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22 Cards in this Set

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Skin functions?
1. protection from environment (UV light, chemicals, mechanical injury, invasion by infectious agents, prevent desiccation, adjusts thermal regulation)

2. sensory organ function (temp, position/vibration, pain)

3. immunologic surveillance
4. reflects active internal disease processes
What is epidermis composed of?
-multi-layered keratin
-melanocytes
-Langerhan's cells
What is dermis composed of?
-elastic tissue
-supports and protects blood vessels, nerves, lymphatics
-sweat glands and pilosebaceous units
What are impetigo and ecthyma?

How do they differ?
-crusted lesions

impetigo is limited to epidermis

ecthyma can penetrate dermis causing ulceration and bacteremia
3 hair follicle and apocrine region infections:
1. carbuncles - coalescent, extensive
2. furuncles - deep isolated nodules
3. folliculitis - limited to hair follicle
Etiologies of hair follicle and apocrine region infections:
S. aureus and P. aeruginosa* - primary causes

Candida or Malassezia - less common
What is erysipelas?

Cause?

Appearance?
=superficial dermis infection w/ prominent lymphatic involvement

Streptococcal in origin

skin is red, raised, painful, swollen
What is cellulitis?

Pathogens that cause it?
=skin infection involving deeper dermis and subcutaneous tissue

S. aureus and S. pyogenes are usually pathogens
Cellulitis in diabetics, granulocytopenia, immunocompromised pts due to:
gram-neg rods
non-Group A Strep
Cellulitis due to marine water exposure:

(test: person walking on beach cuts foot)
Vibrio species**
Cellulitis with concomitant pneumonia:
Legionella
Cellulitis due to occupational exposure:
Erysipelothrix
Cellulitis due to fresh water exposures:
Aeromonas*
Cellulitis from sweaty tennis shoe syndrome:
Pseudomonas aeruginosa
Who gets clostridial cellulitis?
pts with traumatic injury; neutropenic pts (immunosuppressed)

-can cause a deep myonecrosis
What is non-clostridial cellulitis?
Enterics/Strep

perineum affected
What is necrotizing fascitis?

Difference b/w the two types?
Type I - mixed aerobic/anaerobic bowel flora that is gas producing

Type II - Group A strep

infarction of fascial layers causes all skin above it to die


no difference in clinical appearance, but treatment differs
What is myositis?
=muscle inflammation

multiple etiologies
Rhabdomyolysis
What is pyomyositis?

Causes?

Who gets it?
=pus in the muscles

causes: S. aureus or S. pyogenes

tropical climates
diabetes
collagen vascular disease and immunosuppression
Appearance of clostridial (gas gangrene) myonecrosis?
dishwater exudate

bronze green skin
Appearance of non-clostridial (crepitant) myonecrosis?

Causes:
seropurulent discharge/erythema

causes:
1. anaerobic streptococcal
2. synergistic non-clostridial anaerobic
3. infected vascular gangrene
4. Aeromonas hydrophila
How does one get myonecrosis?

How does it evolve?
penetrating trauma

evolves rapidly (1-4 days) --> painful!