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DERMATOLOGY phase 1b > skin infections and infestations basics > Flashcards

skin infections and infestations basics Flashcards

1
Q

things caused by staphylococcus aureus

A 
impetigo
folliculitis
cellulitis
ecthyma
staohylococcal scalded skin syndrome
superinfections of other skin diseases e.g leg ulcers, atopic eczema
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2
Q

What immune deficiencies make you more prone to bacterial infections?

A

Hypogammaglobulinaemia

HyperIgE syndrome

AIDS

Diabetes Mellitus

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3
Q

conditions caused by streptococcus pyogenes

A 
impetigo
cellulitis
ecthyma
eysipelas
scarlet fever
necrotising fasciitis
superinfects other skin diseases e.g leg ulcers
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4
Q

PVL toxin - panton valentine leukocidin

A

s.aureus toxin
pore forming, painful, multi site, recurrent and present in contact
painful
necrotising fasciitis, pneumonia, purpura fulminans

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5
Q

preventing PVL infection

A 
close contact
contaminated items
crowding
cleanliness
cuts
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6
Q

treatment of PVL infection

A

antibiotics
nasal mupirocin ointment
chlorhexidine body wash
treat any contacts

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7
Q

what is folliculitis

A

follicular erythema, can be pustular
infections or non infectious (HIV)

treated by antibiotics - erythormicin
incision and drainage for furunculosis (large)

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8
Q

what is pseudomonal folliculitis (hot tub)

A

pseudomonas aeruginosa
associated w moisture, 1-3 days post exposure to hottub etc
self limiting

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9
Q

furuncle vs carbuncle

A

furuncle - deep abcess of one follicle

carbuncle - deep abscess of several adjacent follicles (can cause cellulitis or septicaemia)

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10
Q

what is cellulitis

A 
infection of lower dermis/subcut
tender swelling with ill defined blanching erythema/odemea
usually strep pyogenes or s.aureus
odema predisposes
treated by systemic antibiotics
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11
Q

what is impetigo

A

superficial bac infection, honey coloured crust
caused by staphylococcus
affects face
treated with topical and systemic antibiotics

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12
Q

what is impetiginisation

A

infection of atopic eczema

staph aureus
gold crust

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13
Q

what is lyme disease (borreliosis)

A

target shaped (annular erythema)
infected tick bite
carditis and arthritis and neuroborriolis (facial palsy, aseptic meningitis, polyradiulitis)

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14
Q

what is the initial presentation of syphilis?

A

Primary infection Chancre -painless ulcer with a firm indurated border
Painless regional lymphadenopathy one week after the primary chancre
Chancre appears within 10-90 days

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15
Q

What is secondary syphilis, what are the symptoms?

A

Begins 50 days after chancre
Presents with malaise, fever, headache, pruritus, loss of appetite, iritis

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16
Q

Why is syphilis referred to as the great mimicker?

A

Presents with a wide range of symptoms such as
Rash
Alopecia
Mucous patches
Lymphadenopathy
Residual primary chancre
Hepatosplenomegaly

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17
Q

What is lues maligna in syphilis?

A

Rrae manufestation of secondary syphilis

Pleomorphic skin lesions with pustules, nodules and ulcers with necrotising vasculitis

More frequent in HIV manifestations

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18
Q

What is tertiary syphilis?

A

Gumma skin lesions - nodules and plaques

Extend pripherally while central areas heal with scarring and atrophy

Mucosal lesions extend and destroy the nasal cartilage

Cardiovascular disease

Neurosyphilis

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19
Q

How is syphilis diagnosed?

A

Clinal findings
Serology
Strong index of suspicion required in secondary syphilis

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20
Q

What is the treatment for syphilis?

A

IM benzylpenicilin or oral tetracycline

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21
Q

What is herpes simplex virus?

A

Primary and recurrent vesicular eruptions favouring orolabial and genital regions

Travels by retrograde axonal flow to dorsal root ganglia

22
Q

What are the two types of HSV?

A

HSV-1 – direct contact with contaminated saliva / other infected secretions
HSV-2 - sexual contact

23
Q

What is HSV preceded by?

