Skin Flashcards
Intertrigo
Intertrigo is a superficial inflammatory bacterial or fungal skin disorder that occurs in the setting of persistent skin-to-skin contact, friction, moisture, warmth, and inadequate ventilation. It is usually characterized by varying degrees of erythema, peripheral scaling, and macerated erythematous plaques.
Compresses with Burow solution may be soothing. Use of drying agents containing zinc oxide, aluminum sulfate, and calcium acetate solution is recommended. For intertrigo associated with fungal infections (including Candida and tinea), clotrimazole, ketoconazole, oxiconazole, or econazole may be applied
Impetigo
Cutaneous lesions are seen with crusts, translucent vesicle, or pustules in association with a moist erythematous weeping base when the crust is removed. Classically the crust is honey colored.
Topical Antibiotic Therapy.
Mupirocin, 2% ointment, should be applied 3 times a day for 10 days. Oral agents may also be used (cephalexin, dicloxacillin, azithromycin)
Furnucles and Carbuncles
Furuncles, commonly known as boils, are infections that arise at the hair follicle and extend deep into the dermis, where an abscess forms. A painful, pus-filled bump under the skin caused by infected, inflamed hair follicles
A carbuncle forms when several adjacent furuncles coalesce, forming an inflammatory mass with pus draining from multiple follicles.
Cellulitis
cellulitis appears as a red, swollen, and painful area of skin that is warm and tender to the touch. The skin may look pitted, like the peel of an orange, or blisters may appear on the affected skin.
Most cases of cellulitis in adults are caused by group A β-hemolytic streptococci. May be from recent trauma = staph.
Generally, give antibiotics to cover for MRSA (Doxycycline, TMP-SMX, Augmentin, add Cephalexin)
If not purulent, do not culture and may start with presumption of MSSA cause
Fungal Infection Locations
T. corporis involves the trunk, extremities, feet, groin, face, or hand. (Naftifine)
T. pedis involves the soles of the feet and spaces between the toes (selenium shampoo)
T. cruris is seen in the inguinal region (Terbinafine)
T. manuum indicates the involvement of the palms and spaces between the finger (hard to treat)
Onychomycosis (or tinea unguium) refers to any infection of the nails
Viral Herpes
Cutaneous herpes is either HSV-1 (oral) or HSV-2 (genital)
Vesicles form as virus attaches
Travels to nerve ganglion and becomes dormant
First outbreak is most severe
-Lesions for 28 days, burning pain, discharge, fever/malaise
Vesicles are round vesicles on red base with cloudy fluid (easily confused for warts)
Topical may help pain but not healing time
Antivirals within 48 hours of outbreak, suppressive therapy may be neded
Tzanck Test
For herpes
Remove top of vesicular lesions to obtain fresh fluid from the lesion base
Shingles (VZV)
Treatment
Initiate treatment within 72 hr of outbreak; if patient is immunocompromised, can start treatment >72 hr
Wet-to-dry dressings with sterile saline or Aluminum acetate topical (Domeboro) solution 4 to 5 times qd
Acyclovir 800 mg 5 times qd for 7 to 10 days
Steroids alone or in combination with antiviral have not been proven to aid in the resolution of herpes zoster and may increase risk of infection
Pain management with oral narcotics, acetaminophen, and/or NSAIDs (unless contraindicated), TCAs may help
Tinea Versicolor
chronic, asymptomatic, and superficial fungal infection causing small discolored patches of skin
Topical antifungal is the first line of treatment along with medicated shampoo. Medication is applied to the entire torso during active infections to eliminate subclinical lesions.
Systemic antifungals are the second line of treatment for patients with extensive or unresponsive disease. Therapy may include itraconazole or Fluconazole for 2- 4 weeks
Scabies
Intense nocturnal itching is the presenting symptom
Burrows are common between the fingers, flexor areas of the wrist, penis, vulva, nipples, axilla, and buttocks; vesicles can be found on the sides of fingers
Treatment is initiated with topical application of 5% permethrin cream applied from the neck down, left on for 8 to 12 hours and then washed off. The treatment must be repeated after 7 to 14 days.
Lice
For children under the age of 2 months to 2 years Permethrin is the first line of treatment as recommended by the CDC. However, there is some resistance to many over-the-counter permethrin treatments including Nix, lindane, and some pyrethrins. Lindane is generally not recommended due to its risk of neurotoxicity and low efficacy. For those over age 2, malathion (Ovide) is available and is one of the more suitable forms of treatment.
Rosacea
common skin condition that causes blushing or flushing and visible blood vessels in your face. It may also produce small, pus-filled bumps
30 and 50 years. comedones do not occur in rosacea.
Metronidazole., vTopical Azelaic Acid. Plexion Cleanser.
Tetracycline Antibiotics.Isotretinoin
Folliculitis
topical Benzoyl Peroxide.. Dicloxacillin Cephalexin. Ampicillin. hot tub folliculitis, is usually self-limited and treated with ciprofloxacin
Dermatophytic folliculitis. The primary treatment is itraconazole 100 mg by mouth twice a day for 4 days or terbinafine
Atopic Dermatitis
dry, itchy and inflamed skin rash
Warts
Filiform (projections), round domes, flat (plantar), mosiacs (plaques)
Treatment needed only if appearance issue usually
-salicylic acid (to 2mm outside edge of wart)
-cryotherapy
-tretionin cream
