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Infections of the Skin

Infections of the Skin. Andrew N Lin, MD, FRCPC. Infections of the skin: objectives. At the end of this lecture, the student should be able to: Describe the clinical features and treatment of common skin infections caused by viruses

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Infections of the Skin

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  1. Infections of the Skin Andrew N Lin, MD, FRCPC

  2. Infections of the skin: objectives At the end of this lecture, the student should be able to: • Describe the clinical features and treatment of common skin infections caused by viruses • Describe the clinical features and treatment of common skin infections caused by bacteria • Define “superficial dermatophyte”, and discuss the clinical and laboratory features that would lead to the correct diagnosis • Discuss the presentation of necrotizing fasciitis

  3. Grouped 1-2 mm vesicles near vermillion border, erythema. Herpes I

  4. HERPES SIMPLEX type I: painful, grouped blisters, secondary bacterial infection

  5. HERPES SIMPLEX: painful, grouped blisters

  6. HERPES SIMPLEX TYPE II: painful grouped blisters

  7. HERPES SIMPLEX TYPE II: painful ulcers

  8. HERPES SIMPLEX: painful, grouped blisters

  9. HERPES SIMPLEX: painful, grouped blisters usually a prodrome – funny feeling before the onset (pain, numbness)

  10. Herpetic gingivostomatitis: painful ulcers

  11. HERPES SIMPLEX: herpetic whitlow, occupational hazard (dentists, doctors, respiratory therapists from putting finger into mouth

  12. ECZEMA HERPETICUM: widespread herpes simplex infection in patient with atopic dermatitis, but they are still grouped

  13. TZANCK SMEAR: epithelial cell with several large nuclei, scalpel blade and open blister and scrape.

  14. Small erythematous papules scattered – Chicken Pox

  15. CHICKEN POX: dew drop on rose petal, lesions occur in waves

  16. From scapula to posterior axillary fold. Stops at midline – characteristic. Acute. 1-2 mm blisters with erythema around - shingles

  17. HERPES ZOSTER: unilateral, dermatomal diestribution

  18. HERPES ZOSTER: blisters on tip of nose means eyes may be involved (nasociliary branch of V1) affects trigenital nerve

  19. On trunk of small child, 10-15 papules with umbilication (depression in them) – Molluscum contagiosum (in cox family)

  20. MOLLUSCUM CONTAGIOSUM: multiple umbilicated papules

  21. Treat with Scraping or Qtip with chancero that irritates them MOLLUSCUM CONTAGIOSUM: multiple umbilicated papules

  22. These are circular – Ringworm (supeficial dermatophyte – fungus that only goes as far as strata corneum which is the layer above the epidermis)

  23. SUPERFICIAL DERMATOPHYTE: tinea corporis

  24. SUPERFICIAL DERMATOPHYTE: tinea corporis (when on the body, scaly

  25. SUPERFICIAL DERMATOPHYTE: tinea corporis. Corticosteroids suppress immunity and will cause it to spread

  26. Scaling most Marked on Periphery- Characteristic of tinea SUPERFICIAL DERMATOPHYTE: tinea cruris – jock itch

  27. SUPERFICIAL DERMATOPHYTE: tinea pedis

  28. SUPERFICIAL DERMATOPHYTE: potassium hydroxide (KOH) preparation, heat with match which dissolves keratin

  29. This is localized scarring

  30. SUPERFICIAL DERMATOPHYTE: tinea capitis

  31. SUPERFICIAL DERMATOPHYTE: tinea capitis

  32. Irregularly shaped erythematous plaques with crust - impetigo

  33. Impetigo: crusted, oozing plaques (**strep or staph) often occurs in patients whose skin is different to start with need AntB

  34. Somewhat swollen, well demarcated from level of eyes

  35. ERYSIPELAS: painful, sharply demarcated red plaque on face. Infection of the dermis (strep) – acute, also called cellulitis

  36. Staph scalded skin syndrome

  37. Extremely painful, swelling, fever, hx: underlying disease prone to infection ie. Diabetes . This is acute – Nec Fas

  38. NECROTIZING FASCIITIS: severe pain, fever, sick looking patient In early parts, infection is far down so it is hard to see

  39. NECROTIZING FASCIITIS: surgical debridement

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