Signs of Inflammation
Common Organisms for Bacterial Skin Infection
Group A Streptococcus
Caused by S. aureus
Rapidly evolving generalized exfoliative disease of young infants. Has "honey-coloured crusts".
Staph Scalded Skin
Caused by S. aureus
Epidermolytic toxin seperates skin below the stratum corneum. This is not full thickness skin peeling. Systemic reaction to exotoxin.
Inflammation of the follicles.
Acne vulgaris is technically a folliculitis.
A deeper folliculitis.
Often called a boil.
Tender is hot, with a single draining opening. Typically a few deep hair follicles that are involved with S. aureus.
Multiple deep communicating furuncles.
These have multiple draining openings.
Often caused by Streptococcus pyogenes
Punched out deep ulcers.
Often heal with scarring.
Deeper seated infection of S. aureus
Local erythema and swelling that spreads rapidly
Skin often shows superficial necrosis after several days without treatment
Strep cellulitis can occur too and spreads much more rapidly (48 hours).
Inflammation tracking up lymphatic vessels
Actute beta hemolytic group A strep
Involving superficial dermal lymphatics
Dharpyl marginated painful plaque
May have systemic symptoms
"Flesh eating disease"
Intense pain is often the first symptom, then cutaneous changes come late. This spreads across fascial planes and causes necrosis of subcutaneous tissue and fascia. Patients can get ill very, very quickly.
Often caused by strep and often needs surgical debridement.
"Dew drop on a petal"
Caused by Varicella zoster
Lesions appear in three successive "crops"
Heals in 10-14 days
Reactivation of Varicella zoster
Dermatomal in distribution
Major complication is post-herpetic neuralgia
Give antivirals, ideally in first 72 hours.
Caused by HPV
70% gone in a year, 90% gone in two. Remove only if unsightly or causing pain.
If lots of warts, consider immunodeficiency.
Pox (DNA) Virus
Considered an STD
* May appear with eczema. Do not put steroids on. If requiring treatment, may be cryo'd, keratolytized, laser'd etc.
What you see is the host reaction to the fungus.
Consider fungal scraping for all atypical scaling inflammatory dermatoses.
Fungal infection of the feet. (dermatophyte)
Fungal infection of the nail. (dermatophyte)
Very difficult to treat. Requires systemic anti-fungals for ~3 months
NOT normal for thrush to be seen after 1 year of age. Think immunodeficiency.
Species of yeast that is a normal colonizer of adult skin. Causes discolouration of the skin in the affected areas.
A parisitic infection that is intensely pruritic. Burrows are found on the hands in adults, and in the scamp and feet for children.
A massive pain in the ass.
Have to remove each of the knits.