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Dermatology

Dermatology. Anatomy. Skin Infections. Bacterial Impetigo Folliculitis Furuncle Carbuncle Cellulitis Acne Fungal /Parasitic Tinea Pedis Tinea Cruris Tinea Versicolor Tinea Corporis Toenail fungus Pediculosis Scabies. Skin Infections. Viral Herpes Simplex Herpes Zoster Verruca

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Dermatology

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  1. Dermatology

  2. Anatomy

  3. Skin Infections • Bacterial • Impetigo • Folliculitis • Furuncle • Carbuncle • Cellulitis • Acne • Fungal /Parasitic • Tinea Pedis • Tinea Cruris • Tinea Versicolor • Tinea Corporis • Toenail fungus • Pediculosis • Scabies

  4. Skin Infections • Viral • Herpes Simplex • Herpes Zoster • Verruca • Molluscum Contagiosum • Allergic/Irritation conditions • Dermatitis • Hives • Eczema • Psoriasis • Sebacous Cysts • Frostbite • Other • Skin checks - moles • Sunburn • Striae

  5. Impetigo

  6. Impetigo • Superficial bacterial infection of the skin • Most commonly Staph or Strep • Thin vesicles with honey colored crusting • Usually on face, hands, neck & extremities • Spread occurs via contact from fingers, towels, clothing • Tx: Topical antibiotics, severe infections need oral

  7. Folliculitis

  8. Folliculitis • Superficial or deep infection of the hair follicle (Barbae, hot tub) • Usually result of Staph infection • May also occur as a result of contact/plugging with oil, dirt, sweat, etc • Rash appears as small, dome shaped yellow pustules with a hair shaft in the center • Tx: good hygiene, topical antibotics

  9. Furuncle

  10. Furuncle (Boil) • Deep extension of superficial folliculitis into the dermis and subcutaneous tissue • Cause – Staph • 1-5 cm red/tender nodule which may contain pus • Tx: • Simple lesions- warm compress • Severe infections – drainage & antibiotics

  11. Carbuncle

  12. Carbuncle • Large deep abscess that is a progression of a furuncle • May be 3-10 cm in size • Can present c fever/chills • Tx: drainage & antibiotics

  13. Cellulitis

  14. Cellulitis • An acute inflammation of the skin • S/S: redness, swelling, warmth, & tenderness of affected area within 1-2 days of injury • Cause Staph or Strep, complication of wound/trauma • The borders are well defined and change rapidly • Immediate attention (blood test, IV antibiotics) • Facial cellulitis can cause visual damage if spreads to the eyes • NEVER MISS THIS ONE!!!!

  15. Acne

  16. Acne • Obstruction of sebaceous follicles (oil glands) • Open comedones or closed comedones • Usually on the face, chest, back • Causes: • Stressful events (hormonal changes) • Friction acne • Oil based cosmetics • NO correlation between chocolate, chips or colas • Tx: topical +/or oral antibiotics

  17. MRSA

  18. MRSA • Methicillin-resistant Staphylococcus aureus • “super-bug” – caused by staph, unnecessary antibiotic use • Outwits all but the most powerful of drugs – vancomycin • Enters through cuts & wounds • Types: CA (community acquired) or HA (Hospital acquired) • S/S: small red bumps that resememble pimples, quicky turn to painful abscesses that can burrow deep into the body, swelling, redness, pus • Risk Factors: recent hospitalization, long-term care, recent antiobiotic use, young age, contact sports, sharing towels, weak immune system, living in groups, health-care workers • Dx: Tissue sample – 48hrs • Tx: trial & error c strong antiobiotics • Prevention: WASH HANDS, surfaces, cover wounds, use only personal items

  19. Tinea Pedis

  20. Tinea Pedis • Fungal infection - Athlete’s Foot • Rash presents as vesicles/erosions on the soles of the foot as well as between toes • Dx: examine scraping under microscope • Tx: antifungal cream/powders (micronazole), keep feet dry

  21. Tinea Cruris

  22. Tinea Cruris • Fungal infection – Jock itch • Red/scaly rash on inner thighs/inguinal creases; occasionally the buttock, not scrotum or labia • Common in obese patients & athletes in tight fitting clothes • Common in hot/humid weather • Tx: topical antifungal creams

  23. Tinea Versicolor

  24. Tinea Versicolor • Fungal infection of the skin • Multiple patchy lesions (oval shape c fine scales) either light in color or brown • Typically occurs on the back, neck, chest, shoulders • More prominent in the summer when the affected areas do not tan • Recurrence is common • Tx: Topical antifungal

