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Flashcards in Skin Infections Deck (90):
1

What 4 kinds of infections can affect the skin?

Bacterial
Fungal
Viral
Parasitic

2

What kinds of bacterial skin infections can pts have?

Cellulitis
Impetigo
Staphylococcal

3

What kinds of viral skin infections can pts have?

Shingles
Warts
Herpes Simplex

4

What kinds of fungal skin infections can pts have?

Yeast infections
Athletes foot
Ringworm

5

What kinds of parasitic skin infections can pts have?

Body lice
Head lice
Scabies

6

What is cellulitis?

An acute, painful infection of the skin (dermis) and subcutaneous tissues

7

Does cellulitis have clearly demarcated borders?

No

8

What is the term for a superficial form of cellulitis?

Erysipelas

9

Does erysipelas have clearly demarcated borders?

Yes

10

When is cellulitis more common and more serious?

In pts with other underlying disease such as diabetes,cancer, or immunodeficiency

11

What lifestyle factors can increase risk of cellulitis?

Elderly
Alcoholism
IV drug use
Overweight/Obesity
Pregnancy

12

What are some other risk factors for cellulitis?

Previous cellulitis
Venous insufficiency
Lymphoedema
Skin abrasions
Insect bites

13

What organism most commonly causes cellulitis?

Streptococci

14

What other organisms can rarely cause cellulitis?

Gram negative
Anaerobic
Fungi

15

Who is usually affected by these more unusual organisms in cellulitis?

Children
Diabetics
Immunocompromised individuals

16

What can cause cellulitis less than 24 hours post operatively?

Group a beat-haemolytic Strep
Clostridium perfringens

17

Which organism usually causes erysipelas?

Group A Strep

18

Is there lymphatic involevement in cellulitis?

Yes sometimes

19

What is the typical treatment for cellulitis?

Ora antibiotics

20

Which oral antibiotic is commonly prescribed for cellulitis?

Flucloxacillin

21

Which antibiotics is prescribed if the pt has a penicillin allergy in cellulitis?

Clarithromycin

22

If the cellulitis is present on the face, which antibiotics should be prescribed?

Co-amoxiclav, or clarithromycn is penicillin allergy

23

What is impetigo?

A highly infectious skin condition that presents with sores or blisters

24

What are the types of impetigo?

Bullous
Non Bullous

25

Which is the most common impetigo?

Non bullous/contagious

26

How does non bullous impetigo start?

As a red sore near the nose or mouth that breaks, leaks pus/fluid, then forms a yellow scab

27

How can impetigo be spread?

By touching it then touching another area

28

What is bullous impetigo?

Painless, fluid filled blisters on arms/legs/trunk, that are red and itchy. They break and form yellow scabs

29

Who does impetigo most commonly affect?

Children ages 2-5, especially those in school/day care

30

How is impetigo treated?

Hygiene education
Also with oral or topical antibiotics

31

How is localised non bullous impetigo treated?

With topica abx such as fusidic acid

32

How are extensive non bullous impetigo, and bullous infection treated?

With oral antibiotics, usually flucloxacillin, or clarithromycin/erythromycin in penicillin allergy

33

As well as impetigo and cellulitis, what skin conditions can be caused by a Staph infection?

Boils
Skin abscess
Folliculitis
Wound infection
SSSS

34

What is SSSS? Who does it affect?

Staphylococcal scalded skin syndrome (staph toxin causes extensive skin blistering), affecting childen and young babies

35

What is a boil?

A red, apinful lump on the skin, usually developing on the neck, face, armpit, or buttocks

36

Why do boils grow and become more painful?

As they fill with pus

37

What happens to boils after ~2-3 weeks?

They burst and pus drains out (no scarring)

38

What is a carbuncle?

A dome shaped cluster of boils

39

What is a skin abscess?

A collection of pus that appears as a painful lump under the surface of the skin, usually caused by a Staph infection

40

What symptms are associated with an abscess?

Pain around affected area
Pyrexia
General feeling of unwellness

41

What is folliculitis?

Infection of a hair follicle causing an itchy pus-filled bump, typically on the neck, armpit, or groin

42

What is typically used for the treatment of folliculitis?

Topical antibiotics

43

How is SSSS usually treated?

IV abx

44

What is shingles?

A viral disease caused by the herpes zoster virus, which causes a painful, dermatomal rash

45

Is the shingles rash bilateral?

No

46

What can happen a few days before the rash appears in shingles?

Tingling or pain local to the area the rash appears in.
Generally feeling unwell

47

Are there any complications of shingles?

