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INFECTIONS and INFESTATIONS

INFECTIONS and INFESTATIONS. Dr. D. Czarnecki MD MBBS. Infections. Folliculitis Pustules and papules scattered across the shin This case was caused by using plastic occlusion on a glucocorticosteroid cream. Infections. Folliculitis

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INFECTIONS and INFESTATIONS

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  1. INFECTIONS and INFESTATIONS Dr. D. Czarnecki MD MBBS

  2. Infections • Folliculitis • Pustules and papules scattered across the shin • This case was caused by using plastic occlusion on a glucocorticosteroid cream

  3. Infections • Folliculitis • An out break of folliculitis was reported after hot tubs became fashionable. Poor maintenance allowed pseudomonas to proliferate and infect the follicles of those who used the tubs.

  4. Infections • Cellulitis • The infection is spreading through the skin. It is indurated, red, hot, and sore. • This case was a wound infection developing after surgery for skin cancer

  5. Infections • Erysipelas • The infection is spreading through the outer layer of the skin. • It is indurated, red, hot, and sore.

  6. Infections • Lymphangitis • The infection is spreading through the lymphatics. • It is indurated, red, hot, and sore.

  7. Infections • An abscess • A localized collection of pus. • It is indurated, red, hot, and sore. • Surgical drainage is indicated.

  8. Infections • Tinea • There is a raised edge and a clearing centre. • You must look at the feet. • Topical therapy on its own may be adequate.

  9. Infections • Tinea • There is a raised edge and a clearing centre. • You must look at the feet. • You must take scrapings for fungal culture – before prescribing antifungal agents.

  10. Infections • Tines (ringworm) • The is a raised edge • The centre is red and scaly because a glucocorticosteroid cream was used in error (tinea incognito) • The nails are the source of infection

  11. Tinea nails There is yellow-white discolouration and the nails are ‘crumbling’

  12. Infections • Tines (ringworm) • Hair loss, inflammation and scaling • There may be fluorescence under a Woods lamp • Gently pull out some hair for fungal culture

  13. Infections • Tines (ringworm) • The annular lesions have a raised edge with a clearing centre • This case was caused by Micosporum canis (from the cat)

  14. Infections • Scabies • There are burrows – silvery tracts in the skin. • The mite can be seen in scrapings taken from a burrow.

  15. Infections • Scabies • A mite is visible. • Skin scrapings are taken from a burrow, potassium hydroxide is added ant then this is examined under a microscope confirm the diagnosis.

  16. Infections • Post scabetic papules • Itchy papules on the penis are scabies until proved otherwise. • A hypersensitivity reaction to the mite is believed to be the cause. Intralesional triamcinolone is an effective treatment.

  17. Scabies Itchy papules on the penis are scabies until proved otherwise.

  18. A louse crawling along the hair

  19. Infections • Herpes simplex (HS) • The grouped blisters have ruptured to leave erosions • Type II HS has a predilection for the genitalia

  20. Herpes virus enters the skin Blisters on the surface – the immune system can kill the virus Travels along the axon The immune system cannot kill the virus in the axon Lies dormant in the nerve body Is activated, travels along the axon to the surface

  21. Infections • Herpes simplex (HS) lies dormant in the ganglion • There is no cure – treat the outbreaks • Topical therapy is ineffective Herpes simplex in a neonate

  22. Infections • Asymptomatic shedding is very common - infective • Beware of vaginal herpes simplex in pregnant women • Swab for herpes, PCR is accurate Herpes simplex in a child The classical scalloped edge

  23. Chicken poxVaricella • The varicella virus • The lesions are at different stages of evolution. • Some are papules, some are vesicles • The virus lies dormant in the dorsal root ganglia

  24. Chicken poxVaricella • Vesicles caused by chicken pox • The lesions are at different stages of evolution. • Some are papules, some are vesicles • The virus can remain dormant for years

  25. Infections • Herpes zoster • This is due to re-activation of the chicken pox virus. • The virus replicates in the nerve body and travels to the surface where is causes the painful eruption Grouped lesions in a dermatomal distribution

  26. Herpetiform • Herpes zoster incidence • 50-9 4.6 / 1000 (5% PHN) • 60-9 6.9 (10%) • 70-9 9.5 (17%) • 80+ 10.9 (20%) • HIV + men - 29.4/1000 • HIV - men - 2/1000 NEONATE with grouped lesions in a dermatomal distribution. Is it zoster?

  27. Infections • Herpes zoster • Some of the lesions are haemorrhagic – a sign that it is a severe case. • The lesions are in various stages of evolution

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