This document provides information about dermatological infections. It begins by explaining that the skin can become infected and that infections have a variety of causes and symptoms, from mild to serious. It then describes the main types of skin infections: bacterial, viral, fungal, and parasitic. For each type, it lists some examples and discusses symptoms and treatment. The document also covers common skin conditions like psoriasis and scabies, explaining their causes, symptoms, diagnosis, and treatment options.

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2. Dermatological Infections
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PRESENTED BY
Dr. Qureshi Jalib

3. DERMATOLOGICAL
INFECTIONS
0 Skin is the largest organ of your body. Its function is to
protect your body from infection. Sometimes the skin itself
becomes infected.
0 Skin infections are caused by a wide variety of germs, and
symptoms can vary from mild to serious. Mild infections
may be treatable with over-the-counter medications and
home remedies, whereas other infections may require
medical attention.
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4. TYPES OF SKIN INFECTIONS
0 The following are four different types of skin infections:
1. Bacterial skin infections
2. Viral skin infections
3. Fungus skin infections
4. Parasitic skin infections
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5. 1. Bacterial skin infections
0 Bacterial skin infections often begin as small, red bumps
that slowly increase in size. Some bacterial infections are
mild and easily treated with topical antibiotics, but other
infections require an oral antibiotic. Different types of
bacterial skin infections include:
0 cellulitis
0 impetigo
0 boils
0 Leprosy
0 The most common bacterial infections are caused by
staphylococcus and streptococcus bacteria.
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6. 2. Viral skin infections
0 Viral skin infections are caused by a virus. These infections
range from mild to severe. Different types of viral
infections include:
0 shingles (herpes zoster)
0 chickenpox
0 warts
0 measles
0 hand, foot, and mouth disease
0 The most common viruses come from one of three groups
of viruses: poxvirus, human papillomavirus, and herpes
virus.
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7. 3. Fungal skin infections
0 These types of skin infections are caused by a fungus and
are most likely to develop in damp areas of the body, such
as the feet or armpit. Some fungal infections aren’t
contagious, and these infections are typically non-life-
threatening.
0 Different types of fungal infections:
0 athlete’s foot
0 yeast infection
0 ringworm
0 nail fungus
0 oral thrush
0 diaper rash
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8. 4. Parasitic skin infection
0 These types of skin infections are caused by a parasite.
These infections can spread beyond the skin to the
bloodstream and organs. A parasitic infection isn’t life-
threatening but can be uncomfortable.
0 Different types of parasitic skin infections include:
0 lice
0 bedbugs
0 scabies
0 cutaneous larva migrans
0 Common causative agents include: Annelida, Arthropods,
Cyanobacteria & Protozoa.
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9. COMMON SYMPTOMS
0 The symptoms of a skin infection also vary depending on the
type. Common symptoms include redness of the skin and a rash.
You may also experience other symptoms, such as itching, pain,
and tenderness.
0 Skin infections can spread beyond the skin and into the
bloodstream. When this happens it can become life-threatening.
0 Signs of a severe infection include:
0 pus
0 blisters
0 skin sloughing, breakdown
0 dark, necrotic-appearing skin, or skin that becomes discolored
and painful
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10. Psoriasis
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11. PSORIASIS
0 Psoriasis is an inflammatory skin disease in which skin cells
replicate at an extremely rapid rate.
0 New skin cells are produced about eight times faster than
normal--over several days instead of a month.
0 This causes cells to build up on the skin's surface, forming
thick patches, or plaques, of red sores (lesions) covered
with flaky, silvery- white dead skin cells (scales)
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12. 0 People of all ages can get psoriasis, but the early-onset form
of the disease is mostly seen in 16 to 22-year-olds and the
late-onset form strikes those between the ages of 50 and 60.
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13. TYPES OF PSORIASIS
1. Pustular psoriasis : characterized by red and scaly skin
on the palms of the hands and/or feet with tiny pustules.
2. Guttate psoriasis: which often starts in childhood or
young adulthood, is characterized by small, red spots,
mainly on the torso and limbs.
Triggers may be respiratory infections, strep throat,
tonsillitis, stress, injury to the skin, and use of anti-
malarial and beta-blocker medications.
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15. 3. Inverse psoriasis, characterized by bright red, shiny
lesions that appear in skin folds, such as the armpits and
groin area.
4. Erythrodermic psoriasis, characterized by periodic,
fiery redness of the skin and shedding of scales in sheets;
this form of psoriasis, triggered by withdrawal from a
systemic psoriasis treatment, severe sunburn, infection,
and certain medications, requires immediate medical
treatment, because it can lead to severe illness.
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17. EPIDIMEOLOGY
0 Although psoriasis occurs worldwide, its prevalence
varies considerably. In the USA, approximately 2% of
the population is affected. The prevalence of psoriasis
is low in certain ethnic groups such as the Japanese,
and may be absent in aboriginal Australians and
Indians from South America.
