1.1.1. bacterial infection of skin [compatibility mode]

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  • Nice presentation, There are so many different types of bacterial skin infections causes by different disease. If you have any skin infection you can check your symptoms from these Bacterial skin infection symptoms to confirm your infection type.
    http://healthdescription.com/2013/10/21/bacterial-skin-infection-symptoms/
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  • what a nice presentation!
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1.1.1. bacterial infection of skin [compatibility mode]

  1. 1. CommonBacterial Infection of Skin DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  2. 2. The SkinSkin is largest organ of body.Maintains homeostasis, protectsunderlying tissues and organs,protects body from mechanicalinjury, damaging substances, andultraviolet rays of sun. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  3. 3. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  4. 4. Broken skin allows Bacteria to enterDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  5. 5. Unbroken skin prevents entrance of bacteria. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  6. 6. Normal Skin FloraMajor bacterial groups Coryneforms (Gram +ve) Staphylococci (Gram +ve cocci, aerobs)Minor bacterial groups Acinetobacter (25%) Gram –ve Bacilli Micrococcus DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  7. 7. Bacterial Infection of Skin:1. FolliculitisFolliculitis is a localized infection of one hair follicle. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  8. 8. Bacterial folliculitis •Local antiseptics •Cloxacilline 500 mg 4x/d for 10 daysDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  9. 9. folliculitisDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  10. 10. FolliculitsDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  11. 11. Management of folliculitisAvoid greasy applications on theskin.Antibiotic: topically can be used.Systemic antibiotics: - Cloxacillinor erythromycin (Cefadox) ischoices of treatment. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  12. 12. FolliculitisDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  13. 13. Superficial folliculitisDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  14. 14. Deep folliculitisChronicStaph. AureusHair follicles of leg: CommonMultipleAtrophic scarMay become chronic especiallyin beard area (sycosis barbae)DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  15. 15. 2. Furuncle/BoilsA furuncle is an infection deep within the hairfollicle.A furuncle or boil is an acute round,tender, circumscribed, perifollicularstaphylococcal inflammation, whichgenerally tends to suppurate. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  16. 16. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  17. 17. Boils/ FuruncleBoils (also called furuncles) are a deep infection of hair follicles.DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  18. 18. Furuncle (Boil)Acute Staph. Aureus Small, follicular nodular-Pustule-necrotic- discharge pus Heal with scar formation Neck, Wrist, Waist, Buttocks, Face PainfulComplication Thrombosis Septicemia (esp. on malnutrition patients) DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  19. 19. Treatment: General measuresPreventive measures are very important especiallyto prevent recurrence of infection from nasal foci,autoinoculation, from peri-anal areas.Avoid squeezing, irritation and trauma to the lesions.Treatment of the colonized areas and the primary focusas in nostrils.Topical antibacterial cream such as Muperacin creamwhich when applied twice daily in the nostril for oneweek will eradicate colonized micro-organism for 6months.Using a suitable anti septic soap may have some goodeffect. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  20. 20. 3. CarbuncleA carbuncle is an infection involvingsubcutaneous tissue around several hairfollicles. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  21. 21. CarbuncleExtensive infection of a group ofcontagious folliclesStaph. AureusMiddle or old agePredisposing factors Diabetes Malnutuition Severe generalized dermatoses During prolonged steroid therapy DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  22. 22. CarbuncleDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  23. 23. Carbuncle Painful Suppuration begins after 5-7 days Pus discharge from multiple follicular orificies Necrosis of intervening skin Large deep ulcer DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  24. 24. 4. Impetigo: Superficial skin infection .DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  25. 