Yes - postherpetic neuralgia

48

What can happen if the rash in shingles involves the eye?

Vision loss may be a complication

49

Why does shingles occur?

Due to reactivation of the VZV in the pts body after it remains inactive in nerve roots from initial infection (chicken pox)

50

Is shingles usually self limiting?

Yes

51

What are the characteristics of the shingles rash?

Patchy erythema with grouped herpetiform vesicles, usually contained within a dermatone.

52

What is postherpetic neuralgia characterised by?

Persistent/recurring pain lasting 30 days + after the acue infection, usually in the region of the originally involved dermatome. Often severe, and resolves very slowly.

53

What is shingles of the facial nerve called?

Ramsay Hunt syndrome

54

How can shingles be prevented?

Shingles vaccine

55

Is shingles infectious?

Only to people who have not had chicken pox or the VZV vaccine

56

What lifestyle advice can help with shingles?

Avoid sharing clothes or towels
Wear loose-fitting clothing
Cover weeping lesions
Avoid topical creams and tight dressings
Keep it clean and dry

57

Who needs referal to a specialist in shingles?

Those with opthalmic involvement
Immunocompromised adults and children
Systemically unwell pts
Widespread/multiple dermatome involvement
Pregnant/Breastfeeding women

58

Who needs antiviral treatment (without referal) in shingles?

Pts over 50
Pts under 50 if immunocompromised (adults), moderate/severe pain or rash, or non-truncal involvement

59

Which antivirals can be used in shingles?

Oral aciclovir, valaciclovir, or famciclovir within 72 hours of rash onset

60

What can cause warts?

HPV

61

What is the difference between a wart and a veruca?

A veruca is a wart on the sole of the foot that iften gets trodden in

62

How are warts most commonly treated?

They aren't! They usually resolve on their own

63

How does HPV cause warts?

Infection of keratinocytes causes hyperkeratinisation and epidermal thickening.

64

What else can be used to treat warts?

Salicylic acid
Cryotherapy
A combination of the two

65

Where can HPV cause warts?

Genitals
Feet
Hands
(Anywhere where there may be trauma and repeated expoure to moisture without drying)

66

What herpes simplex viruses are there?

HSV-1
HSV-2

67

What is HSV-1?

Oral herpes

68

What is HSV-2?

Genital herpes

69

What can HSV-1 manifest as?

Cold sores

70

What happens when HSV-2 first manifests?

Pt feels generally unwell (mild fever, aches, pains) then groups of small, painful blisters then appear around genitals and/or anus. They tend to erupt in crops over 1-2 weeks. The blisters soon burst and turn to shallow, sore ulcers.

71

What secondary symptoms occur in HSV-2 infections?

Pain on urination
Inguinal lymphadenopathy
Vaginal discharge

72

What is a candidal skin infection?

Yeast infection of the skin

73

Where on skin is candida most likely to thrive?

Anywhere moist or sweaty eg folds of skin, armpits, under breasts

74

How does a candidal skin infection look/feel?

The rash is usually sore and itchy. Small blister-like swellings may develop on the rash. Skin scale can accumulate on the rash to produce a white-yellow, curd-like substance over the affected area.

75

How is a candidal skin infection treated?

Antifungal cream

76

What antifungal creams can be used in candidal skin infections?

Clotrimazole
Econazole
Miconazole
Ketoconazole (adults only)
Terbinafine

77

Which oral antifungals can be prescribed for more severe candidal infection?

Fluconazole

78

What lifestle advice can be given to prevent candidal infections?

Dry the susceptible areas well
Wear light, loose, cotton clothing
Weight loss
Keep prone areas dry and clean

79

What is athlete's foot also known as?

Tinea pedis

80

What is athlete's foot?

A fungal infection of the foot caused by Trichophyton

81

How common is athlete's foot?

Roughly 1 in 4 people have it at an one point

82

Why does athlete's foot happen?

The conditions fungi like best are warm, moist and airless areas of skin, such as between the toes.

83

Where is affected first in athlete's foot?

Between the toes

84

What are the symptoms of athletes foot?

Itchy, scaly rash
Cracked and sore skin
Flaking skin
Gradual spread

85

Can athletes foot spread to the nails?

Yes

86

How is athletes foot treated?

Topical antifungals

87

What is an important part of the athete's foot history?

Sweaty feet
Swimming or other exercise
Footwear

88

What is ringworm?

Fungal infection that causes rounded, red, inflammed patches of skin that spread outwards

89

What is ringworm also known as?

Tinea corporis

90

How can ringworm spread?

Person to person contact with an infected person, or from an item that has had contact with an infected person
From animals
From soil