week 13

Question 1

impetigo primary vs secondary

Answer 1

primary- infection recently
secondary- nbreak in skin and then infected

Question 2

impetigo infections causes

Answer 2

staph aureus
streptococcus pyogens

Question 3

tx of impetigo

Answer 3

2-3 weeks- self resolved

Topical ABX if superficial, nonbullous, localized cases- Mupiricon or retapamulin

EDU: remove crust before applying ABX topically, treat ALL lesions

Oral abx if multiple lesions, infections in family members- cephalexin, augmentin, dicloxacillin, clindamycin

Question 4

what is SSSS

Answer 4

staphylococcal scalded skin syndrome

• abrupt onset of fever, poor feeding, lethargy
• key finding is sandpaper rash resembling scarlet fever that rubs off with light rub

Question 5

treatment of SSSS

Answer 5

IV ABX- dicloxacillin
first or second gen cephalosporins

minimal handling, adding ointments

Question 6

cellulitis cause

Answer 6

s. aureus

Question 7

erysipelas vs cellulitis

Answer 7

erysipelas- local signs and symptoms, well-demarcated area of infection

cellulitis- more severe, systemic symptoms, not well-demarcated

Question 8

celleulitis TX

Answer 8

depends on suspected organism- cephalexin, bactrim, clindimycin

Follow-uo- 24 hours and daily after that to see response

Question 9

folliculitis

Answer 9

• obstruction damage- acne, waxing, shaving

environmental causes- moist environment, maceration, poor hygeine, occlusive emollients, prolonged submersion in contaminated water

Question 10

Furuncle (boil)

Answer 10

abscess with one hair

Question 11

carbuncle

Answer 11

abscess with multiple hair follicles

Question 12

candidiasis

Answer 12

yeast infection and thrush that is fungal related (mouth perianal, breast)
risk factors: immunosuppressed, moist, abx recently

Question 13

dx study for yeast

Answer 13

KOH scraping

Question 14

tx yeast

Answer 14

oral: nystatin 4x day dropper in each cheek
BF: nystatin on nipples
persistent: oral fluconazole
Skin (diaper/folds): nystatin topical, every diaper change
DO NOT COMBINE WITH CORTICOSTERIOD

Question 15

tinia capitis

Answer 15

dermatophyte infection of scalp and hair shaft- ring worm

Question 16

dx of Tinia capitis

Answer 16

clinical observation + cervical or occipital lymphadenopathy

Question 17

antifungal tx tinia capatis

Answer 17

gold standard: griseofulvin- taken 6-8 weeks with fatty food (side effects: gi distrubance, skin eruptuions, headaches, photosensitivity)

or terbinafine (effective over 4 years)

Question 18

tx with kerions

Answer 18

prednisone for inflammation and systemic antibiotics

Question 19

monitoring tinia capatis

Answer 19

follow ups every 2-4 weeks and continue treatment until culture is negative for 2 weeks

Question 20

hair regrowth process (tinia capatis

Answer 20

3-12 months

Question 21

tinia corporis

Answer 21

superficial funal skin infection excluding the scalp, palms, soles, and groin

Question 22

managment of tinia corporis

Answer 22

topical: miconozole or clotrimozole (twice daily for 1-4 weeks including normal skin around the lesions

extensive infection, or immunocompromised: griseofulvin for 2-4 weeks

Question 23

daycare with tinia corporus

Answer 23

return after 24 hours after treatment begins

Question 24

tinea cruris

Answer 24

jock itch
superficial fungal infection

adolescents males, obese people, hygiene issue

Question 25

tx of tinia cruris

Answer 25

same as tinia corporis

Question 26

tinia pedis

Answer 26

athletes foot superficial foot fungal disease showers or locker rooms

Question 27

management of tinia pedis

Answer 27

same as tinia corporis

Question 28

tinia versicolor

Answer 28

pityriasis versicolor fungal infection that commonly appears on the face, neck, upper arm, chest and back hypopigmented in dark skin, hyperpigmented in light skin

Question 29

tinia versicolor

Answer 29

topical: selenium sulfide 2.5 % lotion of 1% shampoo applies in a thin layer several hand widths beyond the lesion for 10 minutes daily before rinsing for 1-2 weeks followed by 3 months to help prevent reoccurance

Question 30

molluscum contagiosum

Answer 30

water warts benign viral skin infection with little risk resolves on own from 2-7 weeks up to 6 months itching, white discrete papules

Question 31

management of molluscum

Answer 31

6 mo - 4 years of self resolving

Question 32

warts

Answer 32

HPV cause- over 100 types, all cause different presentation

Question 33

management of warts

Answer 33

resolve within 3-5 years but recurrence is high no real treatment Topical: salacylic acid, cryotherpy, elecrto surgery, lasar therapy

Question 34

genital warts

Answer 34

concern for sexual abuse and require extensive evaluation

Question 35

pediculosis

Answer 35

lice require human blood for sustanace they can crawl but not jump 3 types: head, pubic, body

Question 36

eggs of lice

Answer 36

nits concrete to hair shaft 7-10 days to hatch, lay 10 eggs a day

Question 37

symtoms of lice

Answer 37

itching, dandruff- like substance, crawling sensation sites: back of head, nape of neck, behind ears

Question 38

pediculosis corporis

Answer 38

body lice associated with homelessness, crowded living conditions

Question 39

treatment for lice

Answer 39

permethrin 1% cream rinse (OTC) is the treatment of choice- can be used 2 months or older

Question 40

environment cleaning after lice

Answer 40

- examine/inform contacts - launder hot water and dry on hot for 20 minutes - non washables: store in plastic bag for 2 weeks -

Question 41

scabies

Answer 41

mite- close contacts through clothing and linen- transmititon happens in 15 min

Question 42

lesions of scabies

Answer 42

S shaped burrows that are worse at night

Question 43

treatment of scabies

Answer 43

scabicide application: thin layer from neck down, special attention - under fingernails, scalp, behind ears, folds, creases, feet, hands. keep on for 8-14 hours and then rinse Permetherin 5% cream drug of choice (VS 1% for lice) severe crusted scabies tx: ivermectin (oral) as a second treatment

Question 44

-school rule for scabies

Answer 44

can return after 24 hours post treatment

Question 45

post scabies treatment symptoms

Answer 45

itching for 3 weeks can use antihistamines or hydrocortisone treatment

Question 46

acne

Answer 46

ages starts: 12-13 girls 14-15 boys

Question 47

treatment for acne

Answer 47

1) tretnoin and benzole peroxide 2) antibiotics topically (gels are more powerful than the creams) 3) antibiotics Tetracyclines (doxycycline and minocycline) alternatives would be erythromycin 4) hormonal control- BC, OCP, spironolactone