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Bacterial infections of the skin
- 2. IMPETIGO • Latin = to attack • Superficial contagious infection • Bullous & non bullous • S . Aureus ,strepto
- 6. Differences • Bullous • Staph aureus • Any age,neonates infants • Thick walled bullae • No erythema • Extend peripherally impetigo circinata • Adenitis & compli rare • Non bullous • Staphstepto • Children • Thin walled , transient • Erythema • No central clearing • Cellulitis , AGN, adenitis
- 7. Impetigo • Non bullous or impetigo contagiosa • Honey coloured crust • Stuck on appearance • Nasal carriage of staph
- 8. Echthyma • Deeper variant • Gp A beta hemolytic strepto • Oval shallow ulcers on legs • Chocolate coloured crust • Indurated base
- 10. Folliculitis • Sup folliculitis & deep folliculitis • Sup folliculitis • Bockharts impetigo- children • Puslules in crops • Scalp , hair margin , extremities
- 11. Sup folliculitis……. • Chronic folliculitis of legs • Young indian males • Anterior aspect of legs
- 13. Deep folliculitis • Sycosis barbae- beared • Sycosis nuchae- neck • Lupoid sycosis- extensive scarring • Folliculitis decalvance – scalp – scarring alopecia
- 16. Furuncle • Boils • Staph aureus • Folliculitis + perifolliculitis • Blind boils- donot discharge pus
- 18. Carbuncle • Tender, firm to hard • Indurated lump • ‘‘A small piece of coal’’ • Gps of boils • Deep infection • Contiguous follicles
- 20. Erysipelas • Streptococcus • Upper subcu & lymphatics • Bright red , warm ,tender • Indurated plaque • Sharp border • Face ,limbs
- 22. Erysipelas
- 23. Cellulitis • Strepto • Indistict border • Adenopathy • Systemic features
- 24. Cellulitis
- 25. Lymphangitis • Strepto • Sub cut lymphatic channels • Linear , red ,tender steaks • Lesion to regional LNs
- 27. Intertrigo • LATIN Inter = between • Trigo = rubbing • Inframammary ,axillae , groin ,gluteal • Gp A & B strepto ,C.minutissimum , P.aeruginosa
- 28. Paronychia • Inflammation of post & lateral nail folds • Caused by • Staphylococcus • Streptococcus • Pneumococcus
- 29. Erythrasma • Greek = red spot • C.minutisimum • Intertriginous areas • Webspaces of feet ,axillae , groin • Sharply marginated macule • Coral red flourescence on woods lamp
- 30. Erythrasma
- 31. Pitted keratolysis • Discrete to confluent • Crater like pits • Hyperhydrosis
- 32. Trichomycosis • Corynebacterium • Trichomycosis axillaris • Adherent granular nodules on hairs in axilla
- 33. SSSS • Staphylococcal scalded skin syndrome • < 5 yrs • Gp 2 phage type 71 • Exotoxin – epidermolysin • Cojunctiva ,middle ear ,nasopharynx • Generalised ,tender , erythematous • Nikolskys sign positive
- 34. SSSS • Potato – chip desquamation • Painful erosion • Mm spared • Heal in 1-2 wks
- 37. SSSS & TEN • SSSS • Staph • Infants & children • MM spared • 1-2 wks • No scarring • Good prognosis • antibiotics • TEN • Drugs • Adults • MM involved • Last > 2 wks • Scarring • Mortality 25-50% • Stop the drug
- 38. Management • Improvement of local hygiene • Avoidance of insect bite • Staph carrier site treatment • Antibacterial powder in folds • Removal of crust • Mupirocin, sodium fusidate 2%
- 39. Cutaneous tuberculosis • Exogenous source • Endogenous source • Tuberculids
- 40. Exogenous • Tuberculous chancre • Warty tuberculosis • Lupus vulgaris
- 41. Endogenous • Contiguous spread – scrofuloderma • Autoinoculation – orificial tuberculosis • Hematogenous – miliary TB , lupus vulgaris , tuberculous gumma
- 42. Tuberculids • Micropapular – lichen scrofulosorum • Papular – papular & papulonecrotic • Nodular – erythema nodosum , erythema induratum
- 43. Tuberculous chancre • No prior immunity to M .TB • Enters throu minor cuts ,wounds • >children , exposed parts • Limbs , face • Nodule – ulcer – crust - LNs
- 44. TBVC • TUBERCULOSIS VERRUCOSSA CUTIS WARTY TUBERCULOSIS • Moderate to high immunity • Hands ,lower limbs • Papule nodule - verrucous
- 47. Scrofuloderma • Extension from underlying focus • LNs or bone • Cervical region • Fistulas & sinus tracts • Undermined ulcers
- 50. Orificial TB • Autoinoculation around muco cutaneous junction • Patients with internal TB • Pulm TB – lips & mouth • Intestinal TB – anal region • Genitourinary TB – ext genitalia
- 52. Lupus vulgaris • Moderate to high immunity • Face , buttocks , thighs ,legs • Red nodule – soft plaque • Apple jelly nodules on diascopy • Ulceration ,crusting ,scarring , atrophy
- 56. Tuberculids
- 60. THANK YOU