Infections and Infestation of the Skin Flashcards
(217 cards)
1
Q
What conditions can s.aureus cause? (8)
A
Ecthyma Impetigo Cellulitis Folliculitis Furunculosis Carbuncles Staphylococcus scalded skin syndrome Superinfects other dermatoses
2
Q
Which portion of its fibrae attaches to epithelial surfaces in strep pyogenes?
A
Lipoteichoic acid portion
3
Q
What does the M protein on strep pyogenes aid in?
A
Evade phagocytosis
4
Q
What virulence factors do streptococci have?
A
Strep pyogenes fimbrae attach to epithelial surfaces
M protein and hyaluronic acid capsule
Produces erythrogenic exotoxins
Produces streptolysins S and O
5
Q
What conditions can streptococci cause?
A
Ecthyma Cellulitis Impetigo Erysipelas Scarlet fever Necrozing fasciitis Superinfects other dermatoses
6
Q
How does folliculitis present?
A
Follicular erythema; sometimes pustular
7
Q
What type of folliculitis is associated with HIV?
A
Eosinophilic (non-infectious) folliculitis
8
Q
Which bacteria may cause recurrent cases of folliculitis?
A
Nasal carriage of s aureus, particularly strains expressing Panton-Valentine leukocidin (PVL)
9
Q
What is the treatment for folliculitis?
A
Antibiotics (erythromycin, flucloxacillin)
Incision and drainage for furunculosis
10
Q
What is the difference between a furuncle and a carbuncle? (2)
A
A furuncle is a deep follicular abscess whereas a carbuncle is composed of multiple furuncles; involves adjacent hair follicles
A carbuncle is more likely to lead to complications i.e. cellulitis, septicaemia
11
Q
Why do some patients develop recurrent staphylococcal impetigo or recurrent furunculosis? (6)
A
Immune deficiency:
- hypogammaglobulinaemia
- hyperIgE syndrome
- chronic granulomatous disease
- AIDS
- HIV
- diabetes mellitus
12
Q
What is PVL?
A
Panton Valentine Leukocidin
beta-pore-forming exotoxin
13
Q
What can PVL cause?
A
Leukocyte destruction and tissue necrosis
-> higher morbidity, mortality, transmissibility
14
Q
How does PVL s aureus present in the skin? (3)
A
Recurrent and painful abscesses
Folliculitis
Cellulitis
-> often painful, more than 1 site, recurrent, present in contacts
15
Q
What are the extracutaneous manifestations of PVL s aureus?
A
Necrotising pneumonia
Necrotising fasciitis
Purapura fulminans
16
Q
What are the risks of acquiring PVL staph? (5)
A
The 5 Cs: Close contact Contaminated items Crowding Cleanliness Cuts and grazes
17
Q
How is PVL staph treated?
A
Antibiotics (often tetracycline)
Decolonisation
Treatment of close contacts
-> consult local microbiologist/guidelines
18
Q
What does the decolonisation of PVL usually involve? (2)
A
Chlorhexidine body wash for 7 days
Nasal application of mupirocin ointment for 5 days
19
Q
How does pseudomonal folliculitis present?
A
Common: -Diffuse truncal eruption 1-3 days after exposure -Follicular erythromatous papule Rare: -Abscesses -Lymphangitis -Fever
20
Q
Which bacterium causes hot tub folliculitis?
A
Pseudomonas aeruginosa
21
Q
What is pseudomonal folliculitis associated with? (3)
A
Hot tub use
Swimming pools and depilatories
Sharing wet suits
22
Q
How are severe and recurrent cases of pseudomonal folliculitis treated?
A
Oral ciprofloxacin
23
Q
Define cellulitis
A
Infection of the lower dermis and subcutaneous tissue
24
Q
How does cellulitis present?
A
Tender swelling with ill-defined, blancing erythema or oedema
25
What causes cellulitis in most cases? (2)
Streptococcus pyogenes
| Staphylococcus aureus
26
What is a predisposing factor of cellulitis?