  25. Tinea Corporis

  26. Tinea Corporis • Fungal infection of skin - Ring Worm • Well defined circular patches with scaly borders • Found on non-hairy surfaces – face, arms, legs, truck • Occurs after contact c another person/object that is carrying the fungus • Common confused c eczema • Tx: topical antifungals (Micronazole, ketoconazole not Nystatin)

  27. Toenail Fungus

  28. Toenail Fungus • S/S:yellow, think nails, painful, brittle, more likely in toenails d/t dark, moist environment • Tx: Lamisil, vicks, takes 6-12 months

  29. Pediculosis

  30. Pediculosis • Lice; six-legged wingless insect • The louse is a grayish/black colored insect ~4mm long • The nits are gelatinous white color ~.8mm long • Can be found in the head, body or pubic hair • They pierce the skin and secrete saliva which causes itching, lay eggs close to scalp • Spread by shared hats, towels, combs, bedding, clothing, upholstery & headphones • Tx: Shampoo – Nix, Rid; fine tooth comb, boil clothing/bedding, dry cleaning

  31. Scabies • Very contagious STD • Intense itchy rash, with linear burrows • Tx: Kwell or Elimite (topical creams) • Wash bedding/clothing in HOT water & stored for 2-3 days

  32. Herpes Simplex

  33. Herpes Simplex • Viral infection either Type I OR Type II • “You can’t kill it and it won’t kill you” • Clear papules c superficial ulcerations/erosions • May cause fever, lymph node enlargement, burning pain • Lesions will crust over in 5-14 days • Tx: analgesic for pain, oral antiviral (acyclovir)

  34. Herpes Zoster

  35. Herpes Zoster • Shingles, a reactivation of varicella zoster (Chicken pox) virus • It remains in the cells of nerve roots in an inactive state (after exposure as a youth) • Unknown reasons for reactivation • Re-exposure to virus • Immunosuppressant issue • Some drugs • Result in vesicles on a red base in a band-like distribution • Painful rash, prickly nerve pain • Tx: symptomatic, pain, calamine lotion

  36. Verruca

  37. Verruca • Warts; caused by human papillomavirus • Verruca plantaris – • Verruca vulgaris – • Round, flesh colored and grow to be yellow-ish tan • 1cm or more wide • 65% will resolve spontaneously • Tx: destruction of epidermal cells that contain virus; cryogenically, chemically

  38. Molluscum Contagiosum

  39. Molluscum Contagiosum • Viral infection of skin/mucous membrane • Single or multiple flesh colored, dome shaped papules c central umbilication • Found on face, trunk, extremities, lips/tongue, genitals • Very contagious – self and others • Common in swimmers/wrestlers • Tx: curettage, silver nitrate to chemically burn the lesions

  40. Dermatitis

  41. Dermatitis • Inflammation of the superficial dermis/epidermis • Atopic Dermatitis: • Heriditary disorder – may also have Hx of asthma, allergic rhinitis, rash • Usually along cheeks, face, trunk, extensor surfaces of extremities • Dry and papular rash, scratching makes it worse, d/t loss of natural oils in skin • Aggravated by stress, anxiety, dry conditions • Tx: good lotions & rehydration of skin • Contact Dermatitis: • Papular and itchy rash resulting from contact c an allergen • Commonly – nickel (cheap jewelry, buckles), soaps, perfumes, cosmetics, posion ivy/oak • Tx: Cortisone cream (anti-inflammatory agent)

  42. Hives

  43. Hives • An allergic reaction resulting in histamine release • Well defined wheals (solid elevations c central clearing) • Extremely itchy & may result in angioedema • Allergy can be to virtually anything • Tx: antihistamines

  44. Eczema

  45. Eczema • Dryness of the epidermis • Usually seen on extremities/trunk • Worse in winter or when bath too much • Rash is itchy, red, scaly, patchy c a cracked appearance • 2ndary bacterial infections d/t scratching • Tx: lotion/creams to hydrate, topical corticosteroids

  46. Proper Skin Care • Frequency of showers • Not so much soap/appropriate type • Use creams, not lotions

  47. Psoriasis

  48. Psoriasis • Inherited skin disorder of increased epidermal cell turnover & thickening of the epidermis • Thick silvery scales • Common on the elbows, knees & feet • Tx: • UV light or high potency corticosteroids • Severe cases need to be hospitalized for a tar ointment or methotrexate

  49. Sebaceous Cysts

  50. Sebaceous Cysts • Solitary skin nodules as a result of proliferation of epidermal cells that secrete protein called keratin • Contains pasty, cheesy looking secretion • Common on eyelids, neck, face, trunk, scalp • Benign slow growing lesions • No treatment necessary unless problems c ADLs

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