Skin infections Flashcards
what is folliculitis?
inflammation around hair follicles normally due to S.A or epilation
what is the appearance of folliculitis?
red papules or pustules in hair follicles in hair bearing skin.
what is the management of folliculitis?
normally self limiting
investigate with a skin swab
can give topical mupiricin
what is a furuncle?
boil: deep infection of a hair follicle.
what does a furuncle look like?
a tender warm red nodules.
what does impetigo look like?
redness and golden crusting of a superficial infection
what is staph scalded skin syndrome?
disruption of keratinocyte adhesion
what are features of staph scalded skin syndrome?
fever tender oral crusting flaccid blisters bullae
what is the management of cellulitis?
elevation
antiobiotics (often flucloxacillin)
penicillin allergic: clarithromycin, erythromycin or doxy
Penicillin allergic and pregnancy: erythromycin
what often causes cellulitis/erysipelas?
group A beta haemolytic strep
Staph A especially if diabetic.
what are risk factors for cellulitis/erysipelas?
tinea pedis, lymphoedema, diabetes, Immunosuppression, wounds or ulcers, minor skin injuries and previous cellulitis
what is necrotising fasciitis?
a life threatenng infection of the dermis, subcutis and muscle
what are features of necrotising fasciitis?
pain swelling poorly defined erythema severe localised pain out of proportion rapidly spreading erythema, oedema, blistering and necrosis
what are risk factors for necrotising fasciitis?
surgery
minor trauma
immunosuppresions
what investigations should be done for necrotising fasciitis?
FBC,U&E,LFT,CRP, Coagulation blood cultures skin swab and aspirate of blister fluid xray to look for gas in the subcut fascia MRI if planning surgery
what is the management of necrotising fasciitis?
early debridement
iv abx
analgesia
ICU
what are treatments for cutaneous warts?
destruction: - salicylic acid - cryotherapy - pulsed dye laser anti mitotic: - podophyllotoxin - intralesions bleomycin
what causes molluscum contagiousum?
common DNA poxyvirus.
what is the appearance of molluscum contagiousum?
skin coloured papules, umbilicated, up to 5mm diameter.
what is tinea corporis?
tinea infection of the trunk and limbs
what is tinea cruris?
fungal infection of the groin and nasal cleft
what is tinea pedis?
athletes foot
what is tinea manuum?
infection of the hand, scaling of palmar creases
what is tinea unguium?
infection of the nail. yellow,thick and crumbling.
what is the managgement of scabies?
permethrin or malathion
what are signs of cellulitis?
often in the shins
erythema, pain and swelling
systemic upset
what are the classes for cellulitis?
- no systemic toxicity and no uncontrolled co-morbidities
- systemically unwell or systemically well with a comorbidity which may complicate or delay resolution of infection
- significant systemic upset with acute confusion, tachycardia, tachypnoea, hypotension or unstable
- sepsis syndrome or life threatening infection such as necrotising fasciitis
who gets iv antibiotics for cellulitis?
class 3-4 of the eron criteria
severe of rapidly deteriorating cellulitis
under 1 or frail patient
immunocompromised
lymphodema
facial cellulitis
Orbital or periorbital (need opthal referral)
what is the antibiotic of choice for cellulitis in pregnancy?
erythromycin
what are possible complications of cellulitis?
Local necrosis
Abscess
Myositis
Sepsis
what is erysipelas?
An acute form of cellulitis affecting the dermis and S/C tissue. Has a more well-defined raised border compared with cellulitis.