Oedema
27
How is cellulitis treated?
Systemic (oral or intravenous) antibiotics
28
What is impetigo?
Superficial bacterial infection
| Presents as stuck-on, honey-coloured crusts overlying an erosion
29
What causes impetigo? (2)
Streptococci (non-bullous)
| Staphylococci (bullous)
30
What causes bullous impetigo?
Caused by exfoliative toxins A and B
| These split the epidermis by targetting desmoglein I
31
How is impetigo treated?
Topical antibiotics +/- systemic antibiotics
32
What is impetiginisation?
Impetigo in the context of atopic dermatitis
| Does not typically blister
33
Which bacterium typically causes impetiginisation?
S aureus
34
What is ecthyma?
Severe form of streptococcal impetigo
35
How does ecthyma present?
Thick crust overlying a punch out ulceration surrounded by erythema
Usually on lower extremities
36
Which populations are more prone to SSS? (3)
Neonates
Infants
Immunocompromised adults
37
What do SSS and bullous impetigo have in common?
Both caused by exfoliative toxin
38
Where does the infection occur relative to the denuded skin in SSS?
Distant i.e. conjunctivitis or abscess
39
Why is SSS more common in neonates?
Kidneys cannot rapidly excrete exfoliative toxin
40
How does SSS manifest? (3)
Diffuse tender erythema
Rapid progression to flaccid bullae
Bullae wrinkle and exfoliate, leaving oozing erythomatous base
41
What does SSS clinically resemble?
Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN)
42
What is toxic shock syndrome (TSS)?
Febrile illness due to Group A s aureus strain that produces pyrogenic exotoxin TSST-1
43
How does TSS present? (4)
Hypotension
Diffuse erythema
Potential involvement of: GI, muscular, CNS, renal, hepatic systems
Thrombocytopenia
44
What may occur after the erythema in TSS resolves?
Desquamation, esp of palms and soles
45
Which bacterium causes erythasma?
Corynebacterium minutissium
46
What does erythrasma present as?
Well demarcated patches in interiginous areas
| -> initially pink, become brown and scaly
47
What do erythrasma and pitted keratolysis have in common?
Both caused by corynebacterium minutissium
48
How does pitting keratolysis present?
Pitted erosions of soles
49
How is pitting keratolysis treated?
Topical clindamycin
50
What is pitting keratolysis often misdiagnosed as?
Athlete's foot
51
How does erysipeloid present?
Erythema and oedema of the hand after handling contaminated raw fish or meat
Slowly extends over weeks
52
What bacterium causes erysipeloid?
Erysipelothrix rhusiopathiae
53
What does anthrax manifest as?
Painless necrotic ulcer with oedema and surrounding regional lymphadenopathy
54
How is anthrax contracted?
Contact with hides, bone meal or wool infected with Bacillus anthracis
55
Which bacteria cause blistering distal dactylitis? (2)
Streptococcus pyogenes
Staphylococcus aureus
-> rare infection
56
Who is typically affected by blistering distal dactylitis?
Young children
57
How does blistering distal dactylitis present?
1+ tender superficial bullae on erythematous base on bolar fat pad of a finger
Toes may rarely be affected
58
What is erysipelas?
Infection of the deep dermis and subcutis
59
Which bacteria cause erysipelas?
Beta-haemolytic streptococci
| Staphylococcus aureus
60
How does erysipelas present? (3)
Preceding of malaise, fever, headache
Erythematous indurated plaque with a sharply demarcated border and cliff-drop edge +/- blistering
+/- red streak of lymphangitis and local lymphadenopathy
61
Which parts of the body are usually affected by erysipelas?
Face or limb
62
How is erysipelas treated?
Portal of entry identified
| IV antibiotics
63
What causes scarlet fever?
