Infections of the Skin: Furunculosis and Carbuncle
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Questions and Answers

What is the primary bacterial cause of Bullous Impetigo?

  • Streptococcus pyogenes
  • Staphylococcus aureus (correct)
  • Escherichia coli
  • Pseudomonas aeruginosa

    • Staphylococcal Scalded Skin Syndrome is caused by Streptococcus pyogenes.

    False

    Name one common clinical feature of Ecthyma.

    Ulcerated lesions

    Superficial folliculitis is primarily caused by __________.

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Match the following conditions with their characteristics:

    <p>Bullous Impetigo = Blistering skin lesions Staphylococcal Scalded Skin Syndrome = Severe skin peeling Ecthyma = Ulcerative lesions with crusting Superficial Folliculitis = Infection of hair follicles</p> Signup and view all the answers

    What is the primary causative agent of Furunculosis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Erysipelas can enter through a superficial break in the skin.

    <p>True</p> Signup and view all the answers

    What are the common clinical features of a carbuncle?

    <p>Tender, indurated, lobulated plaque discharging pus from multiple openings.</p> Signup and view all the answers

    Furunculosis primarily affects ____________ individuals, particularly in adolescent boys.

    <p>young</p> Signup and view all the answers

    Match the type of bacterial infection with its primary characteristic:

    <p>Furunculosis = 1-2 tender, firm nodules Carbuncle = Superficial infection Erysipelas = Rapidly spreading plaques Superficial Folliculitis = Infection of hair follicles</p> Signup and view all the answers

    Which treatment method is appropriate for chronic or recurrent furunculosis?

    <p>Treat carrier state with topical mupirocin</p> Signup and view all the answers

    Facial erysipelas, if untreated, can lead to fatal complications.

    <p>True</p> Signup and view all the answers

    What condition is characterized by acute erythematous, warm, and indurated plaques?

    <p>Erysipelas</p> Signup and view all the answers

    What is the primary causative agent of Staphylococcal Scalded Skin Syndrome?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Localized lesions in Staphylococcal Scalded Skin Syndrome are treated with systemic antibiotics.

    <p>False</p> Signup and view all the answers

    What are the clinical features of Ecthyma?

    <p>Small bulla or pustule on an erythematous base that forms a crusted plaque.</p> Signup and view all the answers

    In cases of superficial folliculitis, the primary infectious agent is __________.

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Match the condition with its description:

    <p>Bullous Impetigo = Superficial infection presenting with vesicles and crusting Staphylococcal Scalded Skin Syndrome = Peeling of skin in thin sheets, sparing mucous membranes Ecthyma = Deeper infection resulting in painful ulcers Superficial Folliculitis = Dome-shaped follicular pustules on the skin</p> Signup and view all the answers

    Which of the following investigations is typically used to diagnose Staphylococcal infections?

    <p>Gram stain and pus culture</p> Signup and view all the answers

    Mucous membranes are affected in patients with Staphylococcal Scalded Skin Syndrome.

    <p>False</p> Signup and view all the answers

    What is the primary treatment for extensive lesions in Staphylococcal Scalded Skin Syndrome?

    <p>IV antistaphylococcal antibiotics</p> Signup and view all the answers

    Which of the following is a characteristic of deep folliculitis?

    <p>Abscess formation in the dermis</p> Signup and view all the answers

    A carbuncle is a group of interconnected furuncles that lead to a single abscess.

    <p>True</p> Signup and view all the answers

    What is the primary treatment for a carbuncle?

    <p>Incision and drainage</p> Signup and view all the answers

    Deep folliculitis can lead to the formation of a __________, which is a painful and swollen area of skin.

    <p>furuncle</p> Signup and view all the answers

    Match the condition with its description:

    <p>Deep Folliculitis = Characterized by red, swollen, and painful bumps around hair follicles Furunculosis = Multiple furuncles occurring over time Carbuncle = A cluster of boils that form a larger abscess</p> Signup and view all the answers

    Which of the following conditions is primarily caused by Staphylococcus aureus?

    <p>Furunculosis</p> Signup and view all the answers

    Furunculosis most commonly affects adult males.

    <p>False</p> Signup and view all the answers

    What treatment is used for chronic or recurrent furunculosis?

    <p>Appropriate antibiotics and treatment of carrier state with topical mupirocin.</p> Signup and view all the answers

    A carbuncle is a deep infection of contiguous hair follicles caused by __________.

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which clinical feature is common in a carbuncle?

