week 13 Flashcards
impetigo primary vs secondary
primary- infection recently
secondary- nbreak in skin and then infected
impetigo infections causes
staph aureus
streptococcus pyogens
tx of impetigo
2-3 weeks- self resolved
Topical ABX if superficial, nonbullous, localized cases- Mupiricon or retapamulin
EDU: remove crust before applying ABX topically, treat ALL lesions
Oral abx if multiple lesions, infections in family members- cephalexin, augmentin, dicloxacillin, clindamycin
what is SSSS
staphylococcal scalded skin syndrome
- abrupt onset of fever, poor feeding, lethargy
- key finding is sandpaper rash resembling scarlet fever that rubs off with light rub
treatment of SSSS
IV ABX- dicloxacillin
first or second gen cephalosporins
minimal handling, adding ointments
cellulitis cause
s. aureus
erysipelas vs cellulitis
erysipelas- local signs and symptoms, well-demarcated area of infection
cellulitis- more severe, systemic symptoms, not well-demarcated
celleulitis TX
depends on suspected organism- cephalexin, bactrim, clindimycin
Follow-uo- 24 hours and daily after that to see response
folliculitis
- obstruction damage- acne, waxing, shaving
environmental causes- moist environment, maceration, poor hygeine, occlusive emollients, prolonged submersion in contaminated water
Furuncle (boil)
abscess with one hair
carbuncle
abscess with multiple hair follicles
candidiasis
yeast infection and thrush that is fungal related (mouth perianal, breast)
risk factors: immunosuppressed, moist, abx recently
dx study for yeast
KOH scraping
tx yeast
oral: nystatin 4x day dropper in each cheek
BF: nystatin on nipples
persistent: oral fluconazole
Skin (diaper/folds): nystatin topical, every diaper change
DO NOT COMBINE WITH CORTICOSTERIOD
tinia capitis
dermatophyte infection of scalp and hair shaft- ring worm
dx of Tinia capitis
clinical observation + cervical or occipital lymphadenopathy
antifungal tx tinia capatis
gold standard: griseofulvin- taken 6-8 weeks with fatty food (side effects: gi distrubance, skin eruptuions, headaches, photosensitivity)
or terbinafine (effective over 4 years)
tx with kerions
prednisone for inflammation and systemic antibiotics
monitoring tinia capatis
follow ups every 2-4 weeks and continue treatment until culture is negative for 2 weeks
hair regrowth process (tinia capatis
3-12 months
tinia corporis
superficial funal skin infection excluding the scalp, palms, soles, and groin
managment of tinia corporis
topical: miconozole or clotrimozole (twice daily for 1-4 weeks including normal skin around the lesions
extensive infection, or immunocompromised: griseofulvin for 2-4 weeks
daycare with tinia corporus
return after 24 hours after treatment begins
tinea cruris
jock itch
superficial fungal infection
adolescents males, obese people, hygiene issue
tx of tinia cruris
same as tinia corporis
tinia pedis
athletes foot
superficial foot fungal disease
showers or locker rooms
management of tinia pedis
same as tinia corporis
tinia versicolor
pityriasis versicolor
fungal infection that commonly appears on the face, neck, upper arm, chest and back
hypopigmented in dark skin, hyperpigmented in light skin
tinia versicolor
topical:
selenium sulfide 2.5 % lotion of 1% shampoo applies in a thin layer several hand widths beyond the lesion for 10 minutes daily before rinsing for 1-2 weeks followed by 3 months to help prevent reoccurance
molluscum contagiosum
water warts
benign viral skin infection with little risk
resolves on own from 2-7 weeks up to 6 months
itching, white discrete papules
management of molluscum
6 mo - 4 years of self resolving
warts
HPV cause- over 100 types, all cause different presentation
management of warts
resolve within 3-5 years but recurrence is high
no real treatment
Topical: salacylic acid, cryotherpy, elecrto surgery, lasar therapy
genital warts
concern for sexual abuse and require extensive evaluation
pediculosis
lice
require human blood for sustanace
they can crawl but not jump
3 types: head, pubic, body
eggs of lice
nits
concrete to hair shaft
7-10 days to hatch, lay 10 eggs a day
symtoms of lice
itching, dandruff- like substance, crawling sensation
sites: back of head, nape of neck, behind ears
pediculosis corporis
body lice
associated with homelessness, crowded living conditions
treatment for lice
permethrin 1% cream rinse (OTC) is the treatment of choice- can be used 2 months or older
environment cleaning after lice
- examine/inform contacts
- launder hot water and dry on hot for 20 minutes
- ## non washables: store in plastic bag for 2 weeks
scabies
mite- close contacts through clothing and linen- transmititon happens in 15 min
lesions of scabies
S shaped burrows that are worse at night
treatment of scabies
scabicide application: thin layer from neck down, special attention - under fingernails, scalp, behind ears, folds, creases, feet, hands. keep on for 8-14 hours and then rinse
Permetherin 5% cream drug of choice (VS 1% for lice)
severe crusted scabies tx: ivermectin (oral) as a second treatment
-school rule for scabies
can return after 24 hours post treatment
post scabies treatment symptoms
itching for 3 weeks
can use antihistamines or hydrocortisone treatment
acne
ages starts: 12-13 girls
14-15 boys
treatment for acne
1) tretnoin and benzole peroxide
2) antibiotics topically (gels are more powerful than the creams)
3) antibiotics Tetracyclines (doxycycline and minocycline) alternatives would be erythromycin
4) hormonal control- BC, OCP, spironolactone
