Week 3 - Bacterial Skin Infections Flashcards

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1
Q

What are the 3 key reasons why bacteria infect skin?

A
  1. Skin Integrity break down
  2. Poor host immunity
  3. Skin’s normal flora is compromised
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2
Q

What is the most common skin infection in the UK?

A

Impetigo/cellulitis/boils

(Staph infections)

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3
Q

What is the most common cause for skin infections in developing countries?

A
  • TB
  • Leprosy
  • Impetigo
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4
Q

90% of cases of Impetigo are due to Staph A.

What is the second most common organism?

A

Group A Streptococci

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5
Q

What is the topical treatment for localised impetigo?

A

Fucidin TDS

+

Antispetic povidine Iodine for 1 week

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6
Q

What are the antibiotics used for extensive Impetigo due to Staph and the Abx for Strep please?

A

Flucloxacillin 500mg QDS for 7-10 days for Staph.

Penicillin V 500mg QDS for 7-10 days for Strep

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7
Q

What are the school exclusion criteria for impetigo?

A

Avoid school whilst lesions are weepy and crusty

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8
Q

If someone gets recurrent impetigo, cellulitis or boilds…

What should you do?

A
  • Skin swabs (To exclude MRSA or PVL Staph)
  • Nasal swabs
  • Consider immunosuppression/diabetes
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9
Q

If nasal swabs show staph or MRSA, how do you treat this?

A

Mupirocin (TDS for 1 week)

Don’t forget to Ix and treat the whole family - Abx, Chlorhexidine, Mupirocin etc)

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10
Q

What is cellulitis of the face called?

Where on the face does it usually star?

A

Erysepilas

It usually starts under the eye or bridge of the nose.

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11
Q

How can you confirm if cellulitis is due to streptococci infection?

A

ASOT (Streptococcal titres)

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12
Q

What is the treatment for cellulitis?

A

Oral penicillin or Erythromycin 500mg BD

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13
Q

What condition is this?

What is it’s treatment

Who is more likely to get it?

A

Dissecting cellulitis of the scalp

Oral tetracyclines, Intralesional steroids or surgery

Fitzpatrick skin type 6

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14
Q

What is this?

What skin type is more likely to get it?

A

Sycosis Barbae (Folliculitis due to shaving)

Fitzpatrick skin type 6

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15
Q

What are the different types of folliculitis

A
  1. Hot-tub folliculitis
  2. Pityrosporum folliculitis - fungal folliculitis
  3. Steroid acne
  4. Itchy folliculitis - can be a sign of HIV infection
  5. Folliculitis Keloidalis - more common in black males. Avoid shaving and treat with long term antibiotics (6 months)
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16
Q

32y/o IV drug user has this on his skin.

What is this?

A

Echtyma

(Impetigo that invades the dermis)

If someone gets it…consider immunosuppresion - diabetes, HIV etc.

17
Q

What 2 genes are responsible for hydradenitis suppurativa and how is it inherited in some people?

A

Autosomal dominant

PSENEN gene & NCSTN gene

18
Q

What are some other causes of hydradenitis suppurativa?

A
  • Obesity
  • Smoking
  • Drugs e.g. lithium
  • Hormones
  • Infection
  • Apocrine gland structure
19
Q

What are some treatments for HS?

A
  • Weight loss
  • Chlorhexidine soap
  • Oral antibiotics (Erythromycin, Tetracyclines)
  • Oral antiandrogens
  • Isotretinoin/acitretinin
  • Oral zinc sulphate 10mg/kg (max 400-600mg daily)
  • Axillary botox.
20
Q

What is this?

How can you tell the difference from Toxic Epidermal Necrolysis?

A

Staphylococcal Scalded Skin Syndrome

It doesn’t involve the mucosa (mouth etc) because it only attacks the outer epidermis.

21
Q

What is the cause of Scarlet Fever?

A

Strep Pyogenes

(Group A Strep)

22
Q

What are some complications of scarlet fever?

A
  • Arthritis
  • Meningitis
  • Osteomyelitis
23
Q

What is this and what causes it?

A

Erythrasma

Caused by Cornebacterium Minutissimum

It flouresceces coral pink under a Wood’s light.

24
Q

How do you treat Erythrasma?

A

Oral Erythromycin 500mgQDS for 10 days

25
Q

What is this?

What Causes it?

How do you treat it?

A
  • Pitted Keratolysis
  • Corynebacterium
  • Topical antibiotics - Erythromycin, Fusidic Acid orclindamycin-twice daily for 2-4 weeks) + Anti-sweating treatment.
26
Q

What two infectious skin conditions does Corynebacterium cause?

A

Pitted Keratolyis

and

Erythrasma