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141 Cards in this Set
- Front
- Back
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Etiology for Tinea infection
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Dermatophoytosis including Microsporum, Trichophytom, and Epidemophyton
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Tinea Captitis is usually seen in_____ and affects the _____
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Children affects the head
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Gray patch ringworm
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brittle hair shats break off close to the scalp
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black dot ringworm
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closely broken off hair looks like "dots" appears diffuse and poorly circumscribed
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Exam of Tinea by woods lamp reveals
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bright green hair shafts.
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Tinea corporis is usually seen in_______ and affects ________
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all ages affects mostly the forearm and neck
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KOH prep for tinea corporis reveals
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septate and branched hyphae
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Tinea cruris is affects_______
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the groin but usually doesn't involve the scrotum
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KOH prep for Tinea cruris reveals
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septate and branched hyphae
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Rx Tinea Capitis
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Griseofulvin
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Rx Tinea corporis
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Griseofulvin
5%salicycic acid and 5% benzoic acid cream |
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Rx Tinea cruris
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Griseofulvin
5%salicycic acid and 5% benzoic acid cream |
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Rx Tinea manus/pedis
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Griseofulvin
5%salicycic acid and 5% benzoic acid cream |
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Onychomycosis is defined as
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a fungal infection of the finger or toe nail which is difficult to cure
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Onychomycosis Rx
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Griseofulvin for 6 mos $350 40% effective or
Terbinafine for 3 mos $500 70% effictive |
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Tinea versicolor
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chronic asyptomatic fungous infection of the trunk characterized by white or brown macules
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Tinea versicolor etiology
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Pityrosporum orbiculare
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Tinea versicolor is most common in
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young adults
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D/Dx Tinea versicolor
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vitiligo
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Lab for Tinea Versicolor
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hyphae and spores on KOH prep reported as having a "spaghetti and meat balls appearance"
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Rx for tinea versicolor
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5% salicylic acid and 5% benzoic acid cream
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Etiology for candidiasis
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Candida albicans
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Labs for Candidiasis
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KOH for yeast
Gram stain for yeast |
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Rx for candidiasis oral
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nystain suspension or oral ketoconazol
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Rx for intertrigioous candidiasis
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nystain ointment
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Rx for genital/perigenital candidiasis
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nystatin vaginal tablets
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Rx for diper candidias
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topical nystatin ointment
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Impetigo def
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acute skin infection usually caused by group A strep and Staphlococcus aureus
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Impetigo usually effects
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preschool children and young adults
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physical exam of note for Impetigo
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Golden or Honey colored crust
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Impetigo D/Dx
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in early stage vesicles may be confused with Varicella or herpes
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Lab findings for Impetigo
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early vesicle fluid may reveal Gram Pos cocci in chains
culture may reveal Group A strep and sometimes a mixed culture of strep and S. aureus |
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TX for impetigo
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Penicillin, single injection of long lasting benzathine penicillin
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Ecthyma def
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a deeper extension of impetigo with the same etiology except it may also be caused by Pseudomonas
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TX for Ecthyma
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Tx includes systemic antibiotics as well as debridement of epidermis which becomes necrotic
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Cellulitis def
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acute non-contagious inflammation of the epidermis and deep underlying connective tissue of the skin
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Etiology for cellulites
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Staphylococcus, streptococcus or other bacterial infections
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Labs for cellulites
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CBC shows an elevated WBC and indicates a bacterial infection
Blood cultures may be performed if generalized infection is suspected |
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Rx for cellulitis
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mild-dicloxacillin
severe-nafcillin |
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Erysipelas def
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inflammatory disease of the skin
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Etiology of erysipelas
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Beta-hemolytic streptococci
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S/Sx Erysipelas
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well demarcated tender rapidly advancing erythematous plaque with Px and fever and leukocytosis
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Erythrasma etiology
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Corynebacteriae organisms
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Caution in Erythrasma
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often confused with fungal infections
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Erythrasma lab
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the bacteria produces porphyrins so the skin is coral-pink under woods lamp
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Erysipelas Rx
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Preferred Tx is oral erythromycin
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Staphylococcal scalded skin syndrome aka for newborns
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Ritter's disease in newborn
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Scalded skin syndrome mortality in adults
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approaches 50% in adults
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Scalded skin syndrome etiology
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caused by enterotoxin of Staph
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Necrotizing Faciitis manifistations
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Brawny edema, bullae with blue/purple fluid
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Necrotizing fasciitis etiology
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Streptococcal-deep to site of minor non penetrating trauma
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Herpes Simplex Def
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characterized by one or many clusters of small vesicles filled with clear fluid on slightly raised inflammatory bases
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HSV1 commonly causes
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herpes labialis, herpetic stomatitis, and keratitis
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HSV2 commonly causes
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genital herpes, is considered an STD and results in skin lesions
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HSV virus remains dormant_____
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in the nerve ganglia
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Herpes simplex 1 S/Sx
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lesions involving the nose, ears, or fingers can be painful.
vesicles persist for a few days then dry forming a yellow crust |
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HSV1 physical exam
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may appear anywhere on the skin or mucosa but mostly mouth, lips, conjunctiva, cornea, and genitalia
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HSV1 lab
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Tzanck preparation may reveal multinucleate giant epithelial cells. diagnosis is confirmeed by cultures for the virus
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HSV2 primary infection occurs
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on the vulva, vagina or penis in young adults
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HSV2 Tx
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mild outbreak-let it run its course
severe outbreak-antivirals have been used to suppress or decrease length of outbreak |
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herpes zoster general info
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66% of Pts affected are over 50 years, less than 10% under 20 yrs. less contagious than varicella but caused by same virus.
