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Dermatology - PowerPoint PPT Presentation

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Dermatology. Anatomy. Skin Infections. Bacterial Impetigo Folliculitis Furuncle Carbuncle Cellulitis Acne Fungal /Parasitic Tinea Pedis Tinea Cruris Tinea Versicolor Tinea Corporis Toenail fungus Pediculosis Scabies. Skin Infections. Viral Herpes Simplex Herpes Zoster Verruca

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Skin infections
Skin Infections

  • Bacterial

    • Impetigo

    • Folliculitis

    • Furuncle

    • Carbuncle

    • Cellulitis

    • Acne

  • Fungal /Parasitic

    • Tinea Pedis

    • Tinea Cruris

    • Tinea Versicolor

    • Tinea Corporis

    • Toenail fungus

    • Pediculosis

    • Scabies

  • Skin infections1
    Skin Infections

    • Viral

      • Herpes Simplex

      • Herpes Zoster

      • Verruca

      • Molluscum Contagiosum

  • Allergic/Irritation conditions

    • Dermatitis

    • Hives

    • Eczema

    • Psoriasis

    • Sebacous Cysts

    • Frostbite

  • Other

    • Skin checks - moles

    • Sunburn

    • Striae

  • Impetigo1

    • Superficial bacterial infection of the skin

    • Most commonly Staph or Strep

    • Thin vesicles with honey colored crusting

    • Usually on face, hands, neck & extremities

    • Spread occurs via contact from fingers, towels, clothing

    • Tx: Topical antibiotics, severe infections need oral


    • Superficial or deep infection of the hair follicle (Barbae, hot tub)

    • Usually result of Staph infection

    • May also occur as a result of contact/plugging with oil, dirt, sweat, etc

    • Rash appears as small, dome shaped yellow pustules with a hair shaft in the center

    • Tx: good hygiene, topical antibotics

    Furuncle boil
    Furuncle (Boil)

    • Deep extension of superficial folliculitis into the dermis and subcutaneous tissue

    • Cause – Staph

    • 1-5 cm red/tender nodule which may contain pus

    • Tx:

      • Simple lesions- warm compress

      • Severe infections – drainage & antibiotics


    • Large deep abscess that is a progression of a furuncle

    • May be 3-10 cm in size

    • Can present c fever/chills

    • Tx: drainage & antibiotics


    • An acute inflammation of the skin

    • S/S: redness, swelling, warmth, & tenderness of affected area within 1-2 days of injury

    • Cause Staph or Strep, complication of wound/trauma

    • The borders are well defined and change rapidly

    • Immediate attention (blood test, IV antibiotics)

    • Facial cellulitis can cause visual damage if spreads to the eyes



    • Obstruction of sebaceous follicles (oil glands)

    • Open comedones or closed comedones

    • Usually on the face, chest, back

    • Causes:

      • Stressful events (hormonal changes)

      • Friction acne

      • Oil based cosmetics

      • NO correlation between chocolate, chips or colas

    • Tx: topical +/or oral antibiotics


    • Methicillin-resistant Staphylococcus aureus

    • “super-bug” – caused by staph, unnecessary antibiotic use

    • Outwits all but the most powerful of drugs – vancomycin

    • Enters through cuts & wounds

    • Types: CA (community acquired) or HA (Hospital acquired)

    • S/S: small red bumps that resememble pimples, quicky turn to painful abscesses that can burrow deep into the body, swelling, redness, pus

    • Risk Factors: recent hospitalization, long-term care, recent antiobiotic use, young age, contact sports, sharing towels, weak immune system, living in groups, health-care workers

    • Dx: Tissue sample – 48hrs

    • Tx: trial & error c strong antiobiotics

    • Prevention: WASH HANDS, surfaces, cover wounds, use only personal items

    Tinea pedis1
    Tinea Pedis

    • Fungal infection - Athlete’s Foot

    • Rash presents as vesicles/erosions on the soles of the foot as well as between toes

    • Dx: examine scraping under microscope

    • Tx: antifungal cream/powders (micronazole), keep feet dry

    Tinea cruris1
    Tinea Cruris

    • Fungal infection – Jock itch

    • Red/scaly rash on inner thighs/inguinal creases; occasionally the buttock, not scrotum or labia

    • Common in obese patients & athletes in tight fitting clothes

    • Common in hot/humid weather

    • Tx: topical antifungal creams

    Tinea versicolor1
    Tinea Versicolor

    • Fungal infection of the skin

    • Multiple patchy lesions (oval shape c fine scales) either light in color or brown

    • Typically occurs on the back, neck, chest, shoulders

    • More prominent in the summer when the affected areas do not tan

    • Recurrence is common

    • Tx: Topical antifungal

    Tinea corporis1
    Tinea Corporis

    • Fungal infection of skin - Ring Worm

    • Well defined circular patches with scaly borders

    • Found on non-hairy surfaces – face, arms, legs, truck

    • Occurs after contact c another person/object that is carrying the fungus

    • Common confused c eczema

    • Tx: topical antifungals (Micronazole, ketoconazole not Nystatin)

    Toenail fungus1
    Toenail Fungus

    • S/S:yellow, think nails, painful, brittle, more likely in toenails d/t dark, moist environment

