Dermatology MDT's Flashcards
(90 cards)
Folliculitis Most commonly infectious etiology
Most frequently due to S. aureus (+/- MRSA)
Streptococcus species, Pseudomonas (contaminated H20 contamination) Use of hot tubs or saunas
Non-Infectious
Mechanical Folliculitis (Skinny Jeans Syndrome)
Pseudo-folliculitis barbae (PFB)
Pseudomonas folliculitis appears as a
widespread rash, mainly on the trunk and limbs
The clinical hallmark of folliculitis
hair emanating from the center of the pustule.
Initial care for folliculitis
Mupirocin ointment applied TID for 10 days
Cephalexin: 250-500 mg PO QID (7-10 days)
Dicloxacillin: 250-500 mg PO QID (7-10 days
MRSA:
(a) Bactrim DS: 1-2 tablets BID PO (5-10 days)
(b) Clindamycin: 300 mg PO TID (10 to 14 days)
(c) Doxycycline: 50-100 mg PO BID (5-10 days)
Treatment of PFB
Treatment Approach 1 - Medical Treatment with Grooming Modifications (for Mild to Moderate PFB)
Topical retinoid or eflornithine 13.9% (if available) and a temporary waiver of
facial hair standards for up to 60 days.
Treatment Approach 2 - Laser Hair Reduction with grooming modifications (moderate to severe PFB)
Primary impetigo vs Secondary impetigo
Primary= invasion of normal skin
Secondary= Invasion at sites of minor trauma
A contagious, superficial, intraepidermal infection occurring prominently on exposed areas of the face and extremities
Impetigo
Bacteria that cause impetigo
Staphylococcus aureus alone or combined with group A β-hemolytic streptococci
A deeper, ulcerated impetigo infection often with lymphadenitis
Ecthyma
Most common form of impetigo. Formation of vesiculopustules
that rupture, leading to crusting with a characteristic golden appearance
Nonbullous impetigo:
Staphylococcal impetigo that progresses from small to large flaccid bullae (newborns/young children) caused by
epidermolysis toxin release; ruptured bullae leaving brown crust
Bullous impetigo
Impetigo Risk Factors
Warm, humid environment
Minor trauma, insect bites, breaches in skin
Poor hygiene, poverty, crowding, epidemics, wartime
Familial spread
Complication of pediculosis, scabies, chickenpox, eczema/atopic dermatitis
Complications of impetigo
(1) Ecthyma
(2) Cellulitis
Unilateral lower-extremity involvement is typical and systemic symptoms are
usually absent
Most common portal of entry for lower leg cellulitis is toe web intertrigo with fissuring,
2/2 interdigital tinea pedis.
Cellulitis
Useful diagnostic testing for cellulitis
Plain radiographs, CT, or MRI are useful if osteomyelitis, fracture, necrotizing fasciitis,
retained foreign body, or underlying abscess is suspected.
US to r/o Deep Vein Thrombosis (DVT)
initial Cellulitis Treatment
Demarcate area w/a sharpie to measure progress once you start treatment.
Immobilize and elevate involved limb to reduce swelling.
Sterile saline dressings or cool aluminum acetate compresses for pain relief
Acetaminophen +/- NSAIDs for pain relief
Tetanus immunization if needed, particularly if there is an open wound.
Medication for cellulitis
Non-purulent cellulitis
1) Cephalexin 500 mg
2) Dicloxacillin 500 mg
Purulent cellulitis
1) Clindamycin 450mg
2) Trimethoprim-sulfamethoxazole
3) Doxycycline 100 mg
Human/animal Bites
1) Amoxicillin + clavulanic acid (Augmentin)
Necrotizing Fasciitis Treatment
Prompt and wide surgical debridement is the cornerstone of treatment.
Broad-spectrum antibiotics should be administered once diagnosis of NSTI is
suspected.
A well-circumscribed, painful, suppurative inflammatory nodule at
any site that contains hair follicles
Furuncle (AKA boil)
A collection of pus within the dermis and deeper skin tissues.
Skin abscess
A coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles
Carbuncle
Typically presents with systemic symptoms and fever
What is the mainstay of treatment for an abscess, furuncle, or
carbuncle.
Incision and Drainage
the most common benign cutaneous cysts.
Epidermal cysts
The most common benign mesenchymal neoplasm in adults and are composed of
mature white adipocytes.
Lipoma
