermatophyte

A

Oral terbinafine for 6 weeks to 6 months

Requires LFT monitoring

64
Q

If caused by candida

A

Itracanazole

Topical if mild but require longer course

65
Q

What is pityriasis versicolour

A

Superficial cutaneous fungal infection with Malazzeia

Common on trunk

66
Q

How does it present

A 
Look at photo 
Hypopigmented / pink or brownn patches
Scales = common
Mild itch
Fail to tan on sun exposure
67
Q

What is predisposing

A

Immunosuppression
Malnutrition
Cushings

68
Q

How do you Rx

A

Topical anti-fungal

Send sample if fail to respond

69
Q

What causes Scabies

A

Sarcoptes scabiei

Mite infestation

70
Q

How do you get scabies

A

Close contact with human for about a minute

71
Q

What does it do

A

Mite burrows into skin
Leaves egg in striatum corneum
Tend to be in cool peripheral places
Protein in poo = allergic reaction

72
Q

What happens

A

DADS RASH
Papules+ vesicles develop after 6 weeks
Excoriations
Widespread pruritus - type 4

73
Q

What can stay after treatment

A

Itch

74
Q

How do you Dx

A

Presence of burrow
Dermatoscope to view mites
Skin scrap

75
Q

How do you Rx

A

Cream all over body for 8-12 hours - scabicide
Repeat after 7 days
Treat all house hold contacts
Anti-Histamine for itch

76
Q

What is a viral exanthema

A

Itchy rash associated with any viral illness

Fever, malaise, headache then rash

77
Q

What causes

A 
Chicken pox
Measles <1 without MMR 
Rubella
Scarlet fever
Parovirus B-19 
Roseala infantum
78
Q

What do you do for oral thrush

A

Swab to confirm
Possibly test for HIV
Sporonox spray or nystatin
Fluclonazole tablet

79
Q

If skin looks infected / inflamed

A

Topical fusidic acid (fusabet = Ax + steroid)

Oral fluclox next

Dermatology (12 decks)

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