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*Dermatology > Skin Infections + Infestations > Flashcards

Skin Infections + Infestations Flashcards

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Dermatology Board Prep flashcards
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
Q

What is the danger if syphilis is left undiagnosed?

A

Tertiary syphilis can develop years later and cause a variety of problems affecting the brain, eyes, heart and bones

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26
Q

How does primary syphilis present?

A

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

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27
Q

When does secondary syphilis occur?

A

3 weeks to 3 months after 1st stage

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28
Q

How does secondary syphilis present?

A

Widespread skin rash
May be subtle or appear as rough, red/reddish brown papules/patches
Typically on trunk/palms + soles
Not itchy

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29
Q

How does tertiary syphilis present?

A

Solitary granulomatous lesions (gummas) may be on skin, in mouth and throat/occur in bones
Brain, spinal cord, heart, liver, eyes may be affected

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30
Q

What tests can be done for syphilis?

A

Non-specific non-treponemal tests (VDRL)

Specific anti-treponemal antibody tests (TTPA)

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31
Q

Treatment of syphilis?

A

Penicillin by injection depending on stage of disease

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32
Q

What are the most common viral skin infections?

A 
Herpes simplex
Chicken pox
Shingles
Viral warts 
Molluscum contagiosum
33
Q

How does HSV-1 present?

A

Most commonly sores around mouth

Present in approx 90% of individuals between 20-40 yrs

34
Q

How does HSV-2 present?

A

Most commonly genital infection (associated with sexual activity)

35
Q

How are the sores in herpes described?

A

V sore areas with erythematous base, with vesicles followed by pustules and ulcerations

36
Q

What does the antiviral therapy depend on?

A

Type

37
Q

What virus is chicken pox caused by?

A

Varicella-Zoster Virus (VZV)

38
Q

What else does VZV cause? Is it related to chicken pox?

A

Shingles (herpes zoster)

Yes, shingles is the reactivation of latent varicella

39
Q

What is chicken pox?

A

Highly contagious viral infection that causes an acute fever and blistered rash, mainly in children

40
Q

How is chickenpox spread?

A

Airborne respratory droplets from an infected person’s coughing/sneezing, or through direct contact with fluid from open sores

41
Q

How is the development of lesions in chickenpox described?

A

Red macules -> vesicles -> pustules -> crusts

Starts which vesicle on top of erythema - ‘dew drops on a rose petal’ - v characteristic

42
Q

How is chickenpox treated?

A

Symptomatics

Calamine lotion

43
Q

What is shingles?

A

Localised, blistering and painful rash caused by reactivation of varicella-zoster virus (VZV)

44
Q

How is shingles characterised?

A

Dermatomal distribution

45
Q

Why does shingles have a dermatomal distribution?

A

Blisters are confined because VZV remains dormant in specific dorsal root ganglia nerve cells in the cells

46
Q

Complications of shingles?

A

Infection

Post-herpetic neuralgia

47
Q

How is shingles treated?

A

Keep area clean to prevent infection

Pain relief and rest

48
Q

What virus causes viral warts?

A

Human papillomavirus

49
Q

What are the lesions in viral warts described as?

A

Hyperkeratotic papules (looks like cauliflower - typical)
Thick hyperkeratotic plaques
When grouped - ‘mosaic’

50
Q

Treatment for viral warts?

A

Most resolve spontaneously
Salicylic acid
Cryotherapy

51
Q

When should viral warts patient be referred to secondary care?

A

Diagnostic uncertainty
Immunocompromised patients
Large/extensive warts

52
Q

Who is mainly affected by molluscum contagiosum?

A

Infants
Children <10 yrs
Warm climates/overcrowded environments

53
Q

What virus causes molluscum contagiosum?

A

Poxvirus (poxviridae family)

54
Q

What are the lesions like in molluscum contagiosum?

A

Firm, umbilicated pearly papules w waxy surface

Common in skinfolds/genitals

55
Q

How is MC treated?

A

Curettage (try to avoid as theres loads)
Liquid nitrogen
Chemovesicants
Can go away on own

56
Q

What are the 3 commonest fungal skin infections?

A

Dermatophytosis
Candidiasis
Pityriasis versicolor

57
Q

Dermatophytosis = ringworm = tinea; what are the types?

A 
Tinea corporis (general)
Tinea cruris (groin)
Tinea capitis (scalp) (only one that is common in children)
Tinea pedis (foot)
Tinea unguium (nail)
58
Q

What does ringworm look like?

A

Circular lesion; ‘wave’ of fungus going through healthy skin - redder at outline than middle

59
Q

Predisposing factors of mucocutaneous candida infections?

A 
Diabetes
Occlusion (e.g. nappies)
Hyperidrosis 
Broad spectrum abx
Immunosuppression
60
Q

What fungus causes candida infections?

A

Candida albicans

61
Q

What does candida infection present as?

A 
Erythematous patches often accompanied by satellites pustules 
Intertriginous zones (submammary, inguinal creases, finger spaces) and nappy area in infants
62
Q

Treatment of candida?

A

Remove predisposing factors
Topical antifungals
Oral antifungal in some cases

63
Q

What fungus causes pityriasis versicolor?

A

Malassezia sp

64
Q

What do lesions of PV look like?

A

Multiple oval round patches w mild scale

65
Q

More info on PV?

A

Increased incidence in adolescents and preference for sebum-rich areas of skn
High temperatures and humidity, oily skin, excessive sweating

66
Q

Treatment of PV?

A

Topical antimycotic (shampoos, creams)

67
Q

What are the 2 skin infestations?

A

Scabies

Headlice

68
Q

What mite causes scabies?

A

Sarcoptes scabei

69
Q

How is scabies transmitted?

A

Direct close contact

70
Q

Predisposing factors for scabies?

A

Overcrowding

Delayed treatment

71
Q

How can scabies be diagnosed?

A

Skin scraping

Burrows visualisation

72
Q

Scabies is v v itchy, when is the itch characteristically more severe?

A

At night (disturbing sleep)

73
Q

Where does scabies affect?

A

Trunk and limbs; sparing scalp

74
Q

How do scabies burrows appear?

A

0.5–1.5 cm grey irregular tracks in the web spaces between the fingers, on the palms and wrists

75
Q

Treatment of scabies?

A

Antiscabietic topical treatment in patient and close contacts, repeat after 1 week
Oral meds in some cases

76
Q

What do head lice cause?

A

Itch and irritation in scalp

77
Q

How do headlice present?

A

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
Q

Treatment for headlice?

A

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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