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Year 2 - Dermatology > Skin infections and infestations > Flashcards

Skin infections and infestations Flashcards

1
Q

Name 5 bacterial skin infections

A 
Impetigo
Folliculitis
Cellulitis
Erysipela
Syphilis
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2
Q

Describe impetigo

  • bacterial or viral
  • what age group
  • causative organism
A

Highly contagious and common bacterial infection of the skin that causes superficial blistering

typically occurs in children

Staph aureus or strep progenies

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3
Q

Treatment of impetigo

  • if superficial/limited infection
  • if widespread lesions
A

Topical antibiotics

Oral antibiotics

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4
Q

Describe folliculitis

  • what is it
  • causative organism
A

Infection of hair follicle

usually by staph aureus

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5
Q

Clinical features of folliculitis

A

erythematous papules or pustules around hair follicles

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6
Q

Clinical features of folliculitis

A

Erythematous papules or pustules around hair follicles

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7
Q

Treatment of folliculitis (2)

A

Antibacterial soap/washes
Topical antibiotics

Only oral antibiotics if acute and severe

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8
Q

Risk factors of folliculitis (3)

A

Trauma from shaving
Topical steroids
Diabetes

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9
Q

What is erysipelas + where does it usually affect +what condition is it similar to

A

Infection of the dermis (superficial cellulitis with lymphatic involvement); usually lower legs and face

Cellulitis but cellulitis affects deeper layers of the skin

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10
Q

Erysipelas (infection of the dermis) is mostly caused by what organism

A

Group A streptococci (Strep pyogenes)

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11
Q

Key clinical feature of erysipelas (superficial cellulitis) + others

A

Raised erythematous lesions (plaques) sharply demarcated from uninvolved skin (i.e. well defined margins)

Hot, swollen, sore skin

Fever/chills

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12
Q

Biochemical finding in erysipelas and cellulitis

A

Elevated WBC

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13
Q

Treatment of erysipelas

A

Oral antibiotics - penicillin

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14
Q

What is cellulitis + causative organisms

A

Infection of the deep dermis and subcutaneous tissue caused most commonly by Str.pyogenes and S.aureus

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15
Q

Risk factors of cellulitis (3)

A

Open wound/ulcer
Lymphoedema
IV drug abuse

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16
Q

Cardinal signs of inflammation are seen in cellulitis - name these

A

rubor (erythema), calor (warmth), dolor (pain) and tumor (swelling

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17
Q

Distinct skin difference between erysipelas and cellulitis

A

Cellulitis lesions have ill-defined, non-papable borders whereas erysipelas lesions are raised and palpable and well demarcated next to normal skin

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18
Q

Treatment of cellulitis

A

Antibiotics

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19
Q

What is syphilis + causative organism

A

sexually transmittedinfection(STI) caused by thebacteriaTreponema pallidum

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20
Q

Clinical features of cellulitis

A

Erythema with indistinct borders
Hot, red, swollen skin
Fever

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21
Q

Clinical features of

  • primary syphilis
  • secondary syphilis
  • tertiary syphilis
A

Primary

  • initially macule –> papule –> ulcerates into a chancre (painless ulcer) in the genital area or mouth
  • may get unilateral lymphadenopathy of nodes close to the ulcer
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22
Q

Primary syphilis often manifests as what but can go unnoticed by patients

A

Painless genital/mouth ulcers (chancres)

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23
Q

Clinical features of secondary syphilis

A
  • NON ITCHY diffuse rash - macules/papules on trunk/palms/soles
  • flu like symptoms - fever, malaise
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24
Q

Clinical features of tertiary syphilis (after a long latent period)

A

neurological impairment
solitary granulomatous lesions (gummas)
cardiovascular problems

