SKin Infections and folliculitis

Question 1

Two main types of impetigo

Answer 1

bullous vs. non-bullous: staph aureus MCC of both (other is strep pyo)

Question 2

Clinical presentation of bullous impetigo

Answer 2

2/2 staph aureus
vesicles enlarge rapidly to form bullae (clear then couldy contents)
Honey colored crust

Question 3

Clinical presentation of nonbullous impetigo

Answer 3

Need traumatized skin to infect initially with strep pyo (then usually additional staph)
Anti-DNase B is a sensitive indicator

Question 4

Tx of impetigo

Answer 4

2% mupirocin TID or oral antibx such as diclocacillin, Keflex, augmentin, or Clinda

Question 5

Cellulitis vs. erysipelas

Answer 5

Cellulitis involves subq while erysipelas is just superficial layers of skin (the latter also has more streaking and distinct margins)

Question 6

Uncomplicated cellulitis treatment

Answer 6

Beta-lactam: keflex or augmentin

Question 7

Elephantiasis nostras

Answer 7

End stage of recurrent impaired lymphatic drainage with dermal fibrosis, lymphedema, and epidermal thickening of lower leg

Question 8

Clinical presentation of erysipelas

Answer 8

Prodromal symptoms prior
1+ tender red spots that rapidly grow/coalesce into a red, raised, well defined, fiery red plaque. As it expands can see vesicles at the advancing border
Common sites of recurrence are legs and pinna

Question 9

Perianal cellulitis

Answer 9

Often mistaken for candida
Children not systemically ill
Tx with oral antibiotics +/- bactroban locally to help with symptoms

Question 10

Nectrotizing fasciitis

Answer 10

Pain out of proportion to exam
Blue-dusky discoloration as it progresses, bullae initially clear but then violaceous
Tx: Unasyn/Zosyn + CLinda + Cipro
Usually polymicrobial but can be group A strep with toxin mediated damage

Question 11

Gas gangrene

Answer 11

Caused by clostridium species

Question 12

Pseudofolliculitis barbae

Answer 12

Razor bumps. Can use PFB razor (does not shave directly to skin or definitively treat with laser hair removal)

Question 13

Sycosis Barbae

Answer 13

Follicular inflammation of the entire depth of the hair follicle

• Only in med who have commenced shaving
• can be caused by staph or dermatophyte fungi (more severe)
• tx: topical bactroban to Keflex depending on severity

Question 14

Acne keloidalis

Answer 14

Primary form of scaring alopecia

- tx: antibiotics, ILK once infection controlled