Uncommon Infections Flashcards
What are the uncommon infections of the skin?
- Parasites
- Mycobacterium Diseases including Leprosy
- HIV Infection
What are the 3 main types of parasites?
- Arthropods
- Worms
- Protozoa
For what are the parasitical arthropods?
- Lice
- Ticks
- Arachnids
For what are the parasitical worms?
- Roundworms (Hookworms, pinworms)
- Onchocerciasis
- Schistosomiasis
What is this and what causes it?
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Erythema Chronicum Migrans
It is caused by Borrelia Burgdorferi (A spriochete - type of bacteria)
It is transmitted by ticks.
Describe the different forms wereby Erythema Migrans can present.
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What can happen if the Lyme’s disease is undiagnosed or treated?
- Neurological complications
- Rarely
- Arthritis
- Cardiac Disease
What is a late manifestation of of Lyme’s Disease?
Acrodermatitis chronica atrophicans (Scleroderma like rash)
It affects the distal parts of the body - due to chronic Borrelia Burgdorferi infection.
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What is the investigation for lyme’s disease?
What is interesting about this investigation?
Borrelia serology
(it may take several months to be postive)
What would be the clinical picture if someone had skin disease due to worms?
- Pruritus
- Bloods - eosinophilia
- History of foreign travel
For worms that affect the skin, how long can the incubation period be?
10 years
What is Onchocerciasis (“River Blindness) ?
How is it investigated and treated?
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- It is a parasitic worm (Ochocerca Volvulus) from central Africa and Southern America. It causes Pruritus with urticarial and papular rashes. It can then inhabit the eyes causing blindness (blue eyes).
- Investigation: Skin snips
- Treatment: Ivermectin
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What is schistosomiasis?
How is it investigated and treated?
Schistosomiasis is a parasite called Schistosoma Mansoni. It is endemic in Africa, South America, India and the Far East.. It causes itchy skin, urticaria and eosinophilia. Skin lesions are most common on the trunk and can have a zosteriform appearance.
- Investigations: stool ova/cysts/parasites may be seen on skin biopsy.
- Treatment: Mebendazole
What is Leishmaniasis?
A Protozoa found in Africa, South America.
Initially crusts, then ulcers form and then they heal.
Treatment: Pentavalent Antimony
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What are some other parasites of the skin?
-
Onchocerciasis - Central Africa and South America.
- Itchy buttocks, lets, shoulders.
- Diagnose with skin snips.
- Treat with mebendazole.
- Threadworms - treat with mebendazole
- Larva currens - a larva that crawls under the skin leaves urticarial lines.
- Larva migrans - dog/cat hookorm in faeces.
What are the two types of mycobacterium?
- Atypical mycobacteria
- Mycobacterium leprae
When should cutaneous TB be suspected?
If someone is coming form an endemic area with TB and has an unusual skin lesion.
What are the ways that TB manifests in the skin?
- Lupus Vulgaris
- Warty TB
- Scrofuloderma
- Tuberculides
What is this?
How does it present?
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Lupus vulgaris
- Due lymphatic/haematogenous spread from an underlying focus.
- Affects normal skin especially head/neck/face.
- Initially painless red-brown plaque with apple jelly.
- Slowly enlarges & progressively destructive.
- May be a plaque, a nodule or ulcerated.
- Regional lymphadenopathy may be present.
What is this?
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Warty TB
- Presents due to re-infection in a sensitized patient usually from the far east.
- Usually occurs on the hands and feet.