    • Tx: Lamisil, vicks, takes 6-12 months


    • Lice; six-legged wingless insect

    • The louse is a grayish/black colored insect ~4mm long

    • The nits are gelatinous white color ~.8mm long

    • Can be found in the head, body or pubic hair

    • They pierce the skin and secrete saliva which causes itching, lay eggs close to scalp

    • Spread by shared hats, towels, combs, bedding, clothing, upholstery & headphones

    • Tx: Shampoo – Nix, Rid; fine tooth comb, boil clothing/bedding, dry cleaning


    • Very contagious STD

    • Intense itchy rash, with linear burrows

    • Tx: Kwell or Elimite (topical creams)

    • Wash bedding/clothing in HOT water & stored for 2-3 days

    Herpes simplex1
    Herpes Simplex

    • Viral infection either Type I OR Type II

    • “You can’t kill it and it won’t kill you”

    • Clear papules c superficial ulcerations/erosions

    • May cause fever, lymph node enlargement, burning pain

    • Lesions will crust over in 5-14 days

    • Tx: analgesic for pain, oral antiviral (acyclovir)

    Herpes zoster1
    Herpes Zoster

    • Shingles, a reactivation of varicella zoster (Chicken pox) virus

    • It remains in the cells of nerve roots in an inactive state (after exposure as a youth)

    • Unknown reasons for reactivation

      • Re-exposure to virus

      • Immunosuppressant issue

      • Some drugs

  • Result in vesicles on a red base in a band-like distribution

  • Painful rash, prickly nerve pain

  • Tx: symptomatic, pain, calamine lotion

  • Verruca1

    • Warts; caused by human papillomavirus

    • Verruca plantaris –

    • Verruca vulgaris –

    • Round, flesh colored and grow to be yellow-ish tan

    • 1cm or more wide

    • 65% will resolve spontaneously

    • Tx: destruction of epidermal cells that contain virus; cryogenically, chemically

    Molluscum contagiosum1
    Molluscum Contagiosum

    • Viral infection of skin/mucous membrane

    • Single or multiple flesh colored, dome shaped papules c central umbilication

    • Found on face, trunk, extremities, lips/tongue, genitals

    • Very contagious – self and others

    • Common in swimmers/wrestlers

    • Tx: curettage, silver nitrate to chemically burn the lesions


    • Inflammation of the superficial dermis/epidermis

    • Atopic Dermatitis:

      • Heriditary disorder – may also have Hx of asthma, allergic rhinitis, rash

      • Usually along cheeks, face, trunk, extensor surfaces of extremities

      • Dry and papular rash, scratching makes it worse, d/t loss of natural oils in skin

      • Aggravated by stress, anxiety, dry conditions

      • Tx: good lotions & rehydration of skin

    • Contact Dermatitis:

      • Papular and itchy rash resulting from contact c an allergen

      • Commonly – nickel (cheap jewelry, buckles), soaps, perfumes, cosmetics, posion ivy/oak

      • Tx: Cortisone cream (anti-inflammatory agent)


    • An allergic reaction resulting in histamine release

    • Well defined wheals (solid elevations c central clearing)

    • Extremely itchy & may result in angioedema

    • Allergy can be to virtually anything

    • Tx: antihistamines


    • Dryness of the epidermis

    • Usually seen on extremities/trunk

    • Worse in winter or when bath too much

    • Rash is itchy, red, scaly, patchy c a cracked appearance

    • 2ndary bacterial infections d/t scratching

    • Tx: lotion/creams to hydrate, topical corticosteroids

    Proper skin care
    Proper Skin Care

    • Frequency of showers

    • Not so much soap/appropriate type

    • Use creams, not lotions


    • Inherited skin disorder of increased epidermal cell turnover & thickening of the epidermis

    • Thick silvery scales

    • Common on the elbows, knees & feet

    • Tx:

      • UV light or high potency corticosteroids

      • Severe cases need to be hospitalized for a tar ointment or methotrexate

    Sebaceous cysts1
    Sebaceous Cysts

    • Solitary skin nodules as a result of proliferation of epidermal cells that secrete protein called keratin

    • Contains pasty, cheesy looking secretion

    • Common on eyelids, neck, face, trunk, scalp

    • Benign slow growing lesions

    • No treatment necessary unless problems c ADLs


    • Actually freezing of tissue @ cold temps

    • Generally affects the exposed area (Toes, feet, fingers, nose, cheeks, ears)

    • Skin becomes cold, waxy, white, gray, black

    • Early stages – chillblaines-redness, painful

    • Late stages – cyanosis, gangrene, edema, no pain

    • Tx: cover c warm compress, rapid re-warming in water, hands between legs, armpits

    • Avoid pressure on tissue, even light

    Moles cancer

    • Look for:

      • 1. No bigger than an eraser tip

      • 2. Stand out mole on the back

      • 3. Irregular border

      • 4. different colors

    • Think of outdoor sports

      • Tennis, golf, soccer

    • Males – check the head

    • Females – check the ears and lips


    • Superficial burn – only epidermis

    • >15 suncreen

    • 10-2pm is most intese hours, worse in snowy, watery environments

    • Every time you burn c blisters….increases your chances of getting skin cancer 4x

    • Tx: analgesic sprays, lotion…..not oil based


    • A streak or a linear scar

    • Results from rapidly developing tension in the skin

    • Common in pregnancy or when you gain weight fast…..steroid use