25. Impetigo is a bacterial skin infection.It is often called school soresbecause, it most often affectschildren.It is quite contagious. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  26. 26. Impetigo Vesiculopustular skin infection. Bacterial: staphylococcus or streptococcus Spread w/ direct contact w/ lesions Thick, yellow crust (commonly on the face)DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  27. 27. Impetigo S/S - one or more pimple-like lesions surrounded by reddened skin - lesions fill w/ pus and later form a thick crust - itchingInv. : Swab for C/S DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  28. 28. ImpetigoDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  29. 29. Mx:Remove crustLocalized:Topical AntibioticSevere: Systemic antibiotics: Semisynthetic Penicillin : 7-10 d Erythromycine (sensitive) Augmentin (face) Cephalosporin Great care with personal hygiene and possible isolation. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  30. 30. Impetigo •Local antiseptics •Cloxacilline 500 mg 4x/d for 10 days DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  31. 31. 4.1. Non-bullous impetigo Superficial (intraepidermal) Initially vesicular, then becomes crusted S. pyogenes (90%); also S. aureus Mainly children; highly communicable DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  32. 32. Nonbullous impetigoDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  33. 33. 4.2. Bullous impetigo Mainly newborn and younger children About 10% of all cases of impetigo Caused by S. aureus of phage group II DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  34. 34. Bullous impetigoDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  35. 35. Predisposing factors Malnutrition Diabetes Immuno-compromise status DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  36. 36. Impetigo: ManagementLocal management for small lesions: -Wash with betadine solution or saline.Potassium permanganate 1 in 1000solution soaking twice a day until the pusexudates dry up.Gentian violet (GV) paint 0.5% apply BID.Topical antibiotics can be used, such as2% mupirocin, Gentamycine, Fucidic acidcan be used but costly. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  37. 37. Oral amoxacyllin or Ampicillin can also beused.For Bullous impetigo: - cloxacillin 500 mg poQID for 7 to 10 days. In cases, with an allergyto penicillin, erythromycin can be given.The underlining skin conditions such aseczemas, scabies, fungal infection, orpediculosis should be treated.When impetigo is neglected it becomesecthyma, a superficial infection which involvesthe upper dermis which may heal forming ascar. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  38. 38. 5. PeriporitisMiliary papules and papulovesicles withstaphylococcic infection.Pustular lesions.The commonest sites involved are the buttocks,upper part of the trunk and the scalp.The lesion affects mainly malnourished infants andyoung children.Skin lesions may progress to sweat glandabscesses. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  39. 39. RxTreatment is directed towards improving thenutrition and general condition.Preventing sweat retention by aeration.Appropriate topical antibiotic may be enoughto control periporitis.Oral antibiotics may be needed, especiallywhen there are multiple abscesses. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  40. 40. 6. EcthymaFormation of adherent dry crusts,beneath which ulcer presentStrptococcal & staphCommon in childrenSmall bullae or pustulesButocks, thighs and legs, commonlyaffectedHeals with scar and pigementationDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  41. 41. EcthymaDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  42. 42. 7. Sycosis BarbaePustules surrounded by erythemain Beard regionCommon in MalesAfter pubertyAfter traumasUpper lip and chinStaph. auraus common DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  43. 43. Sycosis barbaeDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  44. 44. 8. CellulitisAcute / Sub-acute / Chronicinflammation of loose connective tissueStreptococcal (Group A), Staphylococciand rarely clostridia.Erythematous & oedematous swellingPain/tenderness DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  45. 45. CellulitisDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  46. 46. CellulitisAn acute spreading infectioninvolving the dermisSpread: tissue damage,lowered body defenses, orvirulence of invading organism.DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  47. 47. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  48. 48. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  49. 49. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  50. 50. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  51. 51. CellulitisRed, painful, hot, swollen skin area with ill-defined borders.Deeper involvement of the SubcutaneousRaised, hot, tender, erythematousSource: Cut , abrasion or ulcerPalpable, tender LNFever, leucocytosisDifferential Diagnosis: DVTDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  52. 52. DR. Ram Sharan Mehta, MSND,CON, BPKIHS
