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Dermatology > Skin Infections > Flashcards

Skin Infections Flashcards

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1
Q

What virus cause skin infections

A

HPV
Herpes simplex ( HSV)
Herpes Zoster (HZV)
Molluscum contagiosum

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2
Q

What bacteria cause skin infection

A

Normal skin flora protect but if skin damage micro-organism can penetrate
S.aureus
Strep
Corynebacterium minitissimum in acne

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3
Q

What fungi cause skin infection

A 
Tinea
Candida albican
Yeast 
Piturosporium
True fungi
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4
Q

What ectoparasites cause skin infection

A

Scabies

Cutaneous leishmaniasis

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5
Q

What does HPV lead too

A 
Warts on body
Hyperkeratotoic papules or nodules
Most common at sites of trauma 
Incubation = 4 months
Transferred by direct skin contact
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6
Q

How do you Rx

A

Consider if painful, unsightly or persist
Should resolve 24 months
Chemical paint
Cryotherapy
Imiquidmod for genital - usually sexual transmission

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7
Q

What does primary exposure to HSV cause

A

1st clinical episode
Most severe
Virus becomes latent in neural tissue in DRG

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8
Q

What can reactivate virus

A 
Trauma
Menstruation
Sunlight
Fever
Virus then tracts down nerves
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9
Q

How does HSV present

A 
Closely tinny packed vesicle / pustule
Monomorphic - same 
May only see erosions if skin is fragile e.g. genitals 
May see ulcers on thick skin
Often proceeded by burning or itching
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10
Q

If recurrent vesicles what should you suspect

A

HSV

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11
Q

Who is at risk of severe infection

A

Immunosuppressed

Atopic tendency

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12
Q

How do you Rx

A

Acyclovir - oral or topical

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13
Q

What does primary exposure to HZV lead too

A

Chicken pox
Then becomes latent
When reactivated = shingles

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14
Q

What are features of shingles

A

Pain in dermatome region as virus tracks down nerves
Rash after 4 days of pain
Dermatomal
Vesicular
If in ophthalmic devision of 5th CN = urgent referral

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15
Q

What are complications

A

Scarring
Post-shingles neuralgia
Meningnitis
Encephalitis

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16
Q

How do you Rx

A

Opthamologist if in eye area
Oral acyclovir if immunocompromised, >50, eye involvement
IV if severe

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17
Q

When are you non-infective

A

When vesicles dry up

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18
Q

Who gets shingles vaccine and what type

A

All elderly 70-79 SC

Live attenuated so CI if immunosuppressed

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19
Q

What is molluscs contagiosum

A

Common skin infection caused by MCV virus
Transmission via close contact
Very common in children, immunocompromised, atop eczema

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20
Q

What are the features

A 
Pinky pearly white papules
Central umbilication 
Up to 5mm in diameter
Appear in clusters
Common on trunk and flexure
May get lesions on genitalia if sex
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21
Q

How do you Rx

A 
Self limiting within 18 months
Do not share towels as contagious 
Cryotherapy if lesion troublesome
GUM if on genitals + STI screen
Ophthalmology if eye lid
HIV if +Ve
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22
Q

What are complications and how do you treat

A

Eczema or inflammation so Rx
Emollient or steroid if itch
Ax if bacterial infection on top - topical fusidic or fluclox

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23
Q

What is pityriasis Rosea

A

Acute self-limiting rash
Herald patch - usually on trunk to start
Followed by erythematous oval scaly patches
CHaracterisitc distribution
Longitudinal line

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24
Q

What causes and how do you treat

A

Viral-predrome
Lasts 6-12 weeks - self limiting
Symptomatic treatment of itch wit antihistamine, emollients, steroid