Upper respiratory tract infection with erythrogenic toxin-producing s pyogenes
64
What are the initial symptoms of scarlet fever? (6)
```
Sore throat
Headache
Malaise
Chills
Anorexia
Fever
```
65
What symptoms present 12-48 hours after the inital symptoms of scarlet fever? (3)
Eruption:
Blanchable tiny pink-red spots on chest, neck, axillae
Spread to whole body within 12 hours
Sandpaper-like texture
66
What are the complications of scarlet fever? (9)
```
Otitis
Mastoiditis
Sinusitis
Pneumonia
Myocarditis
Rheumatic fever
Acute glomerulonephritis
Hepatitis
Meningitis
```
67
How does necrotising fasciitis present?
Initial dusky induration, followed by rapid painful necrosis of skin, connective tissue and muscle
->mortality is high
68
How is necrotising fasciitis treated?
Prompt diagnosis essential; high index of suspicion needed
Broad-spectrum parentral antibiotics
Surgical debridement
-> MRI can aid diagnosis
69
What causes necrotising fasciitis? (4)
```
Usually synergistic:
Streptococci
Staphylococci
Enterobacteriae
Anaerobes
```
70
What is Fournier's gangrene?
Necrotising fasciitis that affects the scrotum
71
Which infection is important to consider in immunosuppressed states?
Atypical mycobacterial infection
72
How do mycobacterium marinum infections present? (2)
Indolent granulomatous ulcers (fish-tank granuloma) in healthy people
Sporotrichoid spread
73
How do mycobacterium chelonae and abscessus infections typically develop? (4)
Puncture wounds
Tattoos
Skin trauma
Surgery
74
What is an important cause of limb ulceration in Africa (Buruli ulcer) and Australia (Searle's ulcer)?
Mycobacterium ulcerans
75
What is borreliosis also known as?
Lyme disease
76
How does borreliosis present?
Annular erythema at site of the bite of a borrelia-infected tick:
Erythomatous papule at bite site
Progression to annular erythema of >20cm
77
What causes lyme disease?
Bite from ixodes tick infected with borrelia burgdorferi
78
What symptoms may occur as lyme disease progresses? (5)
Fever and headache 1-30 days after infection
Multiple secondary lesions similar but smaller to inital
Neuroborreliosis
Arthiritis
Carditis
79
What are the symptoms of neuroborreliosis? (3)
Facial/other CN palsies
Aseptic meningitis
Polyradiculitis
80
Why do you need a high index of suspicion when diagnosing borreliosis? (2)
Serology not sensitive
| Histopathology non-specific
81
How does tularaemia present? (5)
Primary skin lesion = small papules at inoculation site that rapidly necroses -> painful ulceration
Local cellulitis
Painful regional Lymphadenopathy
Systemic symptoms: fever, chills, headache, malaise
82
What is the most common form of tularaemia?
Ulceroglandular form
83
How is tularaemia acquired? (3)
Francisella tularensis infection through:
Handling infected animals (rabbits and squirrels)
Tick bites
Deerfly bites
84
What is the difference between ecthyma and ecthyma gangrenosum?
Ecthyma is caused by streptococcus
| Ecthyma gangrenosum is caused by pseudomonas aeruginosa
85
Which patients are usually affected by ecthyma gangrenosum?
Neutropaenic patients
86
How does ecthyma gangrenosum present?
```
Red macule(s) -> becomes oedematus -> forms hemmorhagic bullae
May ulcerate in late stages or form eschar (blackened crust) surrounded by erythema
```
87
What are the differentials for escharcotic lesions? (14)
```
Pseudomonas
Aspergillosis
Leishmaniasis
Cryptococcosis
Lues maligna
Rickettsial infections
Cutaneous anthrax
Tularaemia
Necrotic arachnidism
Scrub typhus
Rat bite fever
Staph or strep
Ecthyma
Lyme disease
```
88
What causes syphilis?
Treponema pallidum
89
How does the primary syphilis infection manifest?
Chancre - painless ulcer with a firm indurated border
| Appears within 10-90 days
90
What develops one week after the primary chancre in syphilis?
Painless regional lymphadenopathy
91
On average, when does secondary syphilis occur?
50 days after chancre
92
What are the symptoms of secondary syphilis?
