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Year 2 - Dermatology > Skin infections and infestations > Flashcards

Skin infections and infestations Flashcards

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Dermatology Board Prep 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
Q

Treatment of syphilis

A

Intramuscular penicillin injection

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26
Q

Herpes simplex virus 1 affects where compared to herpes simplex virus 2

A

HSV1 affects mouth and lips area –> oral herpes (herpes labialis)
-but can also affect genitals

HSV2 affects genitals –> genital herpes

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27
Q

How is HSV transmitted

A

Through mucosal surfaces or breaks in the skin

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28
Q

Clinical features of HSV infection

  • oral
  • genital
A

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
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29
Q

Oral v genital herpes - which usually has more lesions

A

genital; oral usually just one lesion

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30
Q

Investigations of HSV infection

A

Viral swab –> viral culture
Viral swab –> HSV PCR
HSV type specific antibodies

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31
Q

Following primary infection with HSV, what happens

A

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

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32
Q

Treatment of HSV infection

A

Antivirals - aciclovir or famciclovir

33
Q

Chickenpox is caused by what virus

A

Varicella-zoster virus (VZV)

34
Q

Latent varicella-zoster virus (VZV) when reactivated manifests as what infection

A

Shingles (herpes zoster)

35
Q

Symptoms (2) /signs (3) of chicken pox

A

Symptoms

  • malaise
  • pruritus

Signs

  • fever
  • generalised vesicular rash (initially macule –> vesicle –> pustule –> erosion)
  • vesicles on mucous membranes (mouth, nasopharynx)
36
Q

Adverse outcomes of chicken pox are more common in (4)

A

immunocompromised people, adolescents, adults, and pregnant women

37
Q

How is chicken pox spread (2)

A

direct contact with fluid from the lesions

or through airborne spread from respiratory droplets of an infected person

38
Q

Treatment of chicken pox

  • low risk disease (3)
  • severe disease (2)
A

Supportive therapy

  • paracetamol
  • emollient
  • antihistamine

Severe

  • antiviral (aciclovir)
  • supportive therapy
39
Q

Symptoms/signs of shingles

A

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
Q

Treatment of shingles

A

Treatment is primarily to reduce pain using analgesics and viral replication using antiviral medicine such as aciclovir.

41
Q

Investigations of shingles

A

Confirmation can be done using polymerase chain reaction (PCR) methods.

42
Q

After a primary varicella-zoster virus (VZV) infection, the virus establishes latency where in the body (2)

A

in dorsal root and cranial nerve ganglia

43
Q

Why does shingles present as dermatomal pain and rash

A

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
Q

Most common complication of shingles

A

Postherpetic neuralgia

-long lasting nerve pain in an area previously affected by shingles even when rash disappears

45
Q

Shingles treatment (3)

A

Antiviral
Analgesia
Calamine lotion

46
Q

Characteristic distribution of shingles

A

dermatomal due to infected ganglion

47
Q

What virus are viral warts caused by

A

Human paillomavirus (HPV) infection of keratinocytes

48
Q

Warts or verrucae vulgaris is commonly seen in what group of people

A

Children

Young adults

49
Q

Clinical features of viral warts

  • appearance/shape
  • colour
  • associated lesions
A

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
Q

Viral warts treatment (3)

A 
Debridement - soaking then debriding wart with knife/file
\+
salicylic acid 
\+
duct tape occlusion

Cryotherapy

Topical silver nitrate

51
Q

Common warts may mimic what skin cancer type

A

squamous cell carcinoma

52
Q

Clinical features of molluscum contagiosum

  • number/size/shape/texture of lesion
  • associated features
A

Multiple small, firm, raised umbilicated (central depression), pearl like smooth papules on the skin
-not painful; may be itchy

surrounding erythema

53
Q

Molluscum contagiosum is a viral infection caused by what virus

A

Molluscum contagiosa virus (MCV) - a poxvirus

54
Q

Molluscum contagiosum is transmitted by

A

close direct contact – such as touching the skin of an infected person

touching contaminated objects – such as towels

sexual contact

55
Q

Molluscum contagiosum usually resolves itself in children but adults may require what treatment (3)

A

curettage

cryotherapy (topical liquid nitrogen) OR topical cantharidin

56
Q

Molluscum contagiosum usually affects where

A

Face and groin

57
Q

Name some fungal skin infections

A

Dermatophytosis
Candidiasis
Pityriasis versicolor

58
Q

What is dermatophytosis

-where do they like to grow

A

Superficial fungal infections of the hair, skin, and nails caused -restricted in these areas because dermatophytes require keratin for growth

59
Q 
Dermatophyte (ringworm) infection
of 
-the arms and legs
-the scalp 
-the foot
-the nail

is usually caused by what dermatophyte

A

Tinea corporis
Tinea capitis
Tinea pedis
Tinea unguium

60
Q

Ringworm infection of the scalp may present as what

A

Patchy alopecia - patches of hair loss

61
Q

Treatment of dermatophyte (ringworm) infection

A

Systemic antifungals - for ringworm infection if scalp, nails

Topical antifungals - for ringworm infection of foot, arms/legs

62
Q

Risk factors of mucocutaneous candida infections

A 
DM
Occlusion - e.g. nappies
Hyperhidrosis - excessive sweating
Broad spectrum antibiotics
Immunosuppression
63
Q

Candida (yeast) like to grow in what environment + most common form of candida that causes yeast infection

A

Humid environment

Candida albicans

64
Q

Clinical features of mucocutaneous candida infections (yeast (fungal) infection)

  • general
  • oral candidiasis (2)
A

Erythematous patches
Satellite lesions

White/yellow plaques in oral mucosa in oral candidiasis
Cracks/ulcers/crusting at the corners of mouth

65
Q

Candiasis treatment

A

Topical antifungal

Systemic anti fungal if severe

66
Q

What fungus is pityriasis veriscolor caused by

A

Malassezia

67
Q

What is pityriasis versicolor + cause

A

Superficial fungal infection of the stratum corneum due to overgrowth of normal malassezia yeast on the skin

68
Q

Clinical feature of pityriasis versicolor

A

hypo- or hyperpigmented macular lesions with fine scale

hallmark is different colour of the lesions hence versicolor

69
Q

Risk factors of pityriasis versicolor

A

Warm, moist environment

Hyperhidrosis

70
Q

Treatment of pityriasis versicolor

A

Topical antifungal (shampoo or cream)

71
Q

Scabies is caused by what organism

A

Sarcoptes scabiei

-a mite that burrow and deposit eggs in the stratum corneum

72
Q

How is scabies transmitted

A

Skin to skin

73
Q

Clinical features of scabies (3)

A

intense pruritus - worse at night

linear erythematous burrows - linear irregular marks

erythematous papules and nodules

74
Q

Risk factors of scabies

A

overcrowding

75
Q

Investigations of scabies (2)

A

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
Q

Scabies treatment

A

Topical permethrin or oral ivermectin

77
Q

Head lice favour what areas (2)

A

Nape of neck

Behind ears

78
Q

Treatment of head lice (3)

A

Insecticide - pideculicide
Mechanical removal
Treat also close contacts

Year 2 - Dermatology (10 decks)

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