    <p>Lobulated, erythematous plaque</p> Signup and view all the answers

    Match the following conditions with their common symptoms:

    <p>Furunculosis = Tender, firm papules Carbuncle = Indurated, lobulated plaque Erysipelas = Rapidly spreading plaques Folliculitis = Superficial pustules</p> Signup and view all the answers

    Constitutional symptoms such as fever are always present in cases of erysipelas.

    <p>True</p> Signup and view all the answers

    What are the common sites of infection for furunculosis?

    <p>Hair bearing sites such as the face, axillae, buttocks, and perineal region.</p> Signup and view all the answers

    Which of the following is a characteristic feature of deep folliculitis?

    <p>Deep seated, erythematous perifollicular papules and pustules</p> Signup and view all the answers

    Furunculosis primarily affects individuals with poor hygiene.

    <p>True</p> Signup and view all the answers

    Name a common clinical feature of a carbuncle.

    <p>Painful, swollen mass with multiple openings</p> Signup and view all the answers

    In deep folliculitis, the causative agent is primarily __________.

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Match the following conditions to their characteristic features.

    <p>Furunculosis = Painful, localized skin infection Carbuncle = Cluster of boils or abscesses Deep folliculitis = Erythematous perifollicular lesions Ecthyma = Crusted, ulcerative skin lesions</p> Signup and view all the answers

    What is a common treatment for furunculosis?

    <p>Systemic penicillin</p> Signup and view all the answers

    Carbuncles are typically larger and more severe than individual furuncles.

    <p>True</p> Signup and view all the answers

    What are the typical sites for deep folliculitis infections?

    <p>Legs, buttocks, and also areas affected by shaving</p> Signup and view all the answers

    What is a common complication of recurrent cellulitis?

    <p>Lymphedema</p> Signup and view all the answers

    Deep folliculitis can lead to the formation of a carbuncle.

    <p>True</p> Signup and view all the answers

    Name a common treatment for furunculosis.

    <p>Non-steroidal anti-inflammatory drugs</p> Signup and view all the answers

    A fuzzy lesion caused by multiple interconnected furuncles is known as a __________.

    <p>carbuncle</p> Signup and view all the answers

    Match the conditions with their descriptions:

    <p>Furunculosis = Infection of a single hair follicle Carbuncle = Group of interconnected furuncles Deep Folliculitis = Infection of deeper hair follicles Ecthyma = Ulcerative infection of the skin</p> Signup and view all the answers

    Which bacteria is primarily responsible for carbuncle infections?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Constitutional symptoms like fever are always present in cases of furunculosis.

    <p>False</p> Signup and view all the answers

    Name a common site where furunculosis can occur.

    <p>Axillae</p> Signup and view all the answers

    The primary treatment for a carbuncle involves drainage of _____ pockets of pus.

    <p>deep seated</p> Signup and view all the answers

    Match the following conditions with their primary clinical features:

    <p>Furunculosis = 1-2 tender, firm, red nodules Carbuncle = Constitutional symptoms with pus discharge Erysipelas = Rapidly spreading erythematous plaques</p> Signup and view all the answers

    What is a primary clinical feature of erysipelas?

    <p>Acute, erythematous, indurated plaques</p> Signup and view all the answers

    Carbuncles are more frequently seen in adolescent boys than adult males.

    <p>False</p> Signup and view all the answers

    Furunculosis is primarily caused by _____ aureus.

    <p>Staphylococcus</p> Signup and view all the answers

    Which of the following is a primary characteristic of deep folliculitis?

    <p>Deep seated, erythematous perifollicular papules</p> Signup and view all the answers

    Furunculosis primarily affects women more than men.

    <p>False</p> Signup and view all the answers

    What is the main causative agent of furunculosis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    A group of interconnected furuncles is known as a __________.

    <p>carbuncle</p> Signup and view all the answers

    Match the types of folliculitis with their descriptions:

    <p>Superficial folliculitis = Dome shaped follicular pustules Deep folliculitis = Deep seated, erythematous papules Pseudofolliculitis = Post shaving folliculitis in the beard Post waxing folliculitis = Folliculitis after waxing</p> Signup and view all the answers

    What treatment is typically used for superficial folliculitis?

    <p>Topical antibiotics</p> Signup and view all the answers

    The clinical features of a carbuncle include scarring at the site of infection.

    <p>False</p> Signup and view all the answers

    What are the common sites for a carbuncle?

    <p>Buttocks, thighs, legs</p> Signup and view all the answers

    What is the primary method used in diagnosing bacterial skin infections?

    <p>Visual examination of lesions</p> Signup and view all the answers

    Oral antibiotics are only prescribed for mild bacterial infections.

    <p>False</p> Signup and view all the answers

    Name two common bacterial pathogens associated with infections in dermatology.

