Stages
Would Classification
Stage 1
Skin layers remail INTACT
- *Stage 2**
- *blister / partial** thickness
Stage 3
Full thickness skin loss
Stage 4
Further involved tissue and muscle/tendon/ bone
Different types of Infections
that YOU CAN TREAT
no need to refer to MD
Impetigo
direct contact, preschool, small red spots -> vessicles
Topical OTC’s w/ neomycin / bacitracin / Polymixin B
Preferred = Mupirocin 2% (but RX only)
_Folliculitis_
Only if SUPERFICIAL infection
HAIR follicles -> 4+ days dirty yellow/gray erythema
RX only = Mupirocin 2%
What type of INFECTION?
Superficial, bacterial inflammation of HAIR FOLLICLES
Lesions last for 4+ days
dirty yellow / gray w/ erythema
Susceptable areas are usually exposed to
water / grease / oils
FOLLICULITIS
can be treated with MUPIROCIN 2% (RX Only)
Systemic Antibiotic is usually indiated
REFER TO MD
Role of OTC is very limited
limited to SUPERFICIAL infections
Treatment of ErythRASMA
bacterial infection of toes / groin + diabetes -> red SCALY eruptions
RASMA = SCALY ERUPTIONS
Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP
Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS
REFER TO MD
Neosporin + PAIN RELIEF Ointment
Ingredients
Polymixn B
Neomycin
PRAMOXINE
no bacitracin
NEOSPORIN
ingredients
Polymixin B
Bacitracin
Neomycin
Treatment of Faruncles / Carbuncles
nodules
RX Systemic Antibiotics
REFER TO MD
Resolved by I & D
What type of Topical Antibiotic?
Polypeptide Antibiotic
Gram NEGATIVE coverage
minimally absorbed
1-3 times / day
POLYMIXIN - B SULFATE
Treating IMPETIGO
Topical OTC
w/ Neomycin / Bacitracin / Polymixin B
CLEANSE AREA w/ mild soap + water
PREFERRED TREATMENT = MUPIROCIN RX ONLY
Classification of
ACUTE Wounds
Result from Injury
Heal in ONE MONTH
Abrasions / punctures / lacerations / burns
chronic = Require INTENSE Medical treatment
What type of INFECTION?
Acute / Tender / Inflammatory NODULE
Children / Adolescents / Elderly
Located around Hair follicles
MAY BECOME CHRONIC –> REFER TO MD
FURUNCLES
Carbuncles = conglomerate of furuncles
What type of INFECTION?
Chronic bacterial infection of TOES & GROIN
Adults generally affected
Diabetes predisposes patients
Skin Lesions = SHARPLY marginated / Red / SCALY eruptions
May last for months to years
ErythRASMA
RASMA = SCALY ERUPTIONS
Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP
Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS
REFER TO MD
OTC Treatment of INFECTION
Only the MOST SUPERFICIAL CONDITIONS should be treated OTC
Products are adjuncts to PROPER CLEANSING / Bandaging / Hygiene
Topical antimicrobials are usually used in combination
in order to cover a broad spectrum
What type of Topical Antibiotic?
Bactericidal
Gram POSITIVE coverage
- rare resistance development*
- minimal absorpton*
1-3 times / day
BACITRACIN
What type of INFECTION?
Ulcerative Bacterial Infection
Common in children / adolescents & elderly
Erthematous pustule
Common ankles / feet / thighs / buttocks
Lesions are pruritic / tender / last for WEEKS
ECTHYMA
Systemic Antibiotic is usually indiated
REFER TO MD
Role of OTC is very limited
limited to SUPERFICIAL infections
What type of Topical Antibiotic?
AminoGlycoside + Bactericidal Activity
HYPERsensistivity is possible
Gram - NEGATIVES, anaerobes, gram positive (staph)
Can result in systemic toxicity
1-3 times / day
NEOMYCIN
N = NEGATIVE
Treatment of Erysipeloid / Ecthyma / Folliculitis?
- *Systemic Antibiotic** is usually indiated
- *REFER TO MD**
- Role of OTC is very limited*
- *limited to SUPERFICIAL infections**
Folliculitis can be treated by Mupirocin 2% tho
Polysporin Ointment
POLYMIXIN B
BACITRACIN
no neomycin
Questions to Ask Patient with
INFECTION
What type of wound is present?
WHERE is the wound?
Any foreign objects present
Redness / warmth / pus + swelling?
Fever / immunocompromsised
What have you tried
Allergies
What type of Topical Antibiotic?
Gram POSITIVE bacteria
Effective for STAPH + MRSA
IMPETIGO / FOLLICULITIS
AAA TID F7D
MUPIROCIN 2%
RX ONLY
BACTROBAN
Different types of Infections
that you CAN NOT TREAT YOURSELF
SEE MD!
Furuncles & Carbuncles
NODULES around hair follicles -> may be chronic see MD
Ecthyma
ulcerative, erythematous pustule (blister) –> pruritic / tender
ErySIPEloid
evolving cellulitis from fish/meat/poultry -> sharply marginated lesions
ErythRASMA
chronic –> toes/groin -> prediabetes –> SCALY eruptions / marginated
_Folliculitis,_ sometimes treated w/ mupirocin 2% RX
HAIR follicles -> 4+ days dirty yellow/gray erythema
What type of INFECTION?
Superficial Infection
Common in preschool children
Transmitted by direct contact
Lesions are small / red spots that develop into VESSICLES
Seen on Face / Arms / Legs / Buttocks
IMPETIGO
Can be treated with TOPICAL OTC
neomycin + bacitracin + polymixin B
Cleanse area with MILD SOAP + WATER
Preferred treatment = MUPIROCIN RX ONLY
What type of WOUND?
Acute Evolving Cellulitis
Common source is FISH / MEAT / POULTRY
1-4 day inoculation period
Sharply marginated lesions
Skin ITCHES / BURNS / THROBS
resolves in 3 weeks
ErySIPELOID
Systemic Antibiotic is usually indiated
REFER TO MD
Role of OTC is very limited
limited to SUPERFICIAL infections