  53. 53. MxCold application: to relief local discomfortAnalgesic to relief painTreat the fever and pain and elevate theaffected part.Crystalline penicillin or procaine penicillin isthe first line therapy and oral Ampicillin orAmoxicillin may be used for mild infectionand after the acute phase resolves.Appropriate Antibiotic, according to culture:Erythromycin, Augmentin. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  54. 54. 9. ERYSIPELASSuperficial Cellulitis caused by group A β-hemolyticstreptococcus.Usually begins on the face or a lower extremityHaving pain, superficial erythema, and plaque-likeedema with a sharply defined margin to normaltissueFever may precede local signsBoarder easily palpableEarly Stage of Cellulitis? DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  55. 55. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  56. 56. Erysipelas is a type ofcellulites involving mainly thedermis; other forms ofcellulites extend to thesubcutaneous tissues. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  57. 57. ErysipelasDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  58. 58. ErysipelasDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  59. 59. 10. Pyonychia Acute Erythmatous swelling of proximal and lateral nail fold Painful Rx: Drain Pus, Antibiotic, AnalgesicDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  60. 60. PyonychiaDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  61. 61. PyonychiaDR. Ram Sharan Mehta, MSND, CON,BPKIHS
  62. 62. 11. Staphylococcal scalded skin syndrome (Ritter’s disease) A severe reaction to S. aureus strains producing toxins Large, flaccid bullae rupture, causing same effect as a third-degree burn Scald – tender red skin Denuded skin (necked skin) Heals 7-14 day DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  63. 63. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  64. 64. Staphylococcal scalded-skin syndrome DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  65. 65. Complication 2% Cellulitis PneumoniaDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  66. 66. 12. ErysipeloidIt is bacterial infection seen in people who handleraw meat (especially pork) and Fish. Organism get entry through breaks in the skin.Common on fingers, hand or forearms.No systemic symptomsThe main symptom is warmth, tenderness, andredness on the skin.Rx: Penicilline-V or Oxytetracycline 500 mg QID7-10 days DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  67. 67. 13. Principles of therapy of pyodermaGood personla hygieneLocal therapy Cleaning with soap-water and weak KMN04 solution Removal of crusts with KMN04 solution Application of antibacterial creamSystemic therapy Antibiotics DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  68. 68. Management of predisposing factors Local Attend to traumas, pressure Treat pre-existing dermatosis Investigate carrier sites Systemic Treatment of disease like DM, Nutritional deficiency and immunodeficiency DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  69. 69. 14. Common Diagnostic Tests for Integumentary Disorders Biopsy. Patch Testing: Allergy test Tzanck smear: detect type of cells in Chicken Pox, H. simplex, H. Zoster, Bullous diseases Skin scrapings. Culture and sensitivity. Diascopy: visualization by special microscope Wood’s light examination: Use of U.V. rays DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  70. 70. 15DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  71. 71. 16. Prevention and control of Bacterial skin diseasesPersonal hygiene is the most effectivemethods for prevention and control ofbacterial infections.The following points illustrate the possiblepreventive methods for bacterial skin infections: Washing of hands with warm water and soapbefore touching broken skin.Washing the body with warm water and soappreferably everyday to remove dust and dirt. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  72. 72. Prevention and control of Bacterial skindiseases………………… Wearing the right size and type of clothes to suit local weather conditions. After washing clothes, if possible, iron it before wearing Regular exposure of the skin to air and sunlight is beneficial. It is also important to clear the bacteria colonizing the nostrils and under the fingernails with either antibiotic ointment or petroleum jelly several times daily for one week of eachMSND, CON, BPKIHS DR. Ram Sharan Mehta, month.
