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46 Cards in this Set
- Front
- Back
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What is the most common bacterial infection?
If you get this wrong, you shouldn't be here. Do not pass go, just go to jail. |
Staph aureus
Manifests itself: Impetigo Furuncles, carbuncles folliculitis scalded skin syndrome scarlet fever wound infections |
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How does Bullous Impetigo present?
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Early thin lesions, flaccid blisters with cloudy contents or layers of pus
It used staph exfoliative toxins A & B. |
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What is the differential dx for bullous impetigo?
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Pemphigus, Drug eruptions
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What is tx for Bullous Impetigo?
HINT: It is an Antibiotic |
Cephalexin, Oral Dicloxacillin
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What do you give for bullous impetigo if a person can't take oral antibiotics?
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Mupirocin
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What is the difference between a furuncle & carbuncle?
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Boil is deep follicular abscess.
Carbuncle is a bunch of fur-uncles joined together-- more serious may lead to cellulitis! |
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Furunculosis are painful erythematous, and deep seated.
What is the TX for this condition? |
Oral diclox, or cephalexin
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What areas of the body can S.aureus can become resident flora?
hint: you treat one of them for a living |
FEET, groin, axilla, nose
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Where does scalded skin syndrome manifest itself?
What kind of toxin does it exhibit? |
Infants, immunocompromised, kids, <6 yrs old
Exfoliative toxin from Group II staph Toxins A & B cause sterile bullae. |
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What is Nikolsky sign?
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Nikolsky's sign is a clinical dermatological sign, named after Pyotr Nikolsky . Nikolsky's sign is positive when slight rubbing of the skin results in exfoliation of the skin's outermost layer.
It is almost always present in toxic epidermal necrolysis and scalded skin syndrome. A "positive" Nikolsky's sign is associated with pemphigus vulgaris. Nikolsky's sign is useful in differentiating between pemphigus vulgaris (where it is present or positive) and bullous pemphigoid (where it is absent) |
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If cellulitis is the diagnosis, how would you describe it?
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Erythema is the description!
Lyphangitis is the erythematous path along the the lymph chanels. Lymphanenitis is tenderness and palpable lymph nodes. |
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Impetigo, Ecthyma, Erysipelas, Necrotizing fascilitis, Septicemias
are all indicative of what kind of infections? |
Strep infections
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What is the relationship between staph and the wound surfaces it is found on?
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Staph has receptors that bind to fibrin which is found on the wound surfaces!
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Strep impetigo presents as a superficial, stuck on, honey colored crusts over an erosion.
It usually appears where on the body? |
THE FACE
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What is tx for step impetigo?
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Altabax
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Ecthyma usually occurs where?
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On the lower extremities.
Ecthyma is a severe form of strep impetigo. It usually heals with scars and occurs in healthy young adults |
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What is the tx for hot tub folliculitis?
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Self-limiting
Clean out that dirty tub |
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Pseudomonas hot foot syndrome typically occurs where?
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On the plantar surface of children after swimming in pool water with p. aureginosa.
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What is the tx for pseudomonas hot foot syndrome?
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Self limiting
but can tx w/ CIPRO |
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Where does erythrasma commonly manifest?
TX? |
Interspaces
Clinda/Erythromycin |
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Erythrasma occurs as a result of what bacterium?
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Corynebacterium
Fluoresces bright "coral red" on woods lamp! |
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Pitted keratolysis occurs where?
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On WB plantar surfaces
Does not glow coral red on woods lamp. Tx w/ clinda/erythromycin! |
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HPV 1,2,4,5,7 causes what?
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Plantar warts
Present in 34% kids & teenagers! A little more than 1/3 has this problem! |
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T/F Duct tape is a useful preventative measure in the tx against warts.
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FALSE
Recent studies have shown it is not useful. |
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Herpes Simplex Virus (HSV) is a member of the DS DNA virus family.
Primary infection is first infection at any site at the epithelial surface. HSV 1 is oral or genital? |
HSV-1 is ORAL.
