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Skin infections
Shayan behnammanesh
1/3/2015
 Skin is one the most and is the first line agaisnt
bacterial infections.
 The most common cause of skin and soft tissue
infection involves a breach in this barrier.
 These
conditions are
different in
depth and
extent of skin
involvment.
Different types
 Non bullous impetigo bullous impetigo
impetigo
 Common causes of alterations in the normal skin
flora:
 Abrasions
 Trauma
 Insect bite
 Eczema
 Scabies
impetigo
Most common cause:
1- group A hemolytic streptococci
2-staphylococcus aureus
Bullous vs. non bullous
 Good skin hygiene+ removal of crusted lesions in non
bullous type.
 Topical if lesions are local (<5), if the lesions are not
local or there is fever and regional lymphadenopathy
use systemic antibiotics.
 Topical: mupirocin tds for 3 to 5 days
 Systemic: cephalexin 250-500 qid
 Systemic mrsa: Clindamycin 300-450 qid
Management
 Infections
involving upper
dermis
 Distinct margins.
 b-hemolytic strep
is the main cause.
Erysipelas
 Management:
 Elevation if applicable
 Control predisposing conditions
 Hydrate the skin
 Compression stocking and diuretic therapy to improve edema
Erysipelas
 Oral therapy: amoxicillin 500mg tds
 Parenteral therapy: Ceftriaxone 1g iv daily
 Improvement in 24 to 72 hrs.
Erysipelas
 Infection of
deeper dermis
and
subcutaneous
fat.
 The most
common cause:
1- S aureus(50%)
2-GAS(27%)
cellulitis
 History and exam:
 Localized erythema and confluent
 Blanching and swelling
 Warmth
 Tenderness
 Lymphangitis with tender regional lymphadenopathy
cellulitis
 History and physical exam:
 Determine the extent of disease.
 Search for breaches and fungal infections.
 Mark the affected area.
 Purulent or non purulent???
Cellulitis
And classify the severity of cellulitis:
cellulitis
 Risk factors for MRSA:
 Recent hospitalization
 Recent antiobiotic therapy
 Hemodialysis
 Military service
 Daibetes
 Hiv
 Injection drug
 Prolonged hospitalization
cellulitis

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Skin infections

  • 2.  Skin is one the most and is the first line agaisnt bacterial infections.  The most common cause of skin and soft tissue infection involves a breach in this barrier.
  • 3.  These conditions are different in depth and extent of skin involvment. Different types
  • 4.  Non bullous impetigo bullous impetigo impetigo
  • 5.  Common causes of alterations in the normal skin flora:  Abrasions  Trauma  Insect bite  Eczema  Scabies impetigo Most common cause: 1- group A hemolytic streptococci 2-staphylococcus aureus
  • 6. Bullous vs. non bullous
  • 7.  Good skin hygiene+ removal of crusted lesions in non bullous type.  Topical if lesions are local (<5), if the lesions are not local or there is fever and regional lymphadenopathy use systemic antibiotics.  Topical: mupirocin tds for 3 to 5 days  Systemic: cephalexin 250-500 qid  Systemic mrsa: Clindamycin 300-450 qid Management
  • 8.  Infections involving upper dermis  Distinct margins.  b-hemolytic strep is the main cause. Erysipelas
  • 9.  Management:  Elevation if applicable  Control predisposing conditions  Hydrate the skin  Compression stocking and diuretic therapy to improve edema Erysipelas
  • 10.  Oral therapy: amoxicillin 500mg tds  Parenteral therapy: Ceftriaxone 1g iv daily  Improvement in 24 to 72 hrs. Erysipelas
  • 11.  Infection of deeper dermis and subcutaneous fat.  The most common cause: 1- S aureus(50%) 2-GAS(27%) cellulitis
  • 12.  History and exam:  Localized erythema and confluent  Blanching and swelling  Warmth  Tenderness  Lymphangitis with tender regional lymphadenopathy cellulitis
  • 13.  History and physical exam:  Determine the extent of disease.  Search for breaches and fungal infections.  Mark the affected area.  Purulent or non purulent??? Cellulitis And classify the severity of cellulitis:
  • 15.  Risk factors for MRSA:  Recent hospitalization  Recent antiobiotic therapy  Hemodialysis  Military service  Daibetes  Hiv  Injection drug  Prolonged hospitalization cellulitis