Anatomy Review

1. Anatomy Review • Skin • Thick • Cellular • 2 layers

2. Mucus Membranes • Structure • Simple epithelium • Defenses

3. Eyes • Protective structures • Molecules – Lysozyme, Ig A

4. Minor Infections Folliculitis (Pimples) Invasion of hair follicles Eye infection - ______ Multiple follicles – _______________ Many carriers Low bacterial counts needed to infect wounds Scalded Skin Syndrome Exfoliative exotoxins Infants most affected Outer skin layers shed High fever Septicemia and shock may occur Impetigo of Newborn Crusting vesicles on skin surface Antimicrobial lotions needed Bacterial Skin Disease — Staphylococcal

5. Scarlet Fever Bacteriophage toxin causes rash Strep. throat often also seen Complications – glomerulonephritis and rheumatic fever Many carriers Erysipelas St. Anthony’s fire Historically high mortality, not so now Red raised rubbery lesion Focal spread may occur Septicemia Pneumonia Endocarditis Abscesses Bacterial Skin Disease — Streptococcal

6. Bacterial Skin Disease — Nonspecific • Pyoderma/ Impetigo • Strep./Staph./ Corynebacterium • Childhood infection • Skin depigmentation may occur • Penicillin treats most infections

7. Gram negative skin pathogens • Pseudomonas aeruginosa • Common in pools and improperly chlorinated hot tubs • Dermatitis • Ear infections • Severe respiratory infections in burn victims • Also Serratia marcescens

8. Rubella German measles Systemic with skin rash, joint pain Mild but can cause birth defects Stillbirth Deafness, heart and liver problems Measles Lymphatic tissue affected Rash and fever develop, cough and conjunctivitis Middle ear infections and URT infections may occur Respiratory route of transmission Chickenpox/ Shingles Varicella zoster virus (VZS) Respiratory route of infection Systemic symptoms accompanied by vesicular rash May be fatal in adults but childhood vaccination programs provide 20 years immunity Recurrences in elderly patients cause a painful disease – shingles Latent virus, shingle vaccine is newly available Viral Skin Diseases

9. Other Viral Pox diseases • Smallpox • Eradicated • Virus reserves exist • ? Bioterrorism • Cowpox • Milder disease • Similar lesions • Led to vaccine for smallpox • Monkeypox • Similar to smallpox virus • ? Species barrier? • Vaccination precaution in endemic areas

10. Viral Skin Diseases — Warts • Human Papilloma virus (HPV) • Affects skin and mucus membranes • May require excision • Link between some strains and cervical cancer • Gardasil

11. Fungal Skin Diseases • Ringworm • Tinea cruris • Tinea capitis/barbae • Tinea pedis/unguium • Very contagious • Secondary bacterial infections may occur • OTC medications available

12. Subcutaneous mycoses • Sporotrichosis • ____________________ is pathogen • Gardeners, farmers • Transmitted from animals or humans • Ulceration and inflammation at puncture site • KI treats subcutaneous lesions

13. Opportunistic Mycoses Candidiasis Oral or vaginal infections common May cause systemic infections in immunocompromised (AIDS)

14. Neonatal Ophthalmia Neisseria gonorrheae Tx via birth canal Routine antibiotics or silver nitrate has greatly reduced incidence of blindness Chlamydia trachomatis Leading cause of preventable blindness worldwide 500 million affected S.W. Native Americans only at risk group in U.S.A. Flies are a vector Bacterial Eye Diseases

15. Viral Eye Diseases • Adenovirus (Shipyard Eye) • Virus carried in dust • Cornea may be cloudy for up to 2 years • Sometimes nosocomial • Herpes Keratoconjunctivitis • Complication for cold sore sufferers • Leading cause of non-retinal blindness in U.S.A.