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Phase 1b - Dermatology > Infections and Infestations of the Skin > Flashcards

Infections and Infestations of the Skin Flashcards

(50 cards)

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1
Q

What is panton valentine leukocidin?

A
  • It is a beta-pore forming toxin released by Staphylococcus aureus
  • Increased morbidity, mortality, trasmissability
  • Painful, multi-site, recurrent, present in contacts
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2
Q

What are the extracutaneous presentations of panton valentine leukocidin (3)?

A
  • Necrotising fasciitis
  • Necrotising pneumonia
  • Purpura fulminans
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3
Q

What is the presentation?

A
  • Purpura fulminans
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4
Q

What is the presentation?

A
  • Necrotising fasciitis
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5
Q

A patient presents with the following symptoms:

What is the most likely diagnosis?

A
  • Panton valentine leukocidin releasing staphylococcus aureus
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6
Q

What are the risks of acquiring panton valentine leukocidin releasing staphylococcus aureus (5Cs)?

A
  • Close contact
  • Contaminated items
  • Crowding
  • Cleanliness
  • Cuts
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7
Q

How is panton valentine leukocidin releasing staphylococcus aureus managed (4)?

A
  • Abx
  • Nasal ointment
  • Chlorhexidine body wash
  • Treat contacts
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8
Q

What is the presentation?

A
  • Folliculitis (follicular erythema; sometimes pustular)

May be infectious or non-infectious (in HIV)

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9
Q

A patient presents with the following symptoms:

What is the most likely diagnosis?

A
  • May be infectious (Staphylococcus aureus, particularly strains expressing panton valentine leukocidin (PVL))

OR

  • Non-infectious (in HIV)
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10
Q

How is folliculitis managed?

A
  • Antibiotics (usually flucloxacillin or erythromycin)
  • Incision and drainage is required for furunculosis
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11
Q

What is the presentation?

What is the cause?

A
  • Pseudomonal folliculitis
  • Staphylococcus aureus from hot tub, swimming pool, depilatories, wet suits
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12
Q

What is a furuncle?

A
  • A furuncle is a deep follicular abscess involving one follicle
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13
Q

What is a carbuncle?

A
  • A carbuncle is a deep follicular abscess involving several adjacent follicles

More likely to lead to complications such as cellulitis and septicaemia than a furuncle

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14
Q

What is the presentation?

A
  • Cellulitis
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15
Q

What is the cause of cellulitis (2)?

A
  • Streptococcus pyogenes
  • Staphylococcus aureus
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16
Q

How is cellulitis managed (1)?

A
  • Systemic antibiotics
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17
Q

What is the presentation?

A
  • Impetigo
    • Superficial bacterial infection, stuck-on, honey-coloured crusts overlying an erosion
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18
Q

What is the cause of impetigo?

A
  • Streptococci (non-bullous)
  • Staphylococci (bullous)

Impetiginisation: occurs in atopic dermatitis-> superimposed infection -> gold crusting

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19
Q

How is impetigo managed (1)?

A
  • Topical +/- systemic antibiotics
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20
Q

What is the presentation?

A
  • Ecthyma
    • Severe form of streptococcal impetigo
    • Thick crust overlying a ‘punch out’ ulceration surrounded by erythema
    • Usually on lower extremities
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21
Q

What is the presentation?

22
Q

What is erysipelas?

Study These Flashcards
A
  • Infection of upper dermis and subcutis caused by β-haemolytic streptococci or Staphylococcus aureus

Presents as erythematous indurated plaque with a sharply demarcated border and a cliff-drop edge (+/- blistering)

23
Q

How is erysipelas managed (1)?

Study These Flashcards
A
  • IV antibiotics
24
Q

What is the presentation?

What is the cause?