Malaise, fever, headache, pruritus, anorexia, iritis
93
Why is secondary syphilis known as the "Great mimicker"?
Skin manifestations are very variable so a low threshold for testing is required
94
What are some of the cutaneous ways secondary syphilis can manifest? (7)
```
Pityriasis rosea-like rash
Moth-eaten alopecia
Lymphadenopathy
Mucous patches
Residual primary chancre
Condylomata lata
Hepatosplenomegaly
```
95
What is lues maligna?
Rare manifestation of secondary syphilis that is more frequent in the context of HIV
96
How does lues maligna present? (2)
Pleomorphic skin lesions with pustules, nodules and ulcers
| Necrotising vasculitis
97
How does tertiary syphilis manifest? (5)
Gumma skin lesions; nodules and plaques
Extend peripherally while central areas heal with scarring and atrophy
Mucosal lesions extend to and destroy nasal cartilage
CV disease
Neurosyphilis
98
What is neurosyphilis?
General paresis or tabes dorsalis
99
How is syphilis diagnosed? (2)
Clinical findings
Serology
->strong index of suspicion needed for secondary syphilis
100
How is syphilis treated? (2)
Intramuscular benzylpenicillin or oral tetracycline
101
What causes leprosy?
Mycobacterium leprae
-> obligate intracellular bacteria
102
What are the 2 types of leprosy on each end of the clinical spectrum?
Lepromatous leprosy
| Tuberculoid leprosy
103
How does lepromatous leprosy present? (2)
Multiple lesions: macules, papules, nodules
| Early on, sensation and sweating normal
104
How does tuberculoid leprosy present?
Solitary or few lesions: elevated borders with atrophic center, sometimes annular
105
What is an important difference between the lesions in tuberculoid and lepromatous leprosy?
Tuberculoid leprosy lesions are typically numb, anhidrotic and hairless
106
How can TB be acquired? (3)
Exogenously
Contigous endogenous spread
Haematogenous/lymphatic endogenous spread
107
What investigations are needed to diagnose TB? (3)
Interferon-gamma release assay (Quantiferon-TB)
Histology - ZN stain
Culture/PCR
108
What are the cutaneous manifestations of TB? (7)
Tuberculosis chancre
Tuberculosis verrucosa cutis
Scrufuloderma (subcutaneous nodue with necrotic material)
Orificial TB (non-healing ulcer in nasal mucosa)
Lupus vulgaris
Miliary TB (pinhead bluish-red papules capped by minute vesicles)
Tuberculosis gumma (firm subcutaneous nodule that later ulcerates)
109
Which cutaneous manifestation of TB resembles hidrandenitis suppuritiva?
Scrofuloderma:
| Subcutaneous nodule with necrotic material; becomes fluctuant and drains, with ulceration and sinus tract formation
110
What does lupus vulgaris have a similar presentation to? (2)
Tuberculoid leprosy
| Tertiary syphilis
111
What is Molluscum Contagiousum?
Poxvirus infection common in children and immunocompromised pts
112
What is the differential for molluscum contagiousum? (4)
Verrucae
Condyloma acuminata
Basal cell carcinoma
Pyogenic granuloma
113
What are the treatment options for molluscum contagiosum? (4)
Usually resolve spontaneously but if causing distress:
Curettage (scraped off)
Imiquimod
Cidofovir
114
How does herpes simplex present?
Primary and recurrent vascular erruptions that favour the oral and genital regions
115
How is HSV-1 transmitted?
Direct contact with contaminated saliva/other infected secretions
116
How is HSV-2 transmitted?
Sexual contact
117
How does HSV travel? (2)
Replicates at mucocutaneous site of infection
| Travels by retrograde axonal flow to dorsal root ganglia -> stays latent here between flares
118
How does HSV first present? (5)
```
Symptoms with 3-7 days of exposure
Tender lymphadenopathy
Malaise
Anorexia
+/- burning, tingling
```
119
What do the initial symptoms of HSV develop into? (5)
Painful rouped vesicles on erythematous base -> ulceration/pustules/erosions with scalloped border
Orolabial lesions
Genital involvement
Systemic manifestations
->crusting and resolution within 2-6 weeks
120
What can the pain in the genital involvement in HSV lead to?