    <p>Staphylococcus aureus, Streptococcus pyogenes</p> Signup and view all the answers

    The management of deep folliculitis typically involves drainage of __________.

    <p>abscess</p> Signup and view all the answers

    Match the bacterial pathogen with its associated condition:

    <p>Staphylococcus aureus = Impetigo Streptococcus pyogenes = Cellulitis Pseudomonas aeruginosa = Burn infections Propionibacterium acnes = Acne vulgaris</p> Signup and view all the answers

    Which of the following is a common feature of cellulitis?

    <p>Widespread redness, swelling, and warmth</p> Signup and view all the answers

    Isolation is necessary for all bacterial skin infections to prevent transmission.

    <p>False</p> Signup and view all the answers

    What role do antiseptics play in the treatment of bacterial skin infections?

    <p>They help in wound care and infection control.</p> Signup and view all the answers

    What is a common outcome of recurrent cellulitis?

    <p>Lymphedema</p> Signup and view all the answers

    Which factor most significantly predisposes a person to recurrent cellulitis?

    <p>Lymphedema</p> Signup and view all the answers

    Which of the following is a characteristic feature of cellulitis upon clinical examination?

    <p>Erythematous and warm plaques</p> Signup and view all the answers

    What is the primary purpose of limb elevation in treating cellulitis?

    <p>To reduce swelling and relieve pain</p> Signup and view all the answers

    Which treatment is specifically recommended for penicillin sensitive patients experiencing acute cellulitis?

    <p>Parenteral penicillin</p> Signup and view all the answers

    What is a primary characteristic of erysipelas?

    <p>Features sharply defined, rapidly spreading plaques</p> Signup and view all the answers

    Which treatment is recommended for draining carbuncles?

    <p>Surgical incision and drainage</p> Signup and view all the answers

    What is the primary site of infection associated with furunculosis?

    <p>Hair-bearing areas including the axillae</p> Signup and view all the answers

    What type of symptoms are primarily associated with carbuncles?

    <p>Constitutional symptoms with high fever</p> Signup and view all the answers

    Which of the following complications is associated with untreated erysipelas?

    <p>Potentially fatal facial erysipelas</p> Signup and view all the answers

    What characteristic is most notably associated with Impetigo contagiosa lesions?

    <p>They consist of thin-walled blisters that form honey-coloured crusts.</p> Signup and view all the answers

    Which patient group is particularly at risk for developing carbuncles?

    <p>Diabetics and those on steroid therapy</p> Signup and view all the answers

    What complications are associated with untreated Impetigo contagiosa?

    <p>Post streptococcal glomerulonephritis</p> Signup and view all the answers

    What is a significant risk factor for recurrent erysipelas?

    <p>Pre-existing lymphedema or venous stasis</p> Signup and view all the answers

    Which bacterial strain is most frequently implicated in Bullous impetigo?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    What is the typical presentation of lesions in Bullous impetigo?

    <p>Bullae with a turbid collection of fluid without erythema</p> Signup and view all the answers

    What is a distinguishing feature of furuncles?

    <p>One to two tender nodules that discharge pus with necrosis</p> Signup and view all the answers

    What is the key investigative method for diagnosing staphylococcal skin infections?

    <p>Gram stain of exudate and culture of pus</p> Signup and view all the answers

    In which population is Bullous impetigo most frequently observed?

    <p>Infants</p> Signup and view all the answers

    Which feature differentiates Ecthyma from other skin infections?

    <p>It presents with deep ulcers covered by crust.</p> Signup and view all the answers

    What is the appropriate treatment for localized cases of Impetigo?

    <p>Topical antibiotics such as fusidic acid</p> Signup and view all the answers

    What is the most effective initial treatment for extensive lesions in Staphylococcal Scalded Skin Syndrome?

    <p>Intravenous antistaphylococcal antibiotics</p> Signup and view all the answers

    Which clinical feature is typically observed in infants suffering from Staphylococcal Scalded Skin Syndrome?

    <p>Fever and skin tenderness</p> Signup and view all the answers

    What distinguishes deep folliculitis from superficial folliculitis in terms of clinical features?

    <p>Deep seated erythematous perifollicular papules</p> Signup and view all the answers

    In the differential diagnosis of Staphylococcal Scalded Skin Syndrome, which condition is considered?

    <p>Toxic epidermal necrolysis</p> Signup and view all the answers

    Which of the following is a predisposing factor for Ecthyma?

    <p>Minor injuries</p> Signup and view all the answers

    What type of antibiotics is typically used for treating superficial folliculitis caused by Staphylococcus aureus?