0 Psoriasis can present at any age and has been
reported at birth and in older people of advanced age.
The mean age of onset for the first presentation of
psoriasis can range from 15 to 20 years of age, with a
second peak occurring at 55–60 years.
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18. CAUSES
0 The cause of psoriasis is not known, but it is believed to
have a genetic component.
0 Several factors are thought to aggravate psoriasis. These
include stress, excessive alcohol consumption and smoking.
0 Individuals with psoriasis may suffer from depression and
loss of self-esteem.
0 Certain medicines, including lithium salt and beta blockers,
have been reported to trigger or aggravate the disease.
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19. SYMPTOMS
0 Pain
0 Erythema- with in the dermis blood vessels dilate and
increase blood flow to skin causing generalized redness and
heat loss
0 Scaling
0 Pustules inflammatory condition
0 Itching
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20. DIAGNOSIS
0 Skin biopsy
0 Auspitz sign- gentle removal of the silvery scale from a
plaque
0 Routine blood tests viral check of full blood count
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21. TREATMENT
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22. TREATMENT
0 The treatment, which should be carried out in close
collaboration between the patient and the dermatologist,
consists of various treatments used locally on the skin and
taken by mouth. It depends on the patient's age, state of
health and on the nature of the psoriasis.
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23. Topical treatments
0 Moisturizers.
0 Moisturizing creams alone won't heal psoriasis, but they can
reduce itching, scaling and dryness. Moisturizers in an ointment
base are usually more effective than are lighter creams and
lotions.
0 Topical corticosteroids.
0 These drugs are used for treating mild to moderate psoriasis.
They reduce inflammation and relieve itching and may be used
with other treatments.
0 They are usually recommended for sensitive areas, such as your
face or skin folds, and for treating widespread patches of
damaged skin.
0 Long-term use or overuse of strong corticosteroids can cause
thinning of the skin. Topical corticosteroids may stop working
over time.
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24. 0 Salicylic acid.
0 Available over-the-counter and by prescription, salicylic acid
promotes sloughing of dead skin cells and reduces scaling.
Sometimes it's combined with other medications, such as
topical corticosteroids or coal tar, to increase its effectiveness.
0 Vitamin D analogues.
0 These synthetic forms of vitamin D slow skin cell growth.
Calcipotriene (Dovonex) is a prescription cream or solution
containing a vitamin D analogue that treats mild to moderate
psoriasis along with other treatments.
0 Anthralin.
0 This medication helps slow skin cell growth
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25. Oral or injected medications
0 If you have severe psoriasis or it's resistant to other
types of treatment, these drugs may be prescribed.
0 This is known as systemic treatment. Because of
severe side effects, some of these medications are
used for only brief periods and may be alternated
with other forms of treatment.
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26. 0 Retinoids.
0 Related to vitamin A, this group of drugs may help if you have
severe psoriasis that doesn't respond to other therapies. Side
effects may include lip inflammation and hair loss.
0 Methotrexate.
0 Taken orally, methotrexate (Rheumatrex) helps psoriasis by
decreasing the production of skin cells and suppressing
inflammation. It may also slow the progression of psoriatic
arthritis in some people.
0 When used for long periods, it can cause a number of serious
side effects, including severe liver damage and decreased
production of red and white blood cells and platelets.
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27. 0 Cyclosporine.
0 Cyclosporine (Gengraf, Neoral) suppresses the immune
system and is similar to methotrexate in effectiveness,
but can only be taken short-term. Like other
immunosuppressant drugs, cyclosporine increases your
risk of infection and other health problems, including
cancer.
0 Other medications.
0 Thioguanine (Tabloid) and hydroxyurea (Droxia,
Hydrea) are medications that can be used when other
drugs can't be given.
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28. Alternate medicines
0 Aloe vera.
0 Taken from the leaves of the aloe vera plant, aloe extract
cream may reduce redness, scaling, itching and inflammation.
You may need to use the cream several times a day for a
month or more to see any improvements in your skin.
0 Fish oil.
0 Omega-3 fatty acids found in fish oil supplements may reduce
inflammation associated with psoriasis, although results from
studies are mixed. Taking 3 grams or less of fish oil daily is
generally recognized as safe, and you may find it beneficial.
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29. Scabies
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30. SCABIES
0 Scabies is a skin infestation caused by a mite known as the
Sarcoptes scabiei. Untreated, these microscopic mites can
live on your skin for months. They reproduce on the surface
of your skin and then burrow into it and lay eggs. This
causes an itchy, red rash to form on the skin.
0 There are approximately 130 million cases of scabies in the
world at any given time. It’s a highly contagious condition
that can easily be passed from one person to another
through direct skin contact. It may also be transmitted
through infested clothing or bedding.
