Skin Infections and Infestations Flashcards
What bacteria live on our skin?
- Staph Epidermis (most common)
- Staph Aureus
- Cornyebacterium
- Propionbacterium
- Malassezia Furfur
What is impetigo?
Identifying features?
- Most common bacterial skin infection in children
- Superficial
- Caused by one or both of the Staphylococci groups (aureus + epidermis)
- Honey-yellow crusting and erythema
- > (itching spreads it over the skin)
What is the Treatment of Impetigo?
always check local forumulary!
If localised:
- Fusidic acid - 3-4x/day for 5 days (!!!)
- Mupirocin (MRSA) - 3x/day for 5 days
Widespread, severe, bullous
- oral Flucloxacillin - 4x/day for 7 days (!!!)
- oral Erythromycin - 4x/day for 7 days (!!!)
What is the differential diagnosis of Cellulitis/Erysipelas?
- DVT
- Venous Eczema
- Allergic contact Dermatitis
- Necrotising Fasciitis
What is the management of Cellulitis/Erysipelas?
- Take swab (or blood culture if systemically unwell)
- Start abx
- Review after 48hrs when skin swab results come back
- > switch according to sensitivities
- If not better in a week: consider alt. diagnosis
What are the identifying features of Lipodermatosclerosis?
- (often misdiagnosed as cellulitis)*
- Acute = hot + tender
- Look for signs of venous disease (usually due to poor circulation in the legs)
- Bilateral
What is the treatment of Lipodermatosclerosis?
- Treat underlying venous disease
(ie. compression hosiery, or surgery for varicose veins) - Topical steroids
What virus is more likely to cause finger/hand warts?
HPV
What is the management of HPV viral warts?
- Contagious, but low risk of transmission
- > kids should NOT be excluded from physical activities
- > cover the plaster with
- Treatment:
- > normally not necessary: give leaflets to pts on viral warts!
- > wart paints and cryotherapy can stimulate the immune system
What are the clinical presentations of HSV skin infection?
- Cold sore
- Eczema Herpeticum
lots of monomorphic and crusted erosions
What is the treatment of HSV skin infection?
- Aciclovir!
What is the treatment of Chickenpox? (VZV)
Nothing!
self-limiting
What is the treatment of Shingles? (HZV)
Nothing!
self-limiting
What is Molluscum Contagiosum?
- Poxvirus
- Umbilicated papules
- potential for 2ary infection (if knocked or irritated)
What is the treatment of Molluscum Contagiosum?
- Nothing!
(self-limiting -> resolves when pt. develops immunity)
- can use 5% Potassium Hydroxide if clinically indicated/pt. preferences
What is Tinea?
What are the different clinical presentations of Tinea?
- Infection by Dermatophyte
- Body (tinea corporis (Ringworm)), Hand (tinea manuum), head (tinea capitis), foot (tinea pedis), groin (tinea cruris), nails (onychomycosis)
What is the treatment of Tinea infection?
- Feet, body, hands or groin = topical terbinafine or clotrimazole
- Scalp or nails = oral antifungals
- Check + treat other family members
What is the treatment of cutaneous candidiasis?
Topical…
- Nystatin
- Miconazole
- Ketoconazole
What is the treatment of Inertrigo?
- Emollients
What causes Inertrigo?
- Skin folds sitting and rubbing together
- Most cases are secondary to friction and irritating effect of sweat (ie. more common in high BMIs)
Which areas does Scabies usually affect?
- Web-spaces (hand)
- Wrists
- Genital skin
- Nipples
- Umbilicus
- Feet and ankles
How to make the diagnosis of scabies?
- Typical burrow pattern on skin
- +/- marker pen + alcohol wipe, or skin scraping and biopsy
What is the treatment of Scabies?
- Permethrin cream top to toe for 8 hours
- > 2 applications, 30g ~1 week apart
- Treat all in household and close contacts
- Explain that itch may take 1-4 weeks to settle
- > treat symptomatically w steroids