  73. 73. Methods of Preventing Long Term Skin DamageAvoid sunAvoid midday sunUse photo-protective clothing,hats etcUse sunblocksDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  74. 74. 17. Practice in BPKIHS: Derma OPD COMMON BACTERIAL INFECTIONS ARE: Periporitis Impetigo (Non-bullous common) Absces Cellulitis Folliculitis STIs DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  75. 75. Rx Prescribe:1. Antibiotics: a. Topical: Mupirocin, Fucidic acid b. Oral: Cefadox, Cloxacyline2. Personal hygiene teaching3. Symptomatic managementDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  76. 76. Summary: Common Bacterial Infections1. Folliculitis: Localized infection of one hair follicles.2. Furnicle/Boil: Deep hair follicle infection.3. Carbuncle: Several hair follicle infection.4. Impetigo: superficial skin infection.5. Periporitis: Millary and papulovesicles infection.6. Ecthyma: Formation of adherent dry crusts.7. Sycosis Barbae: Pustules in beard region.8. Cellulitis: Loose connective tissue infection.9. Erysipelas: Superficial cutaneous cellulitis.10. Pyonochia: Swelling of nail fold. DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  77. 77. 11. Staphylococcal Scalded Skin Syndrome: RT exfoliative toxins.12. Erysipeloid : Bacterial infection among meat handlers.13. Principles of therapy of pyoderma.14. Common diagnostic tests for derma disorders.15. Common antibiotic used in skin disorders16.Prevention and control of Bacterial skin infection.17. Practices in BPKIHS derma OPD DR. Ram Sharan Mehta, MSND, CON, BPKIHS
  78. 78. Thank youDR. Ram Sharan Mehta, MSND, CON, BPKIHS
  79. 79. MACROSCOPIC TERMSMacule: Circumscribed lesion of up to 5 mm in diameter characterized byflatness and usually discolored (often red)Patch: Circumscribed lesion of more than 5 mm in diameter characterized byflatness and usually discolored (often red)Papule: Elevated dome-shaped or flat-topped lesion 5 mm or less across.Nodule: Elevated lesion with spherical contour greater than 5 mm across.Plaque: Elevated flat-topped lesion, usually greater than 5 mm across (may becaused by coalescent papules).Vesicle: Fluid-filled raised lesion 5 mm or less across.Bulla: Fluid-filled raised lesion greater than 5 mm across.Blister: Common term used for vesicle or bulla.Pustule: Discrete, pus-filled, raised lesion.Wheal: Itchy, transient, elevated lesion with variable blanching and erythemaformed as the result of dermal edema.Scale: Dry, horny, platelike excrescence; usually the result of imperfectcornification (i.e., keratinization).Lichenification: Thickened and rough skin characterized by prominent skinmarkings; usually the result of repeated rubbing in susceptible persons.Excoriation: Traumatic lesion characterized by breakage of the epidermis,causing DR. Ramlinear Mehta, MSND,a deep scratch) a raw Sharan area (i.e., CON, BPKIHSOnycholysis: Separation of nail plate from nail bed.
  80. 80. MICROSCOPIC TERMS (histologic)Hyperkeratosis: Thickening of the stratum corneum, often associated with a qualitativeabnormality of the keratin.Parakeratosis: Modes of keratinization characterized by the retention of the nuclei inthe stratum corneum. On mucous membranes, parakeratosis is normal.Hypergranulosis: Hyperplasia of the stratum granulosum, often due to intense rubbing.Acanthosis: Diffuse epidermal hyperplasia.Papillomatosis: Surface elevation caused by hyperplasia and enlargement ofcontiguous dermal papillae.Dyskeratosis: Abnormal keratinization occurring prematurely within individual cells orgroups of cells below the stratum granulosum. Generally the same as DYSPLASIA.Acantholysis: Loss of intercellular connections resulting in loss of cohesion betweenkeratinocytes.Spongiosis: Intercellular edema of the epidermis.Hydropic swelling (ballooning): Intracellular edema of keratinocytes.Exocytosis: Infiltration of the epidermis by inflammatory or circulating blood cells.Erosion: Discontinuity of the skin exhibiting incomplete loss of the epidermis.Ulceration: Discontinuity of the skin exhibiting complete loss of the epidermis and oftenof portions of the dermis and even subcutaneous fat.Vacuolization: Formation of vacuoles within or adjacent to cells; often refers to basalcell-basement membrane zone area.Lentiginous: Referring to a linear pattern of melanocyte proliferation within theepidermal basal cell layer. Lentiginous melanocytic hyperplasia can occur as a reactivechange or as part of a neoplasm ofCON, BPKIHS DR. Ram Sharan Mehta, MSND, melanocytes.

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