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25
What is impetigo and what causes
Superficial bacterial skin infection that occurs when bacteria enter through a break in the skin S.aureus = 70% Strep A Can be primary or secondary to eczema / scabies / bite
26
How does it present
Golden crusted lesion | Tend to be on face and flexures
27
How do you Rx
Topical fusidic acid = 1st line if local Fusabet = Ax + steroid Flucloxacillin if extensive Oral erythromycin if allergic
28
Do you exclude from school
Yes till lesions crust or 48 hours on Ax
29
What is erysipelas and what causes / RF
Form of cellulitis but only in dermis and upper SC tissue Strep pyogene S.aureus ``` RF Wounds Local ulcer Immunosuppression Minor skin injury ```
30
What are the features
``` Most common in LL Swelling Erythema Warm Painful May have associated lymphangitis Systemically unwell - fever / rigors Raised plateau into erythema ``` Differentiated from cellulitis as well defined red raised border
31
How do you Rx
IV Ax - fluclox or benpen Rest Leg elevation Analgesia
32
What is a furuncle
Abcess in hair follicle | Known as boil
33
What do you do if recurrent
Dip urine to check for glucose
34
How do you Rx
Drain pus then Ax
35
What is carbuncles
Lots of furuncles together
36
What is ecthyma
Minature cellulitis Much more localised Crust + rim of erythema
37
How do you Rx
Oral Ax to cover staph and strep
38
What is cellulitis and features of cellulitis and what can it lead too
Bacterial infection involving deep subcutaneous tissue Diffuse swollen Red Tender Hot Fever and rigors Can lead to necrosis, abscess + septicaemia Infection enters through trauma e.g. ulcer or athletes foot
39
What does corynebacterium minutissiumum cause
Erythrasma | Pitted keratosis
40
What is erythrasma
Asymptomatic flat, scaly pink or brown rash Affects groin or axillae Similar to athletes groin
41
How do you Rx
Topical anti-fungal | Ax - erythromycin topical or oral if extensive
42
What types of superficial fungal infection
Dermatophyte - tine / ringworm Yeast - candida/ Malazzeia Moulds - aspergillus
43
What does candida yeast cause
``` Thrush Balantitis Angular stomatisis Nappy rash Chronic paronyhia - inflammation of nail fold ```
44
How do you Rx
Canistan
45
What is a typical candida infection
Affects moist areas such as breast / mucosal Brick red erythema with satellite pustules in flexures White plaque on mucosal
46
What is tinea
Dermatophyte fungal infection
47
What is tinea pedis
``` Athletes foot White macerated rash Scaling Flaking Itching Fissuring ```
48
What is tinea corporis
``` Ring worm Well defined annular, erythematous lesions Scaly Itchy Papules and pustules Flakey skin around ```
49
How do you Dx
Skin scrapings sent for microscopy and culture
50
What is tinea cruris
Infection round the crotch
51
What makes fungal infections worse
Steroid | Can cause tinea incognito (ill defined and less scaly)
52
How do you Rx
``` Correct predisposing where possible - Moist area - Immunosuppression Topical anti-fungal - terbinafine Anti-Fungal shampoo Oral anti-fungal if doesn't improve / severe / widespread or nail infection - itranazole ```
53
What is tinea capitis and what is tinea manuum
Capitas Fungal infection in the scalp Itchy, dry erythematous scalp Patches of broken hair Manuum Scaling and dryness / white of palmar creases of hand
54
What can it lead too
Scarring alopecia
55
How do you Rx
Oral anti-fungal + topical anti-fungal shampoo
56
When do you think fungal
If not gone away with Ax
57
What are typical fungal skin infections
Circular patch Flaky skin around erythematous ring Steroids worsen
58
What causes fungal nail infection (onychomycosis)
Dermatophytes - tinea Candida yeast Non-dermatophye mould (aspergillus)
59
What are RF
Age | DM
60
What are features
Thick, rough, opaque nal Tinea unguium - Yellow discoluration - Thickened nail
61
What is DDX
Psoriasis Trauma Lichen planus Yellow nail
62
How do you Dx superficial fungal infection
Nail clipping or scrapping before Rx | Skin swab for yeasts
63
If caused by dermatophyte
Oral terbinafine for 6 weeks to 6 months | Requires LFT monitoring
64
If caused by candida
Itracanazole | Topical if mild but require longer course
65
What is pityriasis versicolour
Superficial cutaneous fungal infection with Malazzeia | Common on trunk
66
How does it present
``` Look at photo Hypopigmented / pink or brownn patches Scales = common Mild itch Fail to tan on sun exposure ```
67
What is predisposing
Immunosuppression Malnutrition Cushings
68
How do you Rx
Topical anti-fungal | Send sample if fail to respond
69
What causes Scabies
Sarcoptes scabiei | Mite infestation
70
How do you get scabies
Close contact with human for about a minute
71
What does it do
Mite burrows into skin Leaves egg in striatum corneum Tend to be in cool peripheral places Protein in poo = allergic reaction
72
What happens
DADS RASH Papules+ vesicles develop after 6 weeks Excoriations Widespread pruritus - type 4
73
What can stay after treatment
Itch
74
How do you Dx
Presence of burrow Dermatoscope to view mites Skin scrap
75
How do you Rx
Cream all over body for 8-12 hours - scabicide Repeat after 7 days Treat all house hold contacts Anti-Histamine for itch
76
What is a viral exanthema
Itchy rash associated with any viral illness | Fever, malaise, headache then rash
77
What causes
``` Chicken pox Measles <1 without MMR Rubella Scarlet fever Parovirus B-19 Roseala infantum ```
78
What do you do for oral thrush
Swab to confirm Possibly test for HIV Sporonox spray or nystatin Fluclonazole tablet
79
If skin looks infected / inflamed
Topical fusidic acid (fusabet = Ax + steroid) | Oral fluclox next

Dermatology (12 decks)

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