Study These Flashcards
A
  • Erythasma
    • Well demarcated patches in intertriginous areas
  • Corynebacterium
25
What is the presentation? What is the cause?
* **Pitted Keratolysis** * Pitted erosions of sole of foot * Treated with topical clindamycin * **Corynebacterium**
26
A patient presents with the following symptoms: What is the diagnosis?
* **Staphylococcal Scalded Skin Syndrome** (SSSS) due to **exfoliative toxin** ## Footnote Neonates, infants or immunocompromised adults (In neonates, kidneys are immature so cannot excrete the exfoliative toxin quickly)
27
A patient presents with the following symptoms: * Fever > 38.9oC * Hypotension * Diffuse erythema * Involvement of ≥ systems: GI, CNS, renal, hepatic, muscular * Mucous membranes (erythema) * Hematologic (platelets < 100 000/mm3) What is the diagnosis?
* **Toxic shock syndrome** due to **Group A Staphylococcus aureus** strain that produces pyrogenic exotoxin **TSST-1**
28
What is the presentation?
* **Necrotising fascitis** * Initial dusky induration (usually of a limb), followed by rapid painful necrosis of skin, connective tissue and muscle.
29
What is the cause of necrotising fascitis?
* Usually **synergistic**: streptococci, staphylococci, enterobacteriacee and anaerobes > Blood and tissue cultures can determine organisms and sensitivities.
30
A patient presents with the following symptoms: What is the diagnosis?
* **Erysipeloid** * Erythema and edema from contaminated raw fish or meat =› slow spread
31
A patient presents with the following symptoms: What is the diagnosis?
* **Anthrax** * Painless necrotic ulcer + oedema + lymphadenopathy
32
A patient presents with the following symptoms: What is the diagnosis?
* **Blistering distal dactylitis** * Staph or strep * Young children; 1+ superficial bullae on erythematous base ## Footnote Volar fat pad of finger
33
A patient presents with the following symptoms: What is the diagnosis?
* **Lyme disease** * Annular erythema from infected tick bite ## Footnote Borreliosis; 1-30 days from infection * Neuroborreliosis * Arthritis * Carditis
34
A patient presents with the following symptoms: What is the diagnosis?
* **Tularaemia** * Infected bite (rodents, rabbits, hares) ## Footnote Ulceroglandular form Painful ulceration
35
What are the different presentations of herpes simplex virus (HSV) (4)?
* Oral lesions: cold sores * Genital lesions * Herpetic whitlow * Eczema herpeticum
36
How is herpes simplex virus (HSV) diagnosed?
* **Swab** for polymerase chain reaction
37
How is herpes simplex virus (HSV) managed (2)?
* **Oral valacyclovir or acyclovir 200mg five times daily** in immunocompetent localised infection * **Intravenous 10mg/kg TDS** X 7-19 days if severe, systemic or at risk
38
A patient presents with the following symptoms: What is the diagnosis?
* Oral lesion caused by **herpes simplex virus (HSV-1)** ## Footnote HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes (which can include symptoms known as "cold sores"), but can also cause genital herpes. HSV-2 is a sexually transmitted infection that causes genital herpes. Both HSV-1 and HSV-2 infections are lifelong.
39
A patient presents with the following symptoms: What is the diagnosis?
* Genital lesion caused by **herpes simplex virus (HSV-1)** ## Footnote HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes (which can include symptoms known as "cold sores"), but can also cause genital herpes. HSV-2 is a sexually transmitted infection that causes genital herpes. Both HSV-1 and HSV-2 infections are lifelong.
40
A patient presents with the following symptoms: What is the diagnosis?
* **Eczema herpeticum** * Monomorphic, punched out erosions (excoriated vesicles) ## Footnote It's an emergency!
41
A patient presents with the following symptoms: What is the diagnosis?
* **Herpetic whitlow** * HSV (1>2) infection of digits - pain, swelling and vesicles (vesicles may appear later) ## Footnote Misdiagnosed as paronychia or dactylitis Often in children
42
A patient presents with the following symptoms: * Fever * Malaise What is the diagnosis?
* **Varicella zoster virus** (VZV) (Chickenpox) * Results in a characteristic skin rash: small, itchy blisters, which eventually scab over ## Footnote Shingles: reactivation of virus Dermatomal * Single dermatome * Multidermatomal
43
A patient presents with the following symptoms: * Fever * Malaise * Sore throat What is the diagnosis?
* **Hand-Foot-Mouth disease** * Organisms: Coxsackie A16, Echo 71
44
A patient presents with the following symptoms: What is the diagnosis?
* **Morbilliform rashes / eruptions** caused by: * **Measles** (Most likely) * Rubella * EBV * CMV * HHV6 * HHV7
45
A patient presents with the following symptoms: What is the diagnosis?
* **Wart** * >200 subtypes of **HPV** ## Footnote * Self- limiting: most go away by themselves no need TX * Careful: immunocompromised
46
A patient presents with the following symptoms: What is the diagnosis?
* **Orf** * Caused by **parapoxvirus** in direct exposure to **sheep or goats** * Resolve without therapy
47
A patient presents with the following symptoms: What is the diagnosis?
* **Molluscum contagiosum** * **Poxvirus** infection, common in children & immunocompromised * Usually **resolve spontaneously** * Treatment options - curettage, imiquimod, cidofovir
48
A patient presents with the following symptoms: What is the diagnosis?
* **Candidiasis** (Candida Albicans)
49
A patient presents with the following symptoms: What is the diagnosis?
* **Scabies** caused by **sarcoptes species:** * Female mates, burrows into epidermis, lays eggs and dies
50
A patient presents with the following symptoms: What is the diagnosis?
* **Lice**

Phase 1b - Dermatology (6 decks)

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