HSV-2 is GENITAL. |
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Discuss some TX for plantar warts?
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Debridement, keratolytics, LASER, canthrone, chemotherapeutic, candida albicans injection
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How does HSV present?
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Classic presentation is grouped vesicles around a red base.
Use viral culture and Tzanck test to diagnose. (TZANCK heavens I don't have herpes!) |
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Discuss some TX for HSV.
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Vir Family of drugs.
Acyclovir. Famciclovir. Valcyclovir. |
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VZV aka chkn pox presents how?
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VZV presents as pruritic vesicles and papules that become pustules and crusted erosions.
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What is the course of VZV?
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Persists for 1 week.
Highly contagious for 4 days before onset, and until all lesions are crusted. 10-23 incubation period! |
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How does Herpes Zoster Virus (HZV) AKA shingles present?
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Painful and pruritic vesicles.
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Where deos the HZV reside?
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In the sensory ganglia.
Reactivated latent virus in sensory ganglia. |
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How would you treat HZV?
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ORAL prednisone, lyrica, or neurontin
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Hand, foot, mouth disease occurs in the plantar feet in children. How does it present?
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As red macules, gray & elliptical vesicles.
Hand Foot & Mouth disease is contagious with direct contact and is usually self limiting. |
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Molluscum Contagiosum affects which demographics in a given population?
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Children & those with HIV
It presents as dome shaped lesions, felsh colored umbilicated nodules |
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HIV & Karposis Sarcoma affects who the most?
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Homosexual & Bisexual men
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Early lesions of Karposis Sarcoma look like what?
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Red macules with a bruise like halo
(Think Tom Hanks in Philadelphia) Mimics many skin diseases |
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Tx of Kaposis Sarcoma includes:
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Intralesional vinblastine
radiotherapy Cryo Liquid Nitrogen |
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Viral Exanthems are what?
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Any skin rash associated with a viral infection.
Morbilliform is widespread macules and papules. Blistering on a red base Lacy Red Diffuse Red |
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Erythema infectiosum's slapped cheek rash resembles what other systemic disorder?
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SLE
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T/F Atypical mycobacteria occurs at the hands, feet, elbows, and knees
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T
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What is the TX for leprosy?
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Dapsone/rifampin
Clofazimine/Ethionamide |
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Syphilis is caused by Spirochete T. Pallidum.
Its primary lesion is known as___________ chancre. |
Hunterian Chancre.
2* LESION= maculopapular dermatitis or syphiloderm |
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As a toxic and difficult-to-use antibiotic, bacitracin does not work well orally. However, it is very effective topically. Its action is on gram__________ cell walls.
BONUS>>> Bacitracin is used to distinguish between S. pyogenes & S. galactiae. Which is sensitive? |
Bacitracin works on GRAM + cell walls.
Neosporin contains Bacitracin as one of its antibiotic agents along with Neomycin and Polymyxin B. S.pyogenes is sensitive to Bacitracin. |
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Polymyxin B is useful against gram negatives like proteus, pseudomonas, and serratia.
It does not work against _______ and __________. |
Gram + & Fungi.
Polymyxin does not work on these. RANDOM BONUS FACT: Acitretin (trade name Soriatane) is a second generation retinoid. It is taken orally, and is typically used for psoriasis. Acitretin is the least toxic systemic treatment for psoriasis. It is an oral retinoid of choice used in the treatment of severe resistant psoriasis. It binds to nuclear receptors that regulate gene transcription. They induce keratinocyte differentiation and reduce epidermal hyperplasia. Acitretin is readily absorbed and widely distributed after oral administration. A therapeutic effect occurs after 2 to 4 weeks or longer. |
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Mupirocin aka Bactroban aka Centany--
is active against S.aureus, S. epidermis, S.pyogenes, & MRSA. It does not work against _______ & __________ , or fungi. It works great for impetigo, folliculitis, burns, leg ulcers, and lacerations. In the hospital, it is used intranasal for MRSA carriers. |
Muciporin does NOT WORK against anaerobes & pseudomonas & fungi.
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