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*Dermatology > Skin Infections + Infestations > Flashcards

Skin Infections + Infestations Flashcards

(78 cards)

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1
Q

What are the most common bacterial skin infections?

20% of outpatient derm visits

A
  • Impetigo
  • Folliculitis
  • Cellulitis
  • Erysipela
  • Syphilis
  • Leprosy
  • Rickettsial diseases
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2
Q

What is the most common ( and v contagious) bacterial infection in children?

A

Impetigo

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3
Q

Predisposing factors for impetigo?

A

Warm temp, high humidity
Poor hygiene
Skin trauma

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4
Q

What bacteria most commonly cause impetigo?

A

Staph aureus (to a lesser degree Strep pyogenes)

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5
Q

What is the clinical presentation of impetigo?

A

Macule rapidly becomes vesicle then pustule then erosion with ‘honey-coloured’ yellow crust and rapid extension to surrounding skin

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6
Q

How is impetigo treated?

A

Local wound care

Topical abx

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7
Q

What is folliculitis?

A

Infection of the hair follicule

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8
Q

What bacteria most commonly causes folliculitis?

A

Staph aureus

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9
Q

Predisposing features of folliculitis?

A 
Occlusion 
Maceration + hyperhydration 
Shaving/waxing
Topical corticosteriods 
Diabetes
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10
Q

What areas does folliculitis affect?

A

Face, chest, back, axillae, buttocks

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11
Q

How to identify causative organisms?

A

Bacterial cultures

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12
Q

Treatment for folliculitis?

A

Antibacterial washes

Antibacterial ointments

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13
Q

What is erysipelas?

A

Infection of the dermis w lymphatic involvement, most commonly caused by group A strep

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14
Q

What groups of people does erysipelas affect?

A

V young
Elderly
Debilitated
Those with lymphoedema/chronic cutaneous ulcers

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15
Q

Clinical presentation of erysipelas?

A

Erythema with well defined margins
Affected skin is hot, tense, indurated
Face, lower extremities
May have fever, chills, malaise, nausea

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16
Q

Diagnosis is clinical, but what could lab results show that contribute?

A

Elevated leukocyte count w left shift

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17
Q

Treatment for erysipelas?

A

10-14 day course of penicillin

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18
Q

What is cellulitis?

A

Infection of the deep dermis and subcutaneous tissue caused most commonly by Strep pyogenes or Staph aureus

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19
Q

Predisposing factors for cellulitis?

A 
Lymphoedema
Alcoholism 
Diabetes mellitus 
IV drug abuse
Peripheral vascular disease
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20
Q

How does cellulitis present? (4 words for affected area)

A

Affected area = rubor, calor, dolor, tumor
Lesion has ill-defined, non-palpable borders
Children: H+N; adults: extremities

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21
Q

How is cellulitis treated?

A

Abx (depending on systemic symptoms and gravity, also risk factors)

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22
Q

What is syphilis?

A

Complex sexually transmitted infection

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23
Q

What bacteria causes syphilis?

A

Treponema pallidum

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24
Q

What is the time frame of presentation of syphilis?