Urinary retention due to excrutiating pain
121
What is a systemic manifestation of HSV?
Aseptic meningitis in up to 10% of patients
122
How can HSV reactivation occur? (5)
```
Spontaneous
UV
Fever
Local tissue damage
Stress
```
123
What is eczema herpeticum?
Potentially fatal HSV infection that occurs in pts with atopic eczema
124
How does eczema herpeticum manifest?
Monomorphic, punched-out erosions with excoriated vesicles
125
Why does eczema herpeticum require emergent treatment?
It can cause HSV encephalitis and it can be fatal
126
How is eczeme herpeticum treated? (2)
IV acyclovir
| Antibiotics for superinfections
127
What does herpetic whitlow resemble? (2)
Blistering distal dactylitis
| Paronychia
128
Which group of pts is herpetic whitlow most common in?
Children
129
How does herpetic whitlow present? (4)
HSV (1>2) infection of digits
Pain
Swelling
Vesicles (may appear later)
130
How does herpes gladiatorum develop?
HSV 1 involvement of cutaneous site reflecting sites of contact with another athlete's lesions
-> common in contact sports e.g. wrestling
131
How does neonatal HSV arise?
Exposure to HSV 1 or 2 during vaginal delivery
| -> higher risk when HSV acquired near time of delivery
132
How does neonatal HSV present? (4)
Onset from birth to 2 weeks
Localised usually scalp or trunk
Vesicles -> bullae erosions
Encephalitis
133
How is neonatal HSV treated?
Urgent IV antivirals
134
Which patients can be affected by atypical presentations of HSV?
Immunocompromised pts e.g. HIV, transplant recipient
135
What is the most common presentation of HSV in immunocompromised pts? (2)
Chronic, enlarging ulceration
| Multiple sites or disseminated
136
What are the atypical manifestations of HSV? (2)
Verrucous/exophytic/pustular lesions
| Involvement of respiratory/GI tracts
137
How is HSV diagnosed?
Swab for PCR
138
How is HSV treated?
Don't delay
Oral valacyclovir or acyclovie 200mg 5 times daily in immunocompetent localised infection
Intravenous 10mg/kg TDS X 7-19 days
139
How is varicella zoster virus (a herpes virus) distributed?
Dermatomal distribution (single/multiple)
140
What causes hand foot and mouth disease? (2)
Coxsackie A16
| Echo 71
141
How is hand foot and mouth disease transmitted?
Direct contact via oral-oral route or oral-faecal route
142
How does hand foot and mouth disease present? (5)
Prodrome of fever, malaise, sore throat
Red macules
Vesicles (grey and elliptical)
Ulcers
-> develop on buccal mucosa, tongue, palate, parynx, hands and feet
143
What is the difference in presentation between the 2 viruses that cause hand foot and mouth disease?
Coxsackievirus usually acute and self-limiting
| Echo 71 associated with higher incidence of neurological involvement
144
Which viruses cause morbilliform (measles-like) eruptions? (6)
```
Measles
Rubella
EBV
CMV
HHV6
HHV7
```
145
What non-viral agents can cause morbilliform rashes? (3)
Leptospirosis
Rickettsia
Drugs
146
What causes petechial/purpuric eruptions? (8)
```
Coagulation abnormalities
Vasculitis
Viruses
Bacterial (BREN)
Other infections
TEN
Raynauds
Ergot poisoning
```
147
What types of viral infections can cause petechial/purpuric eruptions? (6)
```
Hep B
CMV
Rubella
Yellow fever
Dengue fever
West nile virus
```
148
What becterial infections can cause petechial/purpuric eruptions? (5)
```
Borrelia
Rickettsia
Neisseria
Meningococcus
Endocarditis
```
149
What non-viral/bacterial infections can cause petechial/purpuric eruptions? (3)
Plasmodium
Falciparum
Trichinella
150
How does Gianotti-Crosti syndrome present?
