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Infestations and infectious diseases of the skin

This is a brief video on infestations of the skin and infectious diseases of the dermis and epidermis. I created this presentation with Google Slides. Images were created or taken from Wikimedia Commons I created this video with the YouTube Video Editor. ADDITIONAL TAGS: Cellulitis Bacterial skin infection → red tender plaque, often on lower leg Might see streaks of lymphangitis to lymph nodes Fever, high WBCs, tender lymph nodes, pain Risk factors: trauma/wounds, systemic infxn, edema, inflammatory state, bug bites Erysipelas more superficial, shiny, demarcated cellulitis Notable dermal lymphatic involvement, usually on legs or face Impetigo AKA impetigo contagiosum Superficial bacterial skin infection Epi: often in children (2-5 yo), spread among contacts Abscess Large mass, red, warm, tender Can drain pus/fluid Treat with incision and drainage If pt has multiple abscesses, immunosuppression, or other cellulitis, treat with oral abx Furuncle: small perifollicular abscess, (boil) Folliculitis Bacterial infection of hair follicles Looks like small, red, pustules with pus Usually caused by staph aureus Staphylococcal scalded skin syndrome Secretion of staph aureus toxin into blood causes systemic blisters “Skin peels away in sheets Necrotizing fasciitis Bacterial infection of fascia, spreads quickly Pain unproportional to physical exam findings Secondary syphilis Second stage/presentation of sexually transmitted infection syphilis caused by bacterium Treponema pallidum Secondary syphilis presents with diffuse rash which frequently involves palms of hands, soles of fee Dermatophytes Named “tinea _____” for the site of infection Tinea pedis (athlete’s foot) → foot Shoes create moisture → infected in public gym, pools, showers Scaling/redness Often recurs Three patterns: interdigital, vesiculobullous, and moccasin types Can involve nails → onychomycosis (requires oral antifungals (terbinafine) bc poor access with topicals) Treat with hygiene (change socks, foot powder for dryness) and topical antifungals (imidazoles, allylamines, ciclopirox) Can lead to lower leg cellulitis (fungal infxn creates portal of entry for bacteria) Tinea corporis (ringworm) → trunk and limbs Ring shaped lesion with central clearing → “ringworm” Causes itching, affects all ages, often asymmetric Treat similar to tinea pedis, use oral antifungals (terbinafine and fluconazole in severe cases) Tinea cruris is similar in groin area Tinea capitis → scalp and hair Tinea (pityriasis) versicolor AKA dermatomycosis furfuracea, tinea flava Eruption of macules/patches on the skin, can be many colors .. tan, salmon, hypopigmented patches or macules Usually on trunk Diaper candidiasis Presents in infant with red erosions in diaper area, with satellite lesions, involving skin folds Pathogenesis: urease in feces breaks down urea from urine into ammonia → irritates skin → candida from feces enters the skin Candidal intertrigo Chicken pox AKA varicella Herpes zoster AKA shingles Herpes simplex Kaposi sarcoma Verruca vulgaris AKA common wart Genital warts Sexually transmitted disease caused by HPV → verrucous sessile exophytic papules on external genitalia, perineum, perianal, inguinal fold Extensive infection in immunocompromised (HIV, organ transplant) HPV types 6 and 11 typically cause genital warts (recall 16 and 18 cause high grade intraepithelial neoplasia Prevent with gardasil vaccine, protect against types 6, 11, 16, 18 Treatment: cryotherapy, electrocautery, laser, surgery, imiquimod (TLR7/8 agonist to stimulate immune system Molluscum contagiosum Pediculosis AKA pediculosis capitis, lice Lice infestation of the human head Caused by human louse Pediculus humanus var capitis Causes scalp pruritis (itchiness), might cause posterior cervical lymphadenopathy Scabies AKA seven-year itch Contagious skin infestation by the mite Sarcoptes scabiei Bed bugs Human parasite that feeds on human blood found in bedding and sleep areas, active at night Most common bed bug is Cimex lectularius Saliva has antiplatelet agents, anticoagulant, vasodilators Host presents with edematous papules scattered over the body Treatment: bites resolve in a week or two; topical anti-itch or steroids for symptoms. Clean everything, hire exterminator.