    <p>Topical antibiotics</p> Signup and view all the answers

    What is a common clinical presentation of ecthyma infections?

    <p>Irregular ulcers without crusts</p> Signup and view all the answers

    Which site is commonly affected by superficial folliculitis?

    <p>Legs and beard region</p> Signup and view all the answers

    What condition is least likely to result from a bacterial skin infection?

    <p>Respiratory complications</p> Signup and view all the answers

    Which symptom is most characteristic of impetigo?

    <p>Honey-colored crust</p> Signup and view all the answers

    Which treatment option is least effective for a localized bacterial skin infection?

    <p>Cold compresses</p> Signup and view all the answers

    What is a common reason for the occurrence of impetigo in individuals?

    <p>Weakened immune system</p> Signup and view all the answers

    Which of the following is NOT a recommended practice to prevent the spread of bacterial skin infections?

    <p>Sharing personal hygiene products</p> Signup and view all the answers

    Study Notes

    Furunculosis (Boils)

    • A deep-seated follicular and perifollicular infection caused by Staphylococcus aureus, resulting in necrosis.
    • Common in adolescent boys.
    • Typically presents as 1-2 tender, firm, red, follicular nodules that become necrotic and discharge their central core.
    • Lesions heal with minimal scarring.
    • Occasionally, lymphadenopathy and fever may occur.
    • Sites include hair-bearing areas such as the face, axillae, buttocks, and perineal region.

    Carbuncle

    • Caused by Staphylococcus aureus.
    • A deep infection of contiguous hair follicles, frequently occurring in diabetics and patients on steroid therapy.
    • Common in adult males.
    • Characterized by constitutional symptoms like fever.
    • Presents as a tender, indurated, lobulated, intensely erythematous plaque discharging pus from multiple openings.
    • The back is the most common site of involvement.

    Erysipelas

    • Caused by Streptococcus pyogenes entering through a superficial break in the skin.
    • A superficial infection that recurs if pre-existing lymphedema or venous stasis is present.
    • Acute erythematous, warm, indurated, rapidly spreading plaques with a sharply defined margin. Superficial vesiculation may occur.
    • Constitutional symptoms precede skin lesions.
    • Lower limbs are the most common site, but the upper limbs and face can also be affected.
    • Lymphangitis and lymphedema predispose to recurrent lesions.
    • Facial erysipelas, if left untreated, can be fatal.
    • Complications include staphylococcal scalded skin syndrome.

    Staphylococcal Scalded Skin Syndrome

    • Associated with Staphylococcus aureus infection at various sites such as the ear, lungs, and skin.
    • Occurs primarily in infants.
    • Onset is acute, characterized by fever, skin tenderness, and peeling of skin in thin sheets.
    • Clinically, the skin appears scalded.
    • Mucous membranes are spared.

    Ecthyma

    • A deeper infection caused by Streptococcus pyogenes, Staphylococcus aureus, or both.
    • Predisposing factors include poor hygiene, malnutrition, and minor injuries.
    • Starts as a small bulla or pustule on an erythematous base, forming a crusted, indurated, tender plaque with an erythematous, edematous areola.
    • Removal of adherent crust reveals an irregular ulcer.
    • Lesions heal without scarring.
    • Common sites include the buttocks, thighs, and legs.

    Superficial Folliculitis

    • Three types: infectious, chemical, and mechanical.
    • Infectious type is caused by Staphylococcus aureus.
    • Chemical type is due to occupational or cosmetic exposure.
    • Mechanical type includes pseudofolliculitis (after shaving) in the beard region and post-waxing folliculitis.
    • Presents as dome-shaped follicular pustules.
    • Sites include the legs, beard region (pseudofolliculitis), thighs, and deltoid region (post-waxing folliculitis).

    Deep Folliculitis

    • Caused by Staphylococcus aureus.
    • Deep-seated, erythematous perifollicular papules and pustules.
    • Recurrences are common in the same area.

    Cellulitis

    • Caused by Streptococcus pyogenes entering through a superficial break in the skin.
    • A deeper infection that recurs if pre-existing lymphedema or venous stasis is present.
    • Erythematous, warm, indurated, rapidly spreading plaques with an ill-defined lesion and deeper involvement.
    • Constitutional symptoms precede skin lesions.
    • Lower limbs are the most common site, but the upper limbs and face can also be affected.
    • Lymphangitis and lymphedema predispose to recurrent lesions.
    • Recurrences may result in lymphedema.