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33. EPIDIMEOLOGY
0 Scabies is 1 of the 6 major epidermal parasitic skin
diseases (EPSD) that is prevalent in resource-poor
populations, as reported in the Bulletin of the World Health
Organization in February 2009.
0 Prevalence rates are extremely high in aboriginal tribes in
Australia, Africa, South America, and other developing
regions of the world.
0 In 2009 retrospective study of 30,000 children in India,
scabies was found to be the second most common skin
disease in all age groups of children, and the third most
common skin disease in infants
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34. SYMPTOMS
0 After the initial exposure to scabies, it can take up to six
weeks for symptoms to appear. The symptoms usually
develop more quickly in people who’ve had scabies before.
0 The hallmark symptoms of scabies include a rash and
intense itching that gets worse at night. Continuous
scratching of the infected area can create sores that become
infected. If this occurs, additional treatment with antibiotics
for the skin infection may be recommended.
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35. 0 Scabies rash can appear on any part of the body, but the
most common sites are wrists, elbows, armpits, the skin
between the fingers and toes and around the nails, and skin
usually covered by clothing.
0 Infants and young children may have scabies rash on their
head, face, neck, palms, and soles.
0 In some patients with weakened immune systems, scabies
rash may become crusted.
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36. Norwegian scabies
0 Some people with scabies may develop another form of
scabies known as Norwegian scabies, or crusted scabies.
This is a more severe and extremely contagious type of
scabies. People with crusted scabies develop thick crusts of
skin that contain thousands of mites and eggs.
0 Crusted scabies can also appear:
0 thick
0 gray
0 easy to crumble when touched
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37. 0 Crusted scabies usually develops in people with
weakened immune systems. This includes people with
HIV or AIDS, people who use steroids or certain
medications (such as some for rheumatoid arthritis),
or people who are undergoing chemotherapy.
0 The scabies mites can overpower the immune system
more easily and multiply at a quicker rate. Crusted
scabies spreads in the same way as normal scabies.
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39. How Do You Get Scabies?
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40. 0 Anyone can get scabies.
0 It is found all over the world and the mite is transmitted by
direct and prolonged skin-to-skin contact with a person
who has scabies.
0 Transmission can also happen from parents to children,
particularly mother-to-infant.
0 The mite can only survive about 48 to 72 hours without
human contact, so it is uncommon, though possible, for
scabies to spread through infested bedding or furniture.
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41. DIAGNOSIS
0 Scabies is usually diagnosed by the patient's history and a
physical examination of the lesions (bumps). Other tests
that may be done include:
0 Skin scraping to identify the mites or eggs
0 Dermoscopy, which uses a handheld dermoscope to allow
closer visual examination of the skin to look for mites
0 Adhesive tape test in which a doctor uses strong adhesive
tape applied to the skin lesions and then pulled off and
viewed under a microscope to check for mites
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42. 0 Differential diagnosis:
Symptoms of early scabies infestation mirror other skin
diseases, including dermatitis, syphilis, various urticaria-
related syndromes, allergic reactions, and other
ectoparasites such as lice and fleas .
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43. TREATMENT
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44. TREATMENT
0 There are no over-the-counter approved treatments for
scabies.
0 A first-line treatment for scabies may involve a topical
cream, such as permethrin (Elimite), which is applied
directly to the skin, from the neck to the soles of the feet. It
should be left on overnight and then washed off 8 to 14
hours later. Usually a second application after 1 to 2 weeks
is recommended.
0 Other topical scabies treatments include sulfur ointment,
and benzyl benzoate.
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45. 0 Treatment for scabies usually involves getting rid of the
infestation with prescription ointments, creams, and lotions
that can be applied directly to the skin. Oral medications are
also available.
0 According to the American Academy of Dermatologists,
some common medicines used to treat scabies include:
0 5 percent permethrin cream
0 25 percent benzyl benzoate lotion
0 10 percent sulfur ointment
0 10 percent crotamiton cream
0 1 percent lindane lotion
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46. 0 Your doctor may also prescribe additional medications to
help relieve some of the bothersome symptoms associated
with scabies. These medications include:
0 antihistamines, such as Benadryl or pramoxine lotion to help
control the itching
0 antibiotics to kill any infections that develop as a result of
constantly scratching your skin
0 steroid creams to relieve swelling and itching
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47. 0 More aggressive treatment may be needed for severe
or widespread scabies. An oral tablet called
ivermectin (Stromectol) can be given to people who:
0 don’t see an improvement in symptoms after initial
treatment
0 have crusted scabies
0 have scabies that covers most of the body
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48. 0 During the first week of treatment, it may seem as if the
symptoms are getting worse. However, after the first week,
you’ll notice less itching, and you should be completely
healed by the fourth week of treatment.
0 Skin that hasn’t healed within a month may still be infested
with scabies mites. It’s important to remember that “post-
scabies itch” can last up to one month.
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