Skin infections: Cellulitis, Ersipelas, Pityriasis rosea, Guttate psoriasis, Pityriasis versicolor, Athlete's foot, Eczema herpeticum, Roseola infantum, Shingles Flashcards
Cellulitis
-pathophysiology
-causative organism
-presentation
Dermis and deep SC tissue bacterial infection
Majority strep pyogenes
Staph aureus
Unilateral, erythma with defined borders
Swelling
In severe disease
-blisters
-systemic upset
Clinical diagnosis
Bloods, cultures requested If IP and septic
Cellulitis
-Eron criteria and management
Eron I - no systemic toxicity or uncontrolled comorbidities
1st line - PO fluclox
Penicillin allergy - PO clarithromycin/doxycycline
+pregnant - PO erythromycin
Eron II - systemically unwell or systemically well with comorbidity that may complicate resolution
-IP if unable to give IV ABx in community
Eron III-IV - significant systemic upset that may interfere with treatment response, limb thretening infection
-IP PO/IV coamox, clindamycin, IV cefuroxime, ceftriaxone
Ersipelas
-what is it
-causative organism
-management
Infection of epidermis but strep pyogenes
Fluclox
Pityriasis rosea
-causative organism
-presentation
-management
HH7
Acute self limiting rash affecting young adults
No prodrome, but recent viral infection
Herald patch on trunk followed by erythematous oval patch along Langer lines
Self limiting, disappears after 6-12wks
Guttate psoriasis
-causative organism
-presentation
-management
Precipitated by strep infection 2-4wks before in children and young people
Tear drop papules on trunk, limbs
Acute onset over days
Self limiting in 2months
-TOP psoriasis agents
-UVB phototherapy
Pityriasis versicolor
-causative organism
-presentation
-management
Superficial cutaneous fungal infection - malassezia furfur
Trunk - hypopigmentation, pink, brown
Scaly, mild itch
Worse after sun exposure
Clinical diagnosis but can send scrapings to confirm diagnosis
TOP antifungal - ketozonazole shampoo
If not responsive, consider alternative diagnosis
-PO itraconazole
Athlete’s foot
-causative organism
-presentation
-management
Fungal infection - trichophyton
Itching and stinging between toes
Cracked skin between toes
Small blisters on edge/top of foot
Dry, flaky skin on sole
TOP imidazole, undecenoate or terbinafine
Eczema herpeticum
-pathophysiology
-presentation
-management
Skin infection by HSV in people with atopic eczema
Rapidly progressing painful rash
-monomorphic punched out erosions (1-3mm)
ADMIT FOR IV ACICLOVIR
Roseola infantum
-causative organism
-presentation
-management
HH6
-6months - 2 years
High fever FOLLOWED BY maculopapular rash on trunk
-febrile convulsions can occur
School exclusion not needed
Supportive - paracetamol, fluids
