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Infections of the Integumentary System

• Table of Contents: This document outlines various skin infections, including bacterial, viral, fungal, parasitic, and tick-borne diseases. It categorizes primary and secondary skin lesions, provides outlines for infection types, and presents various diseases in separate sections for detailed study.

Primary and Secondary Lesions

• Primary Lesions: are initial skin abnormalities, characterized by flat, non-palpable macules (less than 1 cm) and patches (more than 1 cm). Papules are superficial, elevated, palpable bumps less than 1 cm, while nodules are similar but larger (more than 1 cm). Other types include fluid-filled vesicles (small) and bullae (large). Crusts are hardened deposits, excoriations are "scraped" marks, fissures are cracks, and cysts are fluid filled bumps.

• Secondary Lesions: are subsequent changes to primary lesions. Examples include scales, which are keratin buildup, and erosions ("scraped" areas) and ulcers resulting from tissue damage. Seborrheic dermatitis presents as yellowish, greasy scales. Psoriasis shows thick, adherent, silvery scales.

Outline of Infections

• Bacterial Infections: Includes impetigo, cellulitis, folliculitis, furuncle, carbuncle, and acne.
• Viral Infections: Measles (also known as Rubeola), German Measles (Rubella), Mumps, Chickenpox (Varicella), Smallpox, Monkeypox, Molluscum Contagiosum, Fifth Disease (Erythema Infectiosum), Roseola Infantum, and Hand-Foot-Mouth Disease.
• Fungal Infections: Candidiasis, Superficial Mycoses (Tinea Versicolor), Cutaneous Mycoses (Dermatophytes), and Subcutaneous Mycoses (Sporothrix schenckii).
• Parasitic Infections: Scabies and Lyme Disease.
• Tick-Borne Diseases: Lyme Disease.

Bacterial Skin Infections

• Impetigo: A common childhood skin infection affecting the epidermis, often seen near the mouth and caused by Staphylococcus aureus and Streptococcus species.
• Cellulitis: Infection of connective tissue, characterized by edema, warmth, erythema, and indistinct borders. Common causative organisms are Staphylococcus aureus and Streptococcus pyogenes.
• Folliculitis, Furuncle, Carbuncle: Infections of the hair follicles (folliculitis), deeper layers (furuncle), or clusters of infected follicles (carbuncle). Staphylococcus aureus is the primary cause.
• Acne: A common skin condition caused by inflammation of the pilosebaceous unit; related to Propionibacterium acnes activity.

Viral Skin Infections

• Measles: A highly contagious respiratory illness marked by characteristic Koplik spots (bright red lesions with white central spots) inside the mouth and a skin rash appearing during fever climax.
• German Measles: A viral infection that also causes a maculopapular rash with postauricular lymphadenopathy.
• Mumps: Causes swelling of the parotid glands (salivary glands) accompanied by fever and general malaise.
• Chickenpox: Characterized by a vesicular (small, fluid-filled blister) rash with intense itching, often presenting in a centrifugal pattern.
• Smallpox: A now eradicated viral infection with characteristic skin lesions.
• Monkeypox: A viral infection marked by a rash that often appears in individuals with close contact with someone who has the infection, or with an infected animal.
• Molluscum Contagiosum: Causes flesh-colored, dome-shaped, umbilicated papules (bumps with a central indentation).
• Fifth Disease (Erythema Infectiosum): Presents with a characteristic "slapped cheek" rash on the face.
• Roseola Infantum: Often seen in young children (less than 3 years old), characterized by a high fever followed by a rose-colored rash.
• Hand-Foot-Mouth Disease: Commonly affects children, presenting with sores on the hands, feet, and mouth.

Fungal Skin Infections

• Candidiasis: Fungal infection commonly caused by Candida albicans. Features beefy-red patches and plaques with satellite skin lesions.
• Superficial Mycoses: Including Tinea Versicolor (affects the skin with hypopigmentation and hyperpigmentation).
• Cutaneous Mycoses (Dermatophytes): Ringworm, an infection caused by fungal elements that live on skin and hair, often with annular or serpentine lesions (rings or wavy shapes).
• Subcutaneous Mycoses (Sporothrix Schenckii): Deep tissue infections, often associated with plant, wood or thorn exposure; usually a pustule/ulcer with nodules.

Parasitic Skin Infections

• Scabies: Caused by the Sarcoptes scabiei mite, characterized by intense itching, particularly at night. Lesions include threadlike burrows.

• Lyme Disease: A tick-borne illness with an initial characteristic "bull's-eye" rash.

• Treatment algorithms: Specific treatment details for various infections, including topical, and systemic therapies.

• Diagnostic tools: Techniques to diagnose these conditions, including KOH preparation, skin scrapings, cultures, and immunologic tests.

• Complication considerations: Potentially serious complications are discussed (SSS).