Viral eruption
| Acute symmetrical erythematous papular eruption on face, extremities, buttocks
151
What is Gianotti-Crosti syndrome also known as?
Papular acrodermatitis of childhood
152
What causes Gianotti-Crosti syndrome? (5)
```
EBV (most common)
CMV
HHV6
Coxsackie viruses A16, B4, B5
Hep B
```
153
What causes erythema infectiosum?
Parvovirus B19
aka 5th disease
154
How does erythema infectiosum present? (3)
Initially mild fever and headache
A few days later - "slapped cheeks" for 2-4 days
Reticulated rash of chest and thighs in 2nd stage of disease
155
What is roseola infantum also known as? (2)
Exanthem subitum
| 6th disease
156
How does roseola infantum present?
2-5 days high fever
| Small pale pink papules on trunk and head that lasts hours - 2 days
157
What causes roseola infantum?
HHV6 (more common)
| HHV7
158
How does orf present? (3)
Dome-shaped, firm bullae that develop an umbilicated crust
Usually develops on hands and forearms
Generally resolves w/o therapy in 4-6 weeks
-> resembles cutaneous anthrax
159
What causes orf?
Parapox virus
160
Which pts are more at risk of developing orf?
People with direct exposure to sheep or goats i.e. farmers
161
What are warts caused by?
HPV
| >200 subtypes of HPV
162
Why is it important to biopsy suspicious warts?
Serious diseases e.g. syphilis, skin cancer can resemble warts
163
What are examples of superficial fungal infections? (3)
Candida
Malassezia
Dermatophytes
164
What are examples of deep/soft tissue fungal infections? (2)
Chromomycosis
| Madura foot
165
What are examples of disseminated fungal infections? (7)
```
Candida
Aspergillus
Fusarium
Histoplasma
Coccidiodes
Blastomycosis
Mucormycosis
```
166
How does pityriasis vesicolour present? (2)
Hypo/hyperpigmented or erythematous macular eruption
| +/- fine scale
167
What causes pityriasis versicolor?
Malassezia spp
168
Why does pityriasis versicolor begin in adolescence?
Sebaceous glands become active
169
When does pityriasis versicolor flare? (3)
High temperatures
High humidity
Immunosuppression
170
How is pityriasis versicolor treated?
Topical azole (OTC drug)
171
What are dermatophytes?
Fungi that live on keratin
172
Which fungus causes the most dermatophyte fungal infections?
Trichophyton rubrum
173
Which fungus causes the most tinea capitis?
Trichophyton tonsurans
174
What is kerion?
Inflammatory fungal infection, frequently secondarily infected with staph aureus
175
How does kerion present?
Mimics bacterial folliculitis or abscess of the scalp
Tender scalp
Posterior cervical lymphadenopathy
176
What are a lot of the symptoms in kerion caused by?
The host's defensive response against fungal infection
177
What is tinea faciei?
Area of erythema and scale
178
What is onychomycosis?
Dermatophyte infection of the toenail
179
What does tinea pedis present as? (2)
Scaling and hyperkeratosis of plantar surface of foot
| Athlete's foot
180
What causes tinea pedis? (2)
Trichophyron rubrum
| Trichophyton interdigitale
181
What can trichophyton interdigitale cause in addition to tinea pedis?
Vesicobullous reaction on arch or side of foot
182
What are Id (aka dermatophytid) reactions?
Inflammatory reactions at sites distant from associated dermatophyte infection
183
What can Id reactions present as? (3)
Urticaria
Hand dermatitis
Erythema nodosum
-> secondary immune-mediated eczema
184
What likely causes Id reactions?
Secondary to host immunologic response against fungal antigens
185
What is a majocchi granuloma?
Follicular abcess produced when dermatophyte infection penetrates the follicular wall into surrounding dermis
186
What usually causes majocchi granulomas? (2)
Trichophyton rubrum
| Mentagrophytes
187
What could be included in the differential for majocchi granulomas?
