A 30-year-old male presented with a scary lesion on his left armpit. The document discusses several common bacterial skin infections seen in primary care settings such as impetigo, erythrasma, and pitted keratolysis. Impetigo is caused by Streptococcus or Staphylococcus and presents as vesicles or pustules with honey-colored crust. Erythrasma is caused by Corynebacterium minutissimum and presents as brown-red patches that fluoresce coral-red under wood's light. Pitted keratolysis presents as crateriform pitting on the feet and is caused by various bacteria. The document provides details on presentation, causative

1. A Case Scenario
A 30 yrs male
presented to your
general OPD with a
scary lesion on his left
axilla .
1. Your questions???
2. Differentials???
3. Management???
November 7, 2016 1Dr. Pawan KB Agrawal

2. ????
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3. ?????
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4. ?????
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5. ?????
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6. Bacterial Skin Infections
in
Primary Care Settings
By:
Dr. Pawan KB Agrawal, MD
Consultant General Practitioner
Bayalpata Hospital, Accham.
26th
October, 2016, Wednesday.

7. Objectives
• To recognize common bacterial infections in
OPD.
• To manage those infections.
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8. Impetigo
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9. Impetigo
• The most common bacterial infection in
children.
• Caused by Streptococcus pyogenes or
Staphylococcus aureus.
• Distribution: face followed by limbs
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10. Impetigo
• Presentation: small vesicles or
pustules
honey-colored crust with a
moist erythematous base.
Fever ±
• Bullous impetigo differs from non
bullous since it occurs more in neonates;
does not form crusts & involves mucosal
membrane.
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11. Impetigo
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12. Impetigo
• Management: Local wound care
Topical antibiotics like
fusidic acid or soframycin or mupirocin.
Systemic antibiotics like
cloxacillin or cefadroxil.
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13. ????
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14. Erythrasma
• chronic superficial infection of the
intertriginous areas of the skin.
• ranges from months to years.
• Caused by Corynebacterium
minutissimum.
• Distribution: inner thighs, scrotum, and toe
webs.
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15. Erythrasma
• Presentation: well-demarcated, brown-red
macular patches.
wrinkled appearance with fine
scales.
often asymptomatic but may
be pruritic.
• Wood light examination reveals coral-red
fluorescence.
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16. Erythrasma
• Management: fusidic acid cream for topical
use.
If fails, administer erythromycin
or clarithromycin or amoxiclavulanic acid.
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17. Erythrasma
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18. ?????
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19. ?????
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20. ?????
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21. Pitted Keratolysis
• characterized by crateriform pitting that
primarily affects the pressure-bearing aspects
of the plantar surface of the feet.
• Caused by Micrococcus, Dermatophilus or
Cornebacterium.
• Distribution: Plantar surface
November 7, 2016 21Dr. Pawan KB Agrawal

22. Pitted Keratolysis
• Presentation: Often asymptomatic
± malodor, hyperhidrosis,
sliminess, soreness or itching.
• Management: avoid occlusive
footwear.
twice-daily applications
of erythromycin, clindamycin, or fusidic acid.
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23. Take Home Message
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24. November 7, 2016 24Dr. Pawan KB Agrawal