Skin Infections and Infestations

Question 1

What is the most common infestation?

Answer 1

Scabies

Question 2

Bacteria lives on the skin and doesn’t usually cause problems.
Give some examples of bacteria which lives on skin.

Answer 2

Staph epidermidis
Staph aureus
Corynebacterium
Propriobacterium

->although staph aureus is found, it is the most likely to cause infection. However, increased staph aureus on a swab doesn’t automatically mean infection…want to contradict yourself anymore Lucy?

Question 3

Give an example of a yeast which is found on the skin.

Answer 3

Malassezia furfur

Question 4

What are some signs of infection of the skin?

Answer 4

Erythema
Hot
Tender
Pus
Exudate
Fever

Question 5

What would be some clues which would suggest a skin issue is not an infection?

Answer 5

No fever
Long history of relapsing rash
No growth of pathogens on skin swab

Question 6

What is impetigo?

Answer 6

Superficial skin infection

Question 7

What is the commonest skin infection in children?

Answer 7

Impetigo

Question 8

Which organisms most commonly cause impetigo?

Answer 8

Staph aureus
Strep pyrogens

Question 9

What is the classic finding on examination in someone with impetigo?

Answer 9

Yellow/gold crust which often starts in one small area and then is easily spread across the skin

Question 10

What is the treatment of impetigo?

Answer 10

If small amount, topical creams can be used
If widespread, oral antibiotics are used as typical treatment

Question 11

What is the most common organism causing cellulitis?

Answer 11

More commonly strep pyrogens

Question 12

Which investigation is good for the diagnosis of necrotising fasciitis?

Answer 12

CT- shows gas pockets appearing

Question 13

When can oedema blisters occur?

Answer 13

In acute exacerbation of oedema

Question 14

Where do oedema blisters usually occur>

Answer 14

Dorsum of feet

Question 15

What is lipodermatosclerosis usually associated with?

Answer 15

Venous insufficiency
Venous hypotension

Question 16

What is the treatment of lipodermatosclerosis?

Answer 16

Treat underlying venous disease
Topical steroids

Question 17

RECAP- what are the two types of fungal infection?

Answer 17

Tinea
Candidiasis

Question 18

Tinea is named based on where it is found.

What is another name for tinea pedis?

Answer 18

Athlete’s foot

Question 19

What is the type of tinea if it affects the head?

Answer 19

Tinea capitis

Question 20

What is the type of tinea if it affects the body?

Answer 20

Tinea corporis

Question 21

What is the type of tinea if it affects the groin?

Answer 21

Tinea cruris

Question 22

What is the type of tinea if it affects the nails?

Answer 22

Onychomycosis

Question 23

What investigation is carried out in fungal infections?

Answer 23

Skin scraping

Question 24

What is the treatment of tinea?

Answer 24

Usually topical creams

Tinea infection of scalp or nails requires oral antifungals

->important to check and treat family members too. Pets can pass it on too!!

Question 25

What is the usual treatment of candida?

Answer 25

Topical antifungal cream

Question 26

Intertrigo?

Answer 26

Inflammation of a skin fold, often secondary to friction and irritating effect of excess sweat ->antifungal treatment may not be required if just due to sweat and friction

Question 27

Which groups of people are more likely to develop viral warts?

Answer 27

Children Immunosuppressed patients

Question 28

What causes warts?

Answer 28

Infection of outer skin layer but the body's immune system isn't really aware of it so it continues to grow

Question 29

Are warts contagious?

Answer 29

Yes- but low risk of transmission ->children with warts should NOT be excluded from physical activities- cover with plaster if swimming

Question 30

What is the treatment of viral warts?

Answer 30

Usually clear spontaneously within a couple of years There are some treatments but not usually effective

Question 31

What is Molluscum Contagiosum?

Answer 31

Viral infection, commonly seen in young children Umbilicated papules on skin Will resolve when patients develops immunity ->can become secondarily infected if irritated or knocked

Question 32

Which virus caused cold sores?

Answer 32

Herpes simplex

Question 33

What do patents describe as happening before the cold sore appears?

Answer 33

Pain/tingling before one appears

Question 34

Herpes simplex can cause lesions in which locations?

Answer 34

Lips Genitals

Question 35

What are patients with Herpes Simplex virus associated cold sores at a greater chance of developing?

Answer 35

Eczema herpeticum

Question 36

What is the treatment of eczema herpeticum?

Answer 36

Aciclovir

Question 37

What does Herpes Zoster cause?

Answer 37

Chicken pox

Question 38

Which site does chickenpox usually effect first before spreading?

Answer 38

Usually face

Question 39

What is the secondary infection of Herpes Zoster?

Answer 39

Shingles ->dermatomal reactivation down the dorsal root ganglion

Question 40

Is Shingles contagious?

Answer 40

Kind of.... people who haven't had chickenpox can catch it from someone with shingles

Question 41

What is the presentation of Scabies?

Answer 41

Intensely itchy, papular rash

Question 42

List some of the typical sites of Scabies.

Answer 42

Wrists, genitals, feet, ankles, nipples, umbilicus

Question 43

What is meant by a Scabies burrow?

Answer 43

Faecal matter of the mite which causes skin irritation

Question 44

Those with scabies tend to have about 10-100 mites. What is it known as when patients have thousands?

Answer 44

Crusted scabies

Question 45

How is a diagnosis of scabies made?

Answer 45

Skin scraping and microscopy

Question 46

What is the treatment of scabies?

Answer 46

Topical Permethrin cream ->30g per tube and patient applies it all over their body before rinsing off for a week All household members and close contacts need treated too

Question 47

How long can the scabies itch take to settle?

Answer 47

1-4 weeks ->steroids can be given to help manage this symptom