    Furunculosis (Boils)

    • Deep seated follicular and perifollicular infection caused by Staphylococcus aureus, leading to necrosis.
    • Usually presents as 1-2 tender, firm, red, follicular nodules that become necrotic and discharge their central core.
    • Most often affects adolescent boys.
    • Lesions typically heal with minimal scarring.
    • May be accompanied by lymphadenopathy and fever.
    • Sites include hair-bearing areas: face, axillae, buttocks, and perineal region.

    Carbuncle

    • Deep infection of contiguous hair follicles caused by Staphylococcus aureus.
    • More common in diabetics and patients on steroid therapy.
    • Primarily affects adult males.
    • Characterized by tender, indurated, lobulated, intensely erythematous plaques with multiple pus-draining openings.
    • Back is the most common site of involvement.
    • Patients experience constitutional symptoms, such as fever.

    Erysipelas

    • Superficial skin infection caused by Streptococcus pyogenes.
    • Bacteria enter through a superficial skin break.
    • Recurrences are common, especially in individuals with pre-existing lymphedema or venous stasis.
    • Presents as acute, erythematous, warm, indurated plaques that spread rapidly.
    • Plaques have sharply defined margins and may exhibit superficial vesiculation.
    • Constitutional symptoms are typical and precede skin lesions.
    • Primarily affects lower limbs, but can also involve upper limbs and face.
    • Lymphangitis and lymphedema can predispose to recurrent lesions.
    • Complications include facial erysipelas (potentially fatal if left untreated), and involvement of mucous membranes.

    Staphylococcal Scalded Skin Syndrome

    • Staphylococcus aureus infection at various sites, including ears (otitis media), lungs (pneumonitis), and skin (minor wounds).
    • Primarily affects infants.
    • Characterized by rapid onset of fever, skin tenderness, and peeling of skin in thin sheets.
    • Skin appears scalded, while mucous membranes are spared.

    Ecthyma

    • Deeper infection caused by Streptococcus pyogenes, Staphylococcus aureus, or both.
    • Predisposing factors include poor hygiene, malnutrition, and minor injuries.
    • Presents as small bullae or pustules on an erythematous base, which quickly form a crusted, indurated, tender plaque with an erythematous, edematous areola.
    • Removal of the crust reveals an irregular ulcer.
    • Lesions usually heal without scarring.
    • Common sites are buttocks, thighs, and legs.

    Superficial Folliculitis

    • Three main types:
      • Infectious (Staphylococcus aureus)
      • Chemical (occupational/cosmetic exposure)
      • Mechanical (pseudofolliculitis after shaving, post-waxing folliculitis).
    • Presents as dome-shaped follicular pustules.

    Deep Folliculitis

    • Caused by Staphylococcus aureus.
    • Characterized by deep-seated, erythematous perifollicular papules and pustules.
    • Recurrences are possible in the same area.

    Cellulitis

    • Deeper skin infection caused by Streptococcus pyogenes.
    • Bacteria enter through a superficial skin break.
    • Recurrent cellulitis is common in individuals with pre-existing lymphedema or venous stasis.
    • Presents as erythematous, warm, indurated, rapidly spreading plaques with ill-defined borders.
    • Constitutional symptoms typically precede skin lesions.
    • Primarily affects lower limbs, but can also involve upper limbs and face.
    • Lymphangitis and lymphedema predispose to recurrent lesions.
    • Complications include recurrent lesions leading to lymphedema.

    Furunculosis (Boils)

    • Deep seated follicular and perifollicular infection caused by Staphylococcus aureus, culminating in necrosis.
    • Commonly affects adolescent boys.
    • Presents as 1-2 tender, firm, red, follicular nodules that become necrotic and discharge their central core.
    • Lesions heal with barely perceptible scarring.
    • Occasionally associated with lymphadenopathy and fever.
    • Frequently occurs on hair-bearing sites like the face, axillae, buttocks, perineal region, and scalp.
    • Treated with hot fomentation and appropriate antibiotics.
    • Chronic and recurrent cases require treatment of the carrier state with topical mupirocin.

    Carbuncle

    • Deep infection of contiguous hair follicles induced by Staphylococcus aureus.
    • More prevalent in individuals with diabetes or those on steroid therapy.
    • Commonly affects adult males.
    • Characterized by constitutional symptoms like fever, tender, indurated, lobulated, intensely erythematous plaques discharging pus from multiple openings.
    • Back is the most common site of involvement.
    • Requires drainage of deep-seated pus pockets and aggressive treatment with penicillinase-resistant antibiotics like flucloxacillin.