A

Episodes of active disease occur, followed by latent periods

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25
What is the danger if syphilis is left undiagnosed?
Tertiary syphilis can develop years later and cause a variety of problems affecting the brain, eyes, heart and bones
26
How does primary syphilis present?
Painless small single ulcer where he infection has entered (around genitals, anus or mouth) and may go unnoticed (known as chancre) Heals in 4-8 weeks w/o treatment and 1-2 weeks w treatment
27
When does secondary syphilis occur?
3 weeks to 3 months after 1st stage
28
How does secondary syphilis present?
Widespread skin rash May be subtle or appear as rough, red/reddish brown papules/patches Typically on trunk/palms + soles Not itchy
29
How does tertiary syphilis present?
Solitary granulomatous lesions (gummas) may be on skin, in mouth and throat/occur in bones Brain, spinal cord, heart, liver, eyes may be affected
30
What tests can be done for syphilis?
Non-specific non-treponemal tests (VDRL) | Specific anti-treponemal antibody tests (TTPA)
31
Treatment of syphilis?
Penicillin by injection depending on stage of disease
32
What are the most common viral skin infections?
``` Herpes simplex Chicken pox Shingles Viral warts Molluscum contagiosum ```
33
How does HSV-1 present?
Most commonly sores around mouth | Present in approx 90% of individuals between 20-40 yrs
34
How does HSV-2 present?
Most commonly genital infection (associated with sexual activity)
35
How are the sores in herpes described?
V sore areas with erythematous base, with vesicles followed by pustules and ulcerations
36
What does the antiviral therapy depend on?
Type
37
What virus is chicken pox caused by?
Varicella-Zoster Virus (VZV)
38
What else does VZV cause? Is it related to chicken pox?
Shingles (herpes zoster) | Yes, shingles is the reactivation of latent varicella
39
What is chicken pox?
Highly contagious viral infection that causes an acute fever and blistered rash, mainly in children
40
How is chickenpox spread?
Airborne respratory droplets from an infected person's coughing/sneezing, or through direct contact with fluid from open sores
41
How is the development of lesions in chickenpox described?
Red macules -> vesicles -> pustules -> crusts | Starts which vesicle on top of erythema - 'dew drops on a rose petal' - v characteristic
42
How is chickenpox treated?
Symptomatics | Calamine lotion
43
What is shingles?
Localised, blistering and painful rash caused by reactivation of varicella-zoster virus (VZV)
44
How is shingles characterised?
Dermatomal distribution
45
Why does shingles have a dermatomal distribution?
Blisters are confined because VZV remains dormant in specific dorsal root ganglia nerve cells in the cells
46
Complications of shingles?
Infection | Post-herpetic neuralgia
47
How is shingles treated?
Keep area clean to prevent infection | Pain relief and rest
48
What virus causes viral warts?
Human papillomavirus
49
What are the lesions in viral warts described as?
Hyperkeratotic papules (looks like cauliflower - typical) Thick hyperkeratotic plaques When grouped - 'mosaic'
50
Treatment for viral warts?
Most resolve spontaneously Salicylic acid Cryotherapy
51
When should viral warts patient be referred to secondary care?
Diagnostic uncertainty Immunocompromised patients Large/extensive warts
52
Who is mainly affected by molluscum contagiosum?
Infants Children <10 yrs Warm climates/overcrowded environments
53
What virus causes molluscum contagiosum?
Poxvirus (poxviridae family)
54
What are the lesions like in molluscum contagiosum?
Firm, umbilicated pearly papules w waxy surface | Common in skinfolds/genitals
55
How is MC treated?
Curettage (try to avoid as theres loads) Liquid nitrogen Chemovesicants Can go away on own
56
What are the 3 commonest fungal skin infections?
Dermatophytosis Candidiasis Pityriasis versicolor
57
Dermatophytosis = ringworm = tinea; what are the types?
``` Tinea corporis (general) Tinea cruris (groin) Tinea capitis (scalp) (only one that is common in children) Tinea pedis (foot) Tinea unguium (nail) ```
58
What does ringworm look like?
Circular lesion; 'wave' of fungus going through healthy skin - redder at outline than middle
59
Predisposing factors of mucocutaneous candida infections?
``` Diabetes Occlusion (e.g. nappies) Hyperidrosis Broad spectrum abx Immunosuppression ```
60
What fungus causes candida infections?
Candida albicans
61
What does candida infection present as?
``` Erythematous patches often accompanied by satellites pustules Intertriginous zones (submammary, inguinal creases, finger spaces) and nappy area in infants ```
62
Treatment of candida?
Remove predisposing factors Topical antifungals Oral antifungal in some cases
63
What fungus causes pityriasis versicolor?
Malassezia sp
64
What do lesions of PV look like?
Multiple oval round patches w mild scale
65
More info on PV?
Increased incidence in adolescents and preference for sebum-rich areas of skn High temperatures and humidity, oily skin, excessive sweating
66
Treatment of PV?
Topical antimycotic (shampoos, creams)
67
What are the 2 skin infestations?
Scabies | Headlice
68
What mite causes scabies?
Sarcoptes scabei
69
How is scabies transmitted?
Direct close contact
70
Predisposing factors for scabies?
Overcrowding | Delayed treatment
71
How can scabies be diagnosed?
Skin scraping | Burrows visualisation
72
Scabies is v v itchy, when is the itch characteristically more severe?
At night (disturbing sleep)
73
Where does scabies affect?
Trunk and limbs; sparing scalp
74
How do scabies burrows appear?
0.5–1.5 cm grey irregular tracks in the web spaces between the fingers, on the palms and wrists
75
Treatment of scabies?
Antiscabietic topical treatment in patient and close contacts, repeat after 1 week Oral meds in some cases
76
What do head lice cause?
Itch and irritation in scalp
77
How do headlice present?
Itchy scalp Nits can be seen once eggs have hatched, as adherent white grains on hair shaft Red-brown spots caused by excreted digested blood
78
Treatment for headlice?
At least 2 applications of an insecticide and/or physical methods (combs) Treat all members of fam Inform day care/school

*Dermatology (11 decks)

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