Skin infections and infestations

Question 1

What lives on your skin?

Answer 1

Your own lil’ microbiome!

Strep epidermis, Staph. Aureous (both aerobic cocci)

Corynebacterium, Propionbacterium

Malassezia furfur (yeast)

Question 2

What are the signs of infection

Answer 2

Redness
Hot
Inflammation
Pain
Swelling
Fever
Pus

Question 3

Does pus = infection?

Answer 3

Not always, can be sterile pus…. mmmmm yumm

Question 4

Common bact. infection in the skin?Due to: Examination findings, tretment.

Answer 4

Impetigo

Due to Staph. Aureus, Strep. Pyogenes

Examination findings = honeycomb crustying like cluster. May have spread if itched then touched/itched elsewhere

Antibiotics: Localised: Fusidic acid/Mupirocin cream (both 5 days)
Widespread: Flucoxacillin (7days)/Erythromycin (7 days)

Question 5

What is Cellulitis and Erysipelas?

Answer 5

Caused by bact. infections. Big patches of redness.

Usually Strep. Pyogenes
Staph.Aureus

If severe: IV Flucloxacillin and Benzylpenicillin

Question 6

What would require hospital admission for Erysipelas?

Answer 6

If occuring around the eye and signs of any form of systemic illness/could have gone to brain/eye eg nausea, systemically unwell etc

Question 7

Bact infection differencials

Answer 7

Deep vein thrombosis

Venous eczema

Allergic contact dermatitis (allergy due to something touching it etc)

Necrotising fasciitis

Question 8

BAct infection investigations and tratments

Answer 8

Charcol swab (MC&S)
Start antibiotics
Review after ~48hrs
check skin swab result
switch according to sensitivities
If not better in a week:
consider alternative diagnosis

Question 9

Oedema blisters

Answer 9

Often due to sudden swelling eg heart failure. Big, hot and red.

Question 10

Lipodermatoscleosis

Answer 10

Inflammation of the fat under the tissue, looks dark and nasty. Often due to poor circulation.

Question 11

Tinea vs candidas

Answer 11

Tinea is mould. Candidasis = yeast

Question 12

Different names for Tinea

Answer 12

Tinea pedis (athletes foot)
Tinea corpis (on body) aka ring worm
Tinea capitis (head)
Tinea Cruris (groin)
Onychomycosis (nails)

Question 13

Treatment of Fungal inections

Answer 13

topical if superficial
Oral antifungals if much deeper (inc. scalp/nails)
check and treat other family members

Question 14

Eczma vs Tinea

Answer 14

Eczma is often bilateral
If unsure send off a skin scraping

Question 15

Candida vs Intertrigo signs, investigation and treatment

Answer 15

Both occur most commonly in creases and places where skin can either rub (Intertrigo) or be warm and moist (Candida).

Candida often has satelite pimples around red area.

If unsure send off skin scraping.

Candida tratment: Nystatin, Miconazole, Ketoconazole cream

Intertrigo treatment = Emollient

Question 16

Viral warts look like

Answer 16

mini crusty cauliflowers

Question 17

Viral wart treatments

Answer 17

Cyrotherapy/ irritating factors for the skin so that the skin can realise there is a virus there and start an immune response. Otherwise usually o in a couple of years. Often caused by HPV (Human Papilla Virus)

Question 18

What are Molluscum Contagiosum?

Answer 18

DNA Pox virus
Simelar to warts. - wait for immune response. But have to monitor secondary infection. Around armpits will spread to chest, or if on hips can spread across. Can give 5% Potassium Hydroxide

Question 19

HSV 1 vs 2 (Herpes Simplex)

Answer 19

HSV1 = mouth ulcers
HSV2 = genital areas.

Question 20

HSV treatment

Answer 20

Aciclovir

Question 21

Chicken pox proper name

Answer 21

Herpes-Zoster virus OR Varicella Zoster Virus

Question 22

What is shingles

Answer 22

Basically reignited chcken pox, just as a strip across the back. You can;t catch shingles bt can pass on the virus to cause chicken pox

Question 23

What is scabies?

Answer 23

Wee mites that come and burrow around. Their poo causes the irritation. If a shed tonne causes crusted (Norwegian Scabies).

Question 24

Typicl scabies sites

Answer 24

Genital areas and Web areas (nipples. genital area, back of hands, top of feet, ankles, wrists, belly button)

Question 25

Scabies treatment

Answer 25

Permethrim (dirty scumbags can’t afford alcohol so just use meth from around the rim) - Per- Meth- Rim twice for 8h 1 week apart

All close contacts and household members