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Herpes zoster progression
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papules (24hrs) vesicles-bullae (48hrs) pustules (96hrs) then crusts. new lesions appear for up to a week.
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herpes zoster PE
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zosteriform (dermatomal) and palm size groups of vesicles along a dermatome with unilateral distribution
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Herpes zoster D/Dx
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it is important to identify zosteriform herpes simplex with neuralgia which may be impossible except by viral culture
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herpes zoster Tx
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corticosteroids
prednisone 60mg 1 week than decrease 20 days |
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Varicella etiology
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chickenpox is the acute invasive phase of the virus and herpes zoster represents the reactivation of the latent phase
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Varicella incubation period
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14-16 days and communicability is considered possible from 10-21 days after exposure
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Varicella PE
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teardrop vesicles containing clear fluid and standing out from base. lesions progress from macule to papule to vesicle and begin crusting in 6-8 hrs
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Varicella Labs
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Innunofluorescent detection of viral antigen in lesions THESE TESTS ARE EXPENSIVE AND SHOULD ONLY BE USED IN CASES WHEN OTHER DISORDERS NEED TO BE R/O
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Varicella Rx
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mild cases require only symptomatic Tx. in severe cases systemic antihistimnes may be used
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Verruca def
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common, contagious epithelial tumors caused by at least 60 types of human papillomavirus
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Verruca S/Sx
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warts may appear at any age but are most frequent in older children and uncommon in the elderly
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Verruca PE
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light gray, yellow, brown, or gray-black nodules 2-10mm in diameter
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Verruca Tx (solution)
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A solution containing 17% salicylic acid and 17% lactic acid applied daily after gentle peeling
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Verruca Tx (cryo)
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freeze the wart for 15 to 30 sec with liquid nitrogen. this may need to be repeted in 2-3 weeks
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Molluscum contagiosum def
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a pox virus characterized by skin colored, smooth, waxy, umbilicated papules 2-10mm in diameter
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Molluscum contagiosum S/Sx
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transmitted by direct contact. small papules may appear anywhere often on the genital and pubic area
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Mollusum contagiosum Dx
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diagnosed easily by characteristic central umbilication filled with semisolid white material
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Molluscum contagiosum lab
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if the white material is giemsa-stained it reveals inclusion bodies within many large cells or extracellularly
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Molluscum contagiosum Tx
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distroy each lesion by freezing. removing the central core of the papul with a needle, comedo extractor, or the tip of a #11 blade
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Condyloma Acuminata def
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hyperplastic lesions of the skin or mucous membranes of the genitalia caused by HPV transmitted sexually
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Condyloma acuminata PE
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soft, moist, minute pink or gray polyps that enlarge and may bee pedunculated usually found in clusters and may resemble cauliflower
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Condyloma acuminata Tx/Rx
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Podophyllotoxin, podophyllin or 5-fluorourail or cryotherapy
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Pediculosis def
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infestation by lice
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Pediculosis subspecies
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head louse (pediculus humanus capitis) body louse (pediculus humanus corporis)
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pediculosis PE
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"ID the little critters hopping around", "ID nits which have a pearly fluorescence
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Pediculosis Labs
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not really necessary "when you see these little creatures jumping around you don't need a lab to tell you what they are"
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how to use NIX, RID, A200 for pediculosis
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apply to affected area, wash off after 10 min reapply 7-10 days
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How to use Malathion (ovide) for pediculosis
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apply to affected area for 8-12 hours than wash off. DO NOT USE IN CHILDREN <6 MOS
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Pediculosis pubis risk factors
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more common in young adults. often sexually transmitted
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Pediculosis pubis Tx
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Treat Pt and sexual partners within last month use NIX, Rid, A200 or Malathion (ovide)
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Pediculosis corporis risk factors
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infestation of humans and their clothing by the body louse is confined to individuals that rarel reemove their clothing and live in overcrowded, unhygienic situations
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Scabies Def
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a transmissible exoparasite infection characterized by superficial burrows intense pruritus and secondary infection
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Scabies etiology
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mite Sarcoptes scabiei
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Scabies PE
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the burrow is a fine wavy and slightly scaly line a few mm to 1 cm long
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Burrows occure predominantly in
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finger webs, flexor surfaces of wrists, elbows and axillary folds male genatalia
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Scabies Dx
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requires demonstration of a burrow if not found in most common sites examine entire skin
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Scabies Lab
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finding mite, ova, or fecal pellets confirms the Dx
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Scabies Rx
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topical scabicide is usually effective and the medication must be applied thoroughly to all skin from the neck down particularly to the finger webs, genitalia, perianal and toe webs
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Scabies management
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all skin-to-skin contacts should be treated at the same time
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Contact dermatitis def
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can be described as acute, subacute, or chronic inflammation of the skin caused by an external factor