    Erysipelas

    • Superficial skin infection caused by Streptococcus pyogenes, entering through a superficial skin break.
    • Recurrences are common in cases of pre-existing lymphedema or venous stasis.
    • Exhibits acute erythematous, warm, indurated, rapidly spreading plaques with a sharply defined margin.
    • Superficial vesiculation may occur on the plaques.
    • Constitutional symptoms precede the onset of skin lesions.
    • Primarily affects the lower limbs, but can also occur in the upper limbs and face.
    • Lymphangitis and lymphedema predispose to recurrent lesions.
    • Untreated facial erysipelas can be fatal.
    • Mucous membranes can be involved.
    • Can lead to staphylococcal scalded skin syndrome.
    • Diagnosed through Gram stain showing polymorphs with intracellular and extracellular gram-positive cocci in clusters, and culture confirming Staphylococcus aureus.
    • Treated with local hygiene measures and antibiotics.
    • Extensive lesions require systemic antistaphylococcal antibiotics like flucloxacillin.

    Staphylococcal Scalded Skin Syndrome

    • Staphylococcus aureus infection at various sites, including the ear (otitis media), lungs (pneumonitis), and skin (trivial wounds).
    • Primarily affects infants.
    • Presents as an acute onset with fever, skin tenderness, and peeling of skin in thin sheets.
    • Clinically appears as scalded skin.
    • Mucous membranes are spared.
    • Diagnosed through Gram stain and pus culture.
    • Managed with supportive and nursing measures along with aggressive treatment using intravenous antistaphylococcal antibiotics followed by oral therapy.

    Ecthyma

    • Deeper infection caused by either Streptococcus pyogenes, Staphylococcus aureus, or both.
    • Precipitated by factors like poor hygiene, malnutrition, and minor injuries.
    • Characterized by small bullae/pustules on an erythematous base, quickly forming a crusted, indurated, tender plaque with an erythematous, edematous areola.
    • Removal of the adherent crust reveals an irregular ulcer.
    • Lesions heal without scarring.
    • Common sites include the buttocks, thighs, and legs.
    • Treated with local hygiene and systemic antibiotics like penicillin.

    Superficial Folliculitis

    • Classified into three types:
      • Infectious: Caused by Staphylococcus aureus.
      • Chemical: Induced by occupational or cosmetic exposure.
      • Mechanical: Pseudofolliculitis (after shaving) in the beard region and post-waxing folliculitis.
    • Presents as dome-shaped follicular pustules.
    • Occurs on the legs (superficial folliculitis), beard region (pseudofolliculitis), and thighs and deltoid region (post-waxing folliculitis).
    • Treated with topical antibiotics for infectious folliculitis and topical steroid antibiotics for chemical and mechanical folliculitis.

    Deep Folliculitis

    • Caused by Staphylococcus aureus.
    • Presents as deep-seated, erythematous perifollicular papules and pustules.
    • Recurrences are possible in the same area.
    • Treated symptomatically with rest, limb elevation, and non-steroidal anti-inflammatory drugs for pain relief.
    • Acute episodes require parenteral penicillin, while penicillin-sensitive patients require alternative antibiotics.

    Cellulitis

    • Deeper infection caused by Streptococcus pyogenes, entering through a superficial skin break.
    • Recurrent cellulitis is common in cases of pre-existing lymphedema or venous stasis.
    • Exhibits erythematous, warm, indurated, rapidly spreading plaques with an ill-defined margin.
    • Constitutional symptoms precede the onset of skin lesions.
    • Predominantly affects the lower limbs, but can also occur in the upper limbs and face.
    • Lymphangitis and lymphedema increase the risk of recurrent lesions.
    • Recurrences may lead to lymphedema.
    • Treated symptomatically with rest, limb elevation, and non-steroidal anti-inflammatory drugs for pain relief.
    • Acute episodes require parenteral penicillin, while penicillin-sensitive patients need alternative antibiotics.

    Diagnosis of Bacterial Skin Infections

    • Visual examination of lesions for features such as size, color, and distribution is part of the clinical assessment.
    • Patient history is crucial, including information on symptom onset, duration, and any potential exposure.
    • Laboratory tests, such as culture and sensitivity tests from wound swabs or drainage, assist in identifying the causative bacteria.
    • Blood tests may be required if systemic infection is suspected.
    • Imaging studies, such as ultrasound or CT scans, are helpful for complicated infections that involve deeper tissues.

    Treatment Options for Bacterial Infections

    • Topical antibiotics, like mupirocin and fusidic acid, are effective for localized infections.
    • Oral antibiotics are generally prescribed for moderate to severe infections, with common options including:
      • Penicillins (e.g., Dicloxacillin)
      • Cephalosporins (e.g., Cephalexin)
      • Clindamycin for infections caused by methicillin-resistant Staphylococcus aureus (MRSA)
    • Drainage of abscesses is important for clearing the infection.
    • Adjunctive therapies include antiseptics, wound care, and measures to support immune function.