Petechia-purpuric eruptions
188
What causes candidiasis?
Candida albicans
189
How does candidiasis present? (2)
Erythema oedema
| Thin, purulent discharge
190
What increases the risk of developing candidiasis? (4)
Occulsion
Moisture
Warm temperature
Diabetes mellitus
191
Which areas are affected by candidiasis?
Usually interiginous infection: affects axillae, submammary folds, crue, digital clefts
Oral mucosa
192
What is a common cause of vulvovaginitis?
Candidiasis
193
When might candidiasis become systemic?
In immunocompromised pts
194
What cn cause deep fungal infections? (6)
```
Implantation or inoculation of the skin:
Phaeohypomycosis
Chromomycosis
Mycetoma (madura foot)
Lobomycosis
Rhinosporidiosis
```
195
How can systemic fungal infections develop?
Secondary to an internal infection i.e. of an organ
196
What are some examples of systemic respiratory endemic fungal infections? (5)
```
Blastomycosis
Histoplasmosis
Coccidiodomycosis
Paracoccidoiodomycosis
Penicillinosis
```
197
What are the risk factors for opportunistic fungal infections (e.g. aspergillosis)? (2)
Neutropenia
| Corticosteroid therapy
198
How does aspergillosis present? (3)
Well-circumscribed papule with necrotic base and surrounding erythematous halo
Lesions may extend into cartilage, bone, fascial planes
Propensity to invade blood vessels and cause thrombosis/infarction
199
What is aspergillosis similar to both clinically and histologically?
Fusarium
200
How does mucormycosis present? (7)
```
Fever
Headache
Facial oedema
Proptosis
Facial pain
Orbital cellulitis
+/- cranial nerve dysfunction
```
201
What causes mucormycosis? (5)
```
Apophysomyces
Mucor
Rhizopus
Absidia
Rhizomucor
```
-> can be caused by a combo of these
202
What is mucormycosis associated with? (7)
```
Diabetes mellitus
Malnutrition
Uraemia
Neutropenia
Medications: steroids/ABs/desferoxamine
Burns
HIV
```
203
How is mucormycosis treated? (2)
Aggressive debridement
| Anti-fungal therapy
204
What is scabies?
Contagious infestation caused by sarcoptes species
205
How does scabies present? (3)
Insidious onset of red to flesh-coloured pruritic papules
Affects interdigital areas, volar wrists, axillary areas, genitalia
Diagnostic burrow w/ fine white scale under dermatoscope
206
What is Norwegian scabies?
Aka crusted scabies
Hyperkeratosis, scaly
Found in immunocompromised
207
How is scabies treated? (5)
```
Permethrin
Oral ivermectin
2 cycles of treatment required
Wash all clothes/bedlinen
Treat close contacts
```
208
Why are 2 cycles of treatment required for scabies?
Eggs are not vulnerable to treatments so need to wait 1 week-10 days after to kill hatchlings
209
What are the 3 types of lice?
Head lice
Body lice
Pubic lice
-> aka pediculius humanus capitis, phithrus pubis
210
How are head lice treated? (3)
Malathion
Permethrin
Oral ivermectin
-> secondary infection common which may require treatment
211
What are the symptoms of body lice?
Pruritic papules and hyperpigmentation
212
How are body lice removed?
Rarely found on skin so can be removed by thorough cleaning/discarding of clothes
213
Where are pubic lice eggs found?(5)
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Hair shaft
Orbital scalp
Body hair
Eyebrow/eyelash
Axillary hair
```
214
What is the treatment for pubic lice?
Malathion
Oermethrin
Oral ivermectin
215
What conditions are body lice common in? (3)
Overcrowding
Poverty
Poor hygeine
216
What do bedbugs (cimex lectularius) cause?
Itchy wheals around central punctum
217
How do you remove bedbugs? (2)
Live behind wallpaper and under furniture so fumigation of home is necessary
Treat pt if symptomatic
