Sycosis Vulgaris
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Sycosis Vulgaris

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Sycosis Vulgaris Presentation Transcript

  • 1. Sycosisvulgaris
    • It is a pyogenic infection of the whole hair follicles
    • 2. causativeorganism: staph aureus
    • 3. Sexandage :males after puberty
    • 4. Site: beard and moustache
    • 5. Morphology :
    discrete , erythematous follicular papules or pustules from which hair emerge
    perifollicular edema
    • Course : chronic with remission and relapses .
  • Differential diagnosis :
    Taeniabarbae
    Psudo-folliculitis
    Herpes simplex
    Impetigo
    Treatment :
    Local :
    • Local compresses
    • 6. Local antibiotic on the beard and nose
    General :
    - Cloxacillin ( anti- staph )
  • 7. Def :
    superficial mild chronic infection of the skin
    Etiology :coryneobactriumminutissimum
    Site : feet, groins, axillae, and submammary areas, which mimics epidermal dermatophyte infections
    Predisposing factor :
    Obisity , DM
    occlusive clothing/shoes
    Anaemia
    Hyperhydrosis
    Increased humidity
    Erythrasma(Greek, "red spot")
  • 8. Clinical picture :
    Subjective symptoms :
    • Non - itchy disfigurement
    • 9. Mild irritation in the grion
    Morphology :
    - Dry , slightly scaly yellowish brown patches with sharply defined irregular border
    • The border is not active
    Localization :
    Flexures , axillae , inner aspect of the thighs , umbilicus
    Anal cleft , under the beast in obese females
    Bilatral
  • 10. Erythrasma: groins Sharply marginated, brownish-red, slightly scaling macular patch on the medial thigh (infectious intertrigo) appears bright coral-red when examined with a Wood's lamp.
  • 11. Erythrasma: webspaceThis macerated interdigitalwebspaceThe webspaceis the most common site for erythrasma in temperate climates
  • 12. DD :
    intertrigo
    Pitryasisversicolar
    Taeniacruris : erythematous scaly patch with active border
    Seborrheic dermatitis
    Psoriasis
    Candidal dermatitis
  • 13. Laboratory Examinations
    Wood'sLamp
    demonstration of the characteristic coral-red fluorescence
    DirectMicroscopy
    Negative for fungal forms on KOH preparation of skin scraping. In the webspaces of the feet, concomitant interdigitaltineapedis may also be present. Gram or Giemsa stains may show fine bacterial filaments.
    BacterialCulture
    Heavy growth of Corynebacterium. Staph aureus, group A strep, and Candida infection.
    In some cases, concomitant Pseudomonas aeruginosawebspace infection (feet) is also present.
    Diagnosis
    Clinical findings, absence of fungi on direct microscopy, positive Wood's lamp examination.
  • 14. Treatment :
    General :
    Erythromycin 1gm daily for 2w ,
    Local :
    local antifungal : e g
    Tolnaftatetwice daily for 2-3w
    Imidazole derivative cream twice daily for 2-3w
    Sodium fusidate ointment,
    Benzoylperoxide (2.5%) gel daily after showering for 7 days
  • 15. Pitted Keratolysis (Keratolysis Sulcata)
    (PK) presents as defects in the thickly keratinized skin of the plantar foot with eroded pits of variable depth, caused by Kytococcussedentarius.
    AgeYoung adults & Sex Males > females
    Predisposing Factors as erythrasma
    K. sedentarius produces proteases which digest keratin.
    Skin Symptoms
    Usually asymptomatic. Foot odor, sliminess of feet. Uncommonly, itching, burning, tenderness.
    Often mistaken for tineapedis.
    Skin Lesions
    Crater-like pits in stratum corneum
    Involved areas are white when stratum corneum is fully hydrated
    Symmetric or asymmetric involvement of both feet
  • 16. Pitted keratolysis: plantar
    The stratum corneumshows loss of keratinization with well-dermarcatedmargins,
    Pitted keratolysis: toePitted epidermis of an intertriginous toe, associated with hyperhidrosis
  • 17. Abscess, Furuncle, andCarbuncle
    Def :
    abscessis an acute or chronic localized inflammation, associated with a collection of pus and tissue destruction
    A furuncle is an acute, deep-seated, red, hot, tender nodule or abscess that evolves from a staphylococcal folliculitis
    A carbuncleis a deeper infection composed of interconnecting abscesses usually arising in several contiguous hair follicles.
  • 18. Etiology :
    Causativeorganism : staph aureus
    Predisposingfactors:
    Pressure ,friction ,irritation of skin in exposed areas and extensor surface
    Chronic S. aureuscarrier state (nares, axillae, perineum, vagina)
    Diabetes mellitus Obesity
    Poor hygiene & Bactericidal defects (e.g., chronic granulomatous disease)
    Chemotactic defects
    Hyper-IgE syndrome (Job's syndrome)
    HIV disease, especially MRSA infection
  • 19. Clinicalpicture :
    Morphology :
    • Perifollicular , tender , hot nodules with erythematous surface within few days transformed into necrotic core (remnant of hair follicle )
    Localization affect area contain hair follicles :
    face , neck , back , axilla , arms and anorectal region
    Symptoms :
    The lesion is painfull , throbbing pain .
    Fever , mild constitutional symptoms
    Carbuncles may be accompanied by low-grade fever and malaise.
  • 20. Furuncle: S. aureus
    Soft-tissue swelling of the forehead with central abscess formation, nearing rupture
    Furuncles: S. aureusMultiple areas of folliculitisin the moustache extending to become furuncles
  • 21. Carbuncle: S. aureusA very large, inflammatory plaque with pustules, on the neck. Infection extends down to the fascia and has formed from a confluence of many furuncles.
    Multiple furuncles: Multiple, painful ulcerated nodules on the buttocks of a 20-year-old male, occurring during hospitalization for ulcerative colitis.
  • 22. DD :
    Acne vulgaris
    Bockhart impetigo
    Herpes simplex
    Sweat rash
    Treatment :
    Local measures :
    - hot compressing
    - pirecing the pointed surface to discharging pus
    - cleaning the area by local antibiotic
    - a void occlusive dressing
    2. General : antibiotic as penicillin & flucloxacillin .
  • 23. Thank You