A

Preceded by tender lymphadenopathy, malaise, anorexia
± Burning, tingling

24
Q

What may cause reactivation of HSV?

A

Reactivation – spontaneous, UV, fever, local tissue damage, stress

25
Q

What is the systemic manifestation of HSV?

A

aseptic meningitis in 10% of omen

26
Q

What is eczema herpeticum?

A

Emergency
Monomorphic punched or erosions (excoriated vesicles)

27
Q

What is herpetic whitlow?

A

HSV (1>2) infection of digits – pain, swelling and vesicles (vesicles may appear later)
Misdiagnosed as paronychia or dactylitis
Often in children

28
Q

What causes neonatal HSV?

A

Exposure to HSV during vaginal delivery – risk higher when HSV acquired near time of delivery

29
Q

what are some features of neonatal HSV?

A

HSV 1 or 2
Onset from birth to 2 weeks
Localised usually – scalp or trunk
Vesicles → bullae erosions
Encephalitis → mortality >50% without treatment, 15% with treatment → neurological deficits
Requires IV antivirals

30
Q

What is severe or chronic HSV, how does it present, other involvements?

A

Immunocompromised patients e.g. HIV / transplant recipient

Most common presentation – chronic, enlarging ulceration

Multiple sites or disseminated

Often atypical e.g. verrucous, exophytic or pustular lesions
Involvement of respiratory or GI tracts may occur

31
Q

How is HSV diagnosed?

A

Swab for PCR

32
Q

What is the treatment for HSV?

A

Don’t delay
Oral valacyclovir or acyclovir 200mg five times daily in immunocompetent localised infection
Intravenous 10mg/kg TDS X 7-19 days

33
Q

What is pityriasis versicolor?

A

Superficial fungal infection
Hypopigmented, hyperpigmented or erythematous macular eruption +/- fine scale
Malassezia spp.

34
Q

When does pityriasis versicolor tend to begin?

A

Adolescence when sebaceous glands become active

35
Q

What causes flares in pityriasis versicolor?

A

When temperatures and humidity are high

36
Q

Treatment for pityriasis versicolor?

A

Topical azole

37
Q

What are dermatophytes?

A

Fungi that live on keratin

38
Q

What two fungi cause the most fungal infections and tinea capitis?

A

Trichophyton rubrum and trichophyton tonsurans

39
Q

What is a kerion?

A

– an inflammatory fungal infection that may mimic a bacterial folliculitis or an abscess of the scalp; scalp is tender and patient usually has posterior cervical lymphadenopathy
- Frequently secondarily infected with Staphylococcus aureus

40
Q

What are Id reactions?

A

Dermatophytid reactions
Inflammatory reactions at sites distant from the associated dermatophyte infection
May include urticaria, hand dermatitis, or erythema nodosum
Likely secondary to a strong host immunologic response against fungal antigens

41
Q

What is the a common cause of vulvovaginitis?

A

Candiasis

42
Q

What is candidiasis predisposed by?

A

occlusion, moisture, warm temperature, diabetes mellitus

43
Q

What are the usual presentations of candidiasis?

A

Most sites show erythema oedema, thin purulent discharge
Usually an intertriginous infection (skin folds) or of oral mucosa.

44
Q

What type of fungal infection is mucormycosis?

A

Opportunistic

45
Q

Typical presentation of mucormycosis?

A

oedema, then pain, then eschar
fever, headache proptosis, facial pain, orbital cellulitis ± cranial nerve dysfunction

46
Q

What is mucormycosis associated with?

A

Diabetes mellitus (1/3 of patients - DKA very high risk
Malnutrition
Uraemia
Neutropaenia
Medications: Steroids / antibiotics / desferoxamine
Burns
HIV

47
Q

What is the treatment for mucormycosis?

A

aggressive debridement & antifungal therapy amphoteracin

48
Q

What is scabies?

A

Contagious infestation caused by Sarcoptes species
Female mates, burrows into upper epidermis, lays her eggs and dies after one month.
Insidious onset of red to flesh-coloured pruritic papules

49
Q

Where does scabies usually affect?

A

Affects interdigital areas of digits, volar wrists, axillary areas, genitalia

50
Q
A

DERMATOLOGY phase 1b (6 decks)

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