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25
Treatment of syphilis
Intramuscular penicillin injection
26
Herpes simplex virus 1 affects where compared to herpes simplex virus 2
HSV1 affects mouth and lips area --> oral herpes (herpes labialis) -but can also affect genitals HSV2 affects genitals --> genital herpes
27
How is HSV transmitted
Through mucosal surfaces or breaks in the skin
28
Clinical features of HSV infection - oral - genital
Oral herpes - SINGLE painful ulcer along the lip starting as vesicle --> ulcer - tingling/burning before lesion fully developed Genital herpes - MULTIPLE painful ulcers that start as vesicles and progress to ulcers, then crusted lesions - dysuria in women - tingling/burning before lesion fully developed
29
Oral v genital herpes - which usually has more lesions
genital; oral usually just one lesion
30
Investigations of HSV infection
Viral swab --> viral culture Viral swab --> HSV PCR HSV type specific antibodies
31
Following primary infection with HSV, what happens
Latent stage - allows the virus to evade the immune system and cause lifelong infection by reducing the number of genes expressed and downregulation of the expression of major histocompatibility complex class I antigens on the surface of the infected cells
32
Treatment of HSV infection
Antivirals - aciclovir or famciclovir
33
Chickenpox is caused by what virus
Varicella-zoster virus (VZV)
34
Latent varicella-zoster virus (VZV) when reactivated manifests as what infection
Shingles (herpes zoster)
35
Symptoms (2) /signs (3) of chicken pox
Symptoms - malaise - pruritus Signs - fever - generalised vesicular rash (initially macule --> vesicle --> pustule --> erosion) - vesicles on mucous membranes (mouth, nasopharynx)
36
Adverse outcomes of chicken pox are more common in (4)
immunocompromised people, adolescents, adults, and pregnant women
37
How is chicken pox spread (2)
direct contact with fluid from the lesions or through airborne spread from respiratory droplets of an infected person
38
Treatment of chicken pox - low risk disease (3) - severe disease (2)
Supportive therapy - paracetamol - emollient - antihistamine Severe - antiviral (aciclovir) - supportive therapy
39
Symptoms/signs of shingles
Symptoms - dermatomal burning or stabbing pain preceding appearance of rash - pruritus Signs - localised vesicular rash in the affected dermatome --> usually pustulate and form crusts - corneal ulceration if trigeminal nerve affected (reduced vision)
40
Treatment of shingles
Treatment is primarily to reduce pain using analgesics and viral replication using antiviral medicine such as aciclovir.
41
Investigations of shingles
Confirmation can be done using polymerase chain reaction (PCR) methods.
42
After a primary varicella-zoster virus (VZV) infection, the virus establishes latency where in the body (2)
in dorsal root and cranial nerve ganglia
43
Why does shingles present as dermatomal pain and rash
Because the bus establishes itself in dorsal root ganglia or cranial nerve ganglia during the latent stage so when reactivated causes ganglionitis (inflammation and destruction of neurons and supporting cells) --> the virus is also carried down the axons to the areas of the skin innervated by the affected ganglion
44
Most common complication of shingles
Postherpetic neuralgia | -long lasting nerve pain in an area previously affected by shingles even when rash disappears
45
Shingles treatment (3)
Antiviral Analgesia Calamine lotion
46
Characteristic distribution of shingles
dermatomal due to infected ganglion
47
What virus are viral warts caused by
Human paillomavirus (HPV) infection of keratinocytes
48
Warts or verrucae vulgaris is commonly seen in what group of people
Children | Young adults
49
Clinical features of viral warts - appearance/shape - colour - associated lesions
Elevated, round, hyperkeratotic (rough, scaly) skin papules Black dots on surface of lesion Grey-white or light brown Satellite lesions - multiple similar smaller lesions develop following the appearance of the initial lesion
50
Viral warts treatment (3)
``` Debridement - soaking then debriding wart with knife/file + salicylic acid + duct tape occlusion ``` Cryotherapy Topical silver nitrate
51
Common warts may mimic what skin cancer type
squamous cell carcinoma
52
Clinical features of molluscum contagiosum - number/size/shape/texture of lesion - associated features
Multiple small, firm, raised umbilicated (central depression), pearl like smooth papules on the skin -not painful; may be itchy surrounding erythema
53
Molluscum contagiosum is a viral infection caused by what virus
Molluscum contagiosa virus (MCV) - a poxvirus
54
Molluscum contagiosum is transmitted by
close direct contact – such as touching the skin of an infected person touching contaminated objects – such as towels sexual contact
55
Molluscum contagiosum usually resolves itself in children but adults may require what treatment (3)
curettage cryotherapy (topical liquid nitrogen) OR topical cantharidin
56
Molluscum contagiosum usually affects where
Face and groin
57
Name some fungal skin infections
Dermatophytosis Candidiasis Pityriasis versicolor
58
What is dermatophytosis | -where do they like to grow
Superficial fungal infections of the hair, skin, and nails caused -restricted in these areas because dermatophytes require keratin for growth
59
``` Dermatophyte (ringworm) infection of -the arms and legs -the scalp -the foot -the nail ``` is usually caused by what dermatophyte
Tinea corporis Tinea capitis Tinea pedis Tinea unguium
60
Ringworm infection of the scalp may present as what
Patchy alopecia - patches of hair loss
61
Treatment of dermatophyte (ringworm) infection
Systemic antifungals - for ringworm infection if scalp, nails Topical antifungals - for ringworm infection of foot, arms/legs
62
Risk factors of mucocutaneous candida infections
``` DM Occlusion - e.g. nappies Hyperhidrosis - excessive sweating Broad spectrum antibiotics Immunosuppression ```
63
Candida (yeast) like to grow in what environment + most common form of candida that causes yeast infection
Humid environment Candida albicans
64
Clinical features of mucocutaneous candida infections (yeast (fungal) infection) - general - oral candidiasis (2)
Erythematous patches Satellite lesions White/yellow plaques in oral mucosa in oral candidiasis Cracks/ulcers/crusting at the corners of mouth
65
Candiasis treatment
Topical antifungal Systemic anti fungal if severe
66
What fungus is pityriasis veriscolor caused by
Malassezia
67
What is pityriasis versicolor + cause
Superficial fungal infection of the stratum corneum due to overgrowth of normal malassezia yeast on the skin
68
Clinical feature of pityriasis versicolor
hypo- or hyperpigmented macular lesions with fine scale hallmark is different colour of the lesions hence versicolor
69
Risk factors of pityriasis versicolor
Warm, moist environment | Hyperhidrosis
70
Treatment of pityriasis versicolor
Topical antifungal (shampoo or cream)
71
Scabies is caused by what organism
Sarcoptes scabiei | -a mite that burrow and deposit eggs in the stratum corneum
72
How is scabies transmitted
Skin to skin
73
Clinical features of scabies (3)
intense pruritus - worse at night linear erythematous burrows - linear irregular marks erythematous papules and nodules
74
Risk factors of scabies
overcrowding
75
Investigations of scabies (2)
Ink burrow test - suspected lesion is marked with a marker then he ink is then wiped away with alcohol and reveals a linear burrow in the case of scabies Skin scraping + microscopy - looking for presence of the mite or its eggs
76
Scabies treatment
Topical permethrin or oral ivermectin
77
Head lice favour what areas (2)
Nape of neck | Behind ears
78
Treatment of head lice (3)
Insecticide - pideculicide Mechanical removal Treat also close contacts

Year 2 - Dermatology (10 decks)

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