    Common Bacterial Pathogens in Dermatology

    • Staphylococcus aureus is a prevalent cause of skin infections like impetigo, folliculitis, and furuncles.
    • Streptococcus pyogenes is commonly associated with cellulitis and impetigo.
    • Pseudomonas aeruginosa often causes infections in burn wounds and moist environments.
    • Propionibacterium acnes plays a role in the development of acne vulgaris.

    Clinical Manifestations of Bacterial Infections

    • Impetigo presents with characteristic honey-colored crusts, often around the mouth and nose.
    • Folliculitis involves inflammation of hair follicles, leading to red bumps or pustules.
    • Furuncles are painful, inflamed nodules that form around infected hair follicles.
    • Carbuncles are larger collections of interconnected furuncles, potentially accompanied by systemic signs like fever and malaise.
    • Cellulitis is a widespread infection affecting the dermis and subcutaneous tissue, characterized by redness, swelling, warmth, and pain.

    Infection Control Measures

    • Good hygiene practices, such as regular handwashing and personal hygiene, are vital to prevent bacterial skin infections.
    • Proper wound care, including cleaning and dressing cuts and abrasions, is crucial for minimizing infection risk.
    • Isolation measures may be necessary for infections like impetigo until effective treatment is initiated.
    • Patient education about transmission and prevention strategies is essential for minimizing the spread of bacterial skin infections.

    Deep Folliculitis

    • Deep infection of hair follicles, often leading to painful nodules.
    • Staphylococcus aureus is the primary causative organism.
    • Symptoms include tenderness, redness, and potential pus drainage.
    • Management typically involves drainage of abscesses and oral antibiotics, especially if the infection is widespread or recurrent.

    Furunculosis

    • Recurrent furuncles, often appearing in clusters.
    • Predisposing factors include poor hygiene, obesity, diabetes, and immunocompromised states.
    • Treatment is similar to individual furuncles, but antibiotic prophylaxis may be necessary in some cases.

    Carbuncle

    • Collection of interconnected furuncles, forming a larger abscess.
    • Multiple openings on the skin are characteristic, along with pus drainage and possible systemic symptoms like fever.
    • Management involves incision and drainage, and systemic antibiotics are often indicated for extensive cases.

    Cellulitis

    • Cellulitis is a bacterial infection of the skin.
    • The most common cause is Streptococcus pyogenes.
    • Cellulitis can occur after a superficial break in the skin.
    • Deep infection with rapidly spreading plaques.
    • The infection is often accompanied by lymphedema and venous stasis
    • Symptoms include erythema, warmth, induration, and pain.
    • Cellulitis is more common in the lower limbs, but can also affect the upper limbs and face.
    • Treatment involves rest, limb elevation, nonsteroidal anti-inflammatory drugs, and antibiotics.

    Impetigo Contagiosa

    • Impetigo contagiosa is highly contagious.
    • Primarily affects school children
    • Caused by Staphylococcus aureus or Streptococcus pyogenes.
    • The infection can occur in outbreaks.
    • The infection is characterized by thin-walled blisters on an erythematous base that rupture to form an area of exudation and honey-colored crusts.
    • The lesions spread peripherally, without central healing.
    • Removal of the crusts reveals an erosion.
    • Typically involve the face, especially around the mouth and nose
    • Treatment involves local hygiene and topical antibiotics like fusidic acid and mupirocin.

    Bullous Impetigo

    • Bullous impetigo is caused by certain strains of Staphylococcus aureus.
    • Typically affects infants.
    • The infection is characterized by bullae with turbid fluid collection, without an erythematous halo.
    • Bullae rupture after a few days to form thin, varnish-like crusts.
    • Lesions may heal in the center to form annular plaques.
    • Mucous membranes may be involved.
    • Requires treatment with antibiotics to prevent staphylococcus scalded skin syndrome.

    Staphylococcal Scalded Skin Syndrome

    • Staphylococcal scalded skin syndrome is a serious bacterial infection.

    • Caused by Staphylococcus aureus that colonizes the skin and other body sites.

    • The infection is characterized by acute onset of fever and skin tenderness, followed by extensive peeling of the skin in thin sheets.

    • Skin appears clinically scalded.

    • Mucous membranes are spared.

    • Treatment involves aggressive IV antistaphylococcal antibiotics followed by oral therapy.

