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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
Impetigo
  • 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
folliculitis1
Folliculitis
  • 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
carbuncle1
Carbuncle
  • 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
cellulitis1
Cellulitis
  • 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
  • NEVER MISS THIS ONE!!!!
slide16
Acne
  • 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
slide18
MRSA
  • 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
pediculosis1
Pediculosis
  • 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
scabies
Scabies
  • 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
Verruca
  • 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
dermatitis1
Dermatitis
  • 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)
hives1
Hives
  • 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
eczema1
Eczema
  • 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
psoriasis1
Psoriasis
  • 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
frostbite1
Frostbite
  • 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
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
sunburn1
Sunburn
  • 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
striae1
Striae
  • 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
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