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Contact Dermatitis etiology
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usually delayed hypersensitivity reaction with a period of a few days or years from first exposure to re-exposure
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Contact dermatitis lab
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Patch testing is usually the definitive test to support the Dx
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Contact dermatitis Tx
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REMOVE THE OFFENDING AGENT
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Atopic dermatitis Def
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acute, subacute, but usuall chronic, pruritic inflammation of the epidermis and dermis, often occurring in association with a personal or fam Hx of hay fever, asthma, allergic rhinitis or atopic derm
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Atopic dermatitis Etiology
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onset in the first months of life. in 75% of cases there is a H of allergic rhinitis, hay fever, allergies or asthma
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Infantile atopic dermatitis S/Sx
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Erythemic skin, tiny vesicles on "PUFFY SURFACE", scalding, exudation with wet crusts and fissures
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Infantile atopic dermatitis Tx
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DOES RESPOND TO TOPICAL CORTICOSTERIODS. PLEASE CONSULT WITH SUPERVISING PHYSICIAN
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Diaper dermatitis onset
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usually after first 6 weeks highest occurrence up to 5 months. may occur in incontinent older persons
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Diaper dermatitis Tx
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frequent changing of diapers "let the kid air dry", copious use of baby powder
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Drug reactions cause
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caused by immunologic or non-immunologic mechanisms. the majority are based on hypersensitivity reactions
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Urticaria/angioedema cause
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a group of disorders where wheals occur in the skin. release of histamine cause blood vessels to leak resulting in swelling
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Urticaria acute vs chronic
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acute is of recent onset (hour, days or a few weeks) chronic has been persistent for several mos to years
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causes of Allergic urticaria
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meds, food, bee or wasp stings
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Non-allergic urticaria
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sinusitis, helicobater, serum sickness
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types of urticaria
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non-allergic, physical, cholinergic, cold, contact urticaria
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Rx urticaria
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oral antihistamines, oral steroids or ultraviolet light treatment. avoid aspirin and codeine
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Folliculitis def
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superficial or deep bacterial infection and inflammation of the hair follicles
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Folliculitis etiology
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usually caused by S. aureus but occasionally by P. aeruginosa (hot-tub folliculitis)
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Folliculitis pathophysiology
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superficial pustule or inflammatory nodule surrounds the hair follicle. Gram-neg folliculitis may develop during Tx of acne
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when folliculitis lesions are deep seated, chronic, and recalcitrant on the head and neck it is called
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Sycosis
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folliculitis S/Sx
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symptoms range from slight burning and tenderness to intense itching
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Folliculitis D/Dx
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it is important to differentiate bacterial from nonbacterial folliculitis often a gram stain culture is needed
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Furnucles def
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acute, tender, perifollicular inflammatory nodules resulting from infection b staphylocci
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Furuncles occure
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mostly on neck, brests, face, and buttocks but are most painful on nose ear or fingers
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Furuncles Tx
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I&D or application of liquid soap containing either chlorhexidine gluconate with isopropyl alcohol
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Furuncles special circ
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a Pt with a furuncle in the nose or central facial area and patients with multiple furuncles should be Tx with systemic antibiotics
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Carbuncle Def
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a cluster of furuncles with subcutaneous spread of staphylococcal infection resulting in deep suppuration often extensive local sloughing slow healing and a large scar
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Alopecia areata
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partial or complete loss of hair resulting from genetic factors or aging or local or systemic disease
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Acne def
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common inflammatory disease of the pilosebacceous glands characterized by comedones, papules, pustules canalizing and deep inflamed sometimes purulent sacs
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Acne usually begins
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in adolescence (10-17yo female 14-19yo male)
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Acne superficial Tx
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in superficial acne topical clindamycin or erythromycin or sunlight
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Acne deep PE
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characterized deep inflamed nodules and pus-filled cysts which often rupture and become abcesses
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Acne deep Rx
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Tetracycline
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Seborrheic dermatitis def
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an inflammatory scaling disease of the scalp face and other areas
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Seborrhic dermatitis S/Sx
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dermatitis usually is apparent as dry or greasy diffuse scaling of the scalp with variable pruritus
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seborrheic dermatitis in newborns
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thick yellow crusted scalp lesion (cradle cap)
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seborrheic dermatitis Tx in adults
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zinc pyrithione, selenium sulfide, sulfer, and salicylic acid, or tar shampoo
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seborrheic dermatitis Tx in infants
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baby shampoo is used daily and 1% hydrocortisone cream is rubbed in twice daily
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Epidermal Cyst def
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slow growing benign cyst containing follicular, keratinous and sebaceous material and frequently found on the scalp ears face back or scrotum
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Epidermal cyst Tx
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I&D evacuate the contents and REMOVE THEE CYST WALL WITH CURET OR HEMOSTAT. Drain for 7-10 days
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