    Ecthyma

    • Ecthyma is deeper infection caused by Streptococcus pyogenes, Staphylococcus aureus, or both
    • Caused by streptococcus pyogenes/Staphylococcus aureus, or both
    • Primarily affects poorly hygienic individuals.
    • Predisposing factors include poor hygiene, malnutrition, and minor injuries.
    • The infection presents as a small bulla/pustule on an erythematous base, forming a crusted, indurated, and tender plaque.
    • Removal of the crust reveals an irregular ulcer.
    • Lesions heal without scarring.
    • Typically affects the buttocks, thighs, and legs.
    • Treatment involves local hygiene, systemic antibiotics like penicillin.

    Superficial Folliculitis

    • Superficial folliculitis is a common skin condition.
    • Caused by Staphylococcus aureus (infectious), occupational/cosmetic exposure (chemical), or pseudofolliculitis (after shaving) (mechanical).
    • The condition is characterized by dome-shaped follicular pustules.
    • Typically affects the legs, beard region, and thighs and deltoid region (post waxing folliculitis).
    • Treatment involves topical antibiotics for infectious folliculitis and topical steroid antibiotics for chemical and mechanical folliculitis.

    Deep Folliculitis

    • Deep folliculitis is a more serious infection.
    • Typically affects the beard and scalp.
    • Caused by Staphylococcus aureus.
    • The condition presents as deep-seated, erythematous perifollicular papules and pustules.
    • Requires treatment with systemic antibiotics.

    Furunculosis (Boils)

    • Furunculosis (boils) are a common bacterial infection.
    • Caused by Staphylococcus aureus.
    • The condition presents as 1-2 tender, firm, red, follicular nodules that become necrotic and discharge a central core.
    • Lesions heal with barely perceptible scarring.
    • Boils usually occur on hair-bearing sites.
    • The condition is usually self-limiting, but may require antibiotics.

    Carbuncle

    • Carbuncles are a severe skin infection.
    • Caused by Staphylococcus aureus, and are a deep infection of contiguous hair follicles.
    • More common in diabetic and steroid therapy patients.
    • The condition presents presents as a tender, indurated, lobulated, intensely erythematous plaque that discharges pus from many openings.
    • The back is the most common site of involvement.
    • Aggressive treatment with flucloxacillin or other penicillinase-resistant antibiotics is necessary.

    Erysipelas

    • Erysipelas is a bacterial infection of the skin.
    • Caused by Streptococcus pyogenes.
    • The infection can occur after a superficial break in the skin.
    • The condition presents as acute erythematous, warm, indurated rapidly spreading plaques.
    • The margin is sharply defined and superficial vesiculation may occur on the plaque.
    • The infection is accompanied by fever, chills, and malaise.
    • Usually affects the lower limbs.
    • Untreated facial erysipelas can be fatal.

    Impetigo Causes

    • Bacterial Infection: Primarily caused by Staphylococcus aureus or Streptococcus pyogenes.
    • Skin Breakdown: Can occur through cuts, insect bites, or skin conditions (like eczema).
    • Contagious: Spreads easily through direct contact with infected sores or contaminated objects.
    • Weakened Immune System: Individuals with a weakened immune system are more susceptible.

    Impetigo Symptoms

    • Skin Lesions: Appear as red sores or blisters that ooze and form a honey-colored crust.
    • Location: Commonly found on the face, especially around the nose and mouth, but can occur anywhere.
    • Itching and Pain: Lesions may be itchy or painful.
    • Swollen Lymph Nodes: Can occur if the infection spreads.

    Impetigo Complications

    • Spread of Infection: Can lead to cellulitis or other skin infections.
    • Kidney Issues: Rarely, poststreptococcal glomerulonephritis can occur.
    • Scarring: Severe cases may lead to permanent skin damage.
    • Secondary Infections: Pre-existing skin conditions can worsen due to impetigo.

    Impetigo Treatment

    • Topical Antibiotics: Mupirocin or retapamulin are applied directly to the affected area.
    • Oral Antibiotics: May be prescribed for severe cases or when the infection is widespread.
    • Hygiene Practices: Regularly wash hands and clean lesions to prevent spreading.
    • Preventing Contagion: Individuals with impetigo should stay home until treatment is effective, typically 24-48 hours after starting antibiotics.
    • Wound Care: Keeping the area clean and dry promotes healing.

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    Description

    This quiz covers the key aspects of furunculosis, carbuncle, and erysipelas, focusing on their causes, symptoms, and affected populations. Test your knowledge on these skin infections, specifically those related to Staphylococcus and Streptococcus bacteria. Gain insights into their presentations and typical sites of occurrence.

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