Common skin infection

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Common skin infection

• Dr GHADA BIN SAIF
• ASSISTANT PROFESSOR CONSULTANT
• DERMATOLOGIST
• KSU KKUH

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• Bacterial Impetigo, Erysipelas, Cellulitis,
  Erythrasma
• Mycobacterial TB
• Viral Warts, Molluscum contagiosum, H.simplex,
  H.zoster
• Fungal Candida, Dermatophyte inf., Pityriasis
  versicolor
• Protozoal Leishmaniasis

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Bacterial
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Impetigo

• Superficial cut. Inf.
• Staph, gp A strept or both
• Child, AD

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• Mx
• Remove crust
• LocalizedTopical Abx (bacroban)
• Severe or Strept (prevent post strept.
  Glomerulonephritis)
• Semisynthetic Penicillin 7-10 d
• Erythromycine (sensitive)
• Augmentin (face)
• 1st generation cephalosporin

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Erysipelas

• Sharply demarcated unilateral, red oedematous.
• Face
• Beta hemolytic gp A Strept.
• Minor abrasion
• sup. Lymph vessels
• -Leucocytosis fever

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• Mx
• Swab
• Cold compressor
• Oral penicillin
• Erythromycin
• Augmentin
• 1st generation cephalosporin

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Cellulitis

• Deeper involvement of the SC
• Raised, hot, tender, erythematous
• Strept. Pyogenes, staph.aureus
• Cut , abrasion or ulcer
• Palpable, tender LN
• Fever, leucocytosis

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• Mx
• Swab - Bl culture
• Treat according to culture patient
• Strept
• Semisynthetic Penicillin
• Erythromycin
• Augmentin ( face H. influenzae)

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Erythrasma

• Corynebacterium minutissimum
• Red, brown, asymptomatic, flexoral

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• Mx
• Swab
• woods lamp coral-red fluorescence
• Topical imidazoles (miconazole) or
• erythromycin
• Oral erythromycin X 7 d

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Mycobacterial Tuberculosis
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Lupus vulgaris

• Commonest
• 1ry inf., good natural immunity
• Heamatogenous spread
• Apple jelly nodule--scar
• Tuberculoid granuloma
• Mx bx, AFB
• Local ttt
• Anti TB

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Viral
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Wart

• HPV (DNA)
• Common wart
• Hand
• Child
• Koebner phenomenon

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• Plane wart Plantar
  wart
• Face , back of hands sole

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• Genital wart
• Condylomata accuminata
• Penile, vulvar skin, mm, perianal area
• Sexual partner
• Child---sexual abuse
• Some oncogenic16, 18

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• Mx
• Involute spontaneously
• Cryotherapy
• Topical SA, TCA
• Electrocautary
• Laser

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Molluscum contagiosum

• Pox virus
• Child
• Face, neck
• Central punctum
• Hunderson-patterson bodies
• Mx curettage, cryotherapy

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Herpes simplex

• Group of small blister
• HSV-1- H. labialis
• HSV-2- genital herpes
• Herpetic whitlow(? pyogenic lesion)
• Eczema herpeticum

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• Mx
• Smear---viral particles
• Topical
• Acyclovir (early) Genital, Recurrent, immune
  suppressed, neonatal, Ecz.H.

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Herpes zoster

• Chickenpox virus
• Adult
• Prodromal paindermatomal (blisters)post-herpetic
  neuralgia
• Ramsey-Hunt syndrome Ophth div. Geniculate
  ganglia---Ear pain blisters
• Mx
• Smear
• Analgesia, drying agent
• Acyclovir immune suppressed, wide spread

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Fungal

• Superficial mycosis
• Deep mycosis

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Candidiasis

• Candida albican (normal commensal of GIT)
• Napkin candidosis Intertrigo (satellite
  lesions)
• Paronychia
• Chronic candidal granuloma
• MM Oral
• Vulvovaginitis-irritation, discharge
• Systemic
• Chronic mucocutaneous candidiasis

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• Mx
• Swab
• Alter moist warm environment
• Nystatin-containing cream
• Imidazole (Daktarin, canastein)
• Oral antifungal (itraconazole) immune suppressed

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Dermatophyte infection

• Skin
• Hair
• Nails

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• Tinea pedis
• Adult (athletes)
• Toe webs , instep
• T.rubrum, T.mentagrophytes

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Tinea ungumT.rubrum, T.mentagrophytes
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• Tinea corporis
• Trunk
• Active edge
• T.rubrum

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T.cruris
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T.manun
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Tinea capitis

• Well circumscriped pruritic scaling area of hair
  loss
• Black dot (T.tonsurans)
• Gray patch (M.audouinii),
• Kerion (T.verrucosum)
• Favus (T.schoenleinii)

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• Mx
• Scraping, hair plug---KOH
• Education
• Topical (terbinafine, daktarin)
• Oral (Griseofulvin, terbinafine, itraconazole)
  extensive, Hair, nail

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Pityriasis versicolor

• Malassezia furfur (hyphea)
• Pityrosporum orbiculare (yeast)
• Trunk
• Hypopig. (in dark skin)
• Mx
• Woods lamp
• Scraping
• Topical imidazol (nizoral)
• Recurrence

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Protozoal Leishmaniasis
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• Transmit sand fly
• Painful noduleulcer
• Exposed site

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• Mx
• Leishmanin test, Bx
• Cryotherapy
• Pentavalnt antimony local injection
• Systemic pentavalent antimony

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Questions ? ?