Skin Infections and Lesions
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Questions and Answers

What is the incubation period of Erysipeloid?

  • 2 to 5 days
  • 1 to 7 days
  • 3 to 6 days
  • 1 to 4 days (correct)

    • What is the characteristic of the lesion of Erysipeloid?

  • Violaceous, sharply marginated, and slightly tender (correct)
  • Red, itchy, and scaly
  • Pus-filled, itchy, and scaly
  • Red, itchy, and hot

    • Which areas of the skin are most susceptible to Folliculitis?

  • Areas with open wounds and cuts
  • Areas with acne and rosacea
  • Areas exposed to tar, grease, and mineral oil (correct)
  • Areas with eczema and psoriasis

    • What is the common complication of S. aureus folliculitis?

    <p>Shaving exacerbates it</p> Signup and view all the answers

    What is the difference between a furuncle and a carbuncle?

    <p>A furuncle is a single lesion and a carbuncle is multiple lesions</p> Signup and view all the answers

    Which age group is most affected by Furuncles and Carbuncles?

    <p>Children, adolescents, and young adults</p> Signup and view all the answers

    What is the common complication of Folliculitis in black men?

    <p>All of the above</p> Signup and view all the answers

    What is the duration of skin lesions in Folliculitis?

    <p>Last for days</p> Signup and view all the answers

    What is a common symptom associated with furunculosis?

    <p>Exquisite tenderness</p> Signup and view all the answers

    What is the primary cause of erythrasma?

    <p>Corynebacterium minutissimum</p> Signup and view all the answers

    What is the recommended treatment for primary impetigo?

    <p>Systemic or topical prescription antibiotic</p> Signup and view all the answers

    What is the role of topical nonprescription antibiotics in the treatment of ecthyma, folliculitis, and erysipeloid?

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

    What is the recommended treatment for furuncles and carbuncles?

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

    What is a common predisposing factor for erythrasma?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of skin lesions in erythrasma?

    <p>Sharply marginated, red, scaly eruptions</p> Signup and view all the answers

    What is the purpose of cleaning the area with mild soap and water in the treatment of primary impetigo?

    <p>To improve response to topical therapy</p> Signup and view all the answers

    What is the most common location of ecthyma lesions?

    <p>Ankles, dorsa of feet, thighs, and buttocks</p> Signup and view all the answers

    What is the characteristic of the fluid found in impetigo vesicles?

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

    Which of the following is a predisposing factor for impetigo?

    <p>All of the above, except a</p> Signup and view all the answers

    What is the characteristic of ecthyma lesions?

    <p>Deeper into the dermis and tender</p> Signup and view all the answers

    What is the occupation most commonly associated with erysipeloid?

    <p>Meat packer</p> Signup and view all the answers

    What is the term for the characteristic crusts formed in impetigo?

    <p>Honey-crusted plaque</p> Signup and view all the answers

    What is the most common bacterial cause of ecthyma?

    <p>Both Group A streptococci and staphylococci</p> Signup and view all the answers

    What is the term for the type of cellulitis that occurs at sites of inoculation?

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

    Erysipeloid is a bacterial infection that always requires antibiotic treatment

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

    Folliculitis is a deep-seated inflammatory nodule that evolves from a staphylococcal infection

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

    Erysipeloid lesions are typically hot and tender to the touch

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

    Folliculitis can lead to scarring

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

    Carbuncles are typically found in children and adolescents

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

    Erysipeloid is a common skin infection in women during the summer

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

    Pseudo-folliculitis barbae is a type of bacterial folliculitis

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

    Furuncles are typically superficial skin lesions

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

    Impetigo is a deep infection of the skin caused by S. aureus and Group A streptococci.

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

    Erysipeloid is a type of bacterial skin infection that occurs in warm, moist areas of the skin.

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

    Ecthyma is a type of skin infection characterized by crusted, oozing lesions with variable amounts of purulence and tenderness.

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

    The stratum corneum normally has a high water content, which supports microbial growth.

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

    Furuncles and carbuncles are types of skin lesions that are often caused by S. aureus.

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

    Excessive scrubbing and irritation of the skin can increase the risk of infection.

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

    Impetigo is a skin infection that is most common in older adults.

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

    A break in the intact skin surface can increase the risk of infection by allowing pathogenic organisms to enter the inner layers.

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

    Erythrasma is a bacterial infection that affects the face and arms.

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

    Furunculosis is a common complication of S. aureus folliculitis.

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

    Impetigo infections can occur in other tissues, such as the liver and lungs.

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

    Erythrasma skin lesions are typically itchy and painful.

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

    Topical antibiotics are the primary treatment for ecthyma and erysipeloid.

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

    Furuncles and carbuncles can be resolved with topical antibiotics only.

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

    Coral red fluorescence is seen with a Wood lamp in patients with impetigo.

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

    Diabetes is a predisposing factor for furunculosis.

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

    What is a common characteristic of skin lesions in furunculosis?

    <p>Throbbing pain and exquisite tenderness</p> Signup and view all the answers

    What is the purpose of using a Wood lamp in the diagnosis of erythrasma?

    <p>To observe coral red fluorescence</p> Signup and view all the answers

    What is the recommended treatment for primary impetigo involving superficial and non-extensive lesions?

    <p>Topical antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate</p> Signup and view all the answers

    What is a common predisposing factor for erythrasma?

    <p>Diabetes and a warm, humid climate</p> Signup and view all the answers

    What is the role of cleaning the area with mild soap and water in the treatment of primary impetigo?

    <p>To improve response to topical therapy</p> Signup and view all the answers

    What is the typical duration of skin lesions in erythrasma?

    <p>Months to years</p> Signup and view all the answers

    What is the recommended treatment for furuncles and carbuncles?

    <p>Incision, drainage, and prescription of systemic antibiotics by a physician</p> Signup and view all the answers

    What is the typical location of erythrasma lesions?

    <p>Intertriginous areas of the toes, groin, and axillae</p> Signup and view all the answers

    What is the characteristic of lesions in impetigo, and which areas of the body are commonly affected?

    <p>Lesions in impetigo are characterized by small red spots that evolve into vesicles filled with amber fluid, followed by the formation of yellow or brown crusts. The face, arms, legs, and buttocks are common affected areas.</p> Signup and view all the answers

    What is ecthyma, and how does it differ from impetigo?

    <p>Ecthyma is an ulcerative bacterial infection that extends deeper into the dermis than impetigo, and it develops in excoriations, insect bites, or minor trauma. It is a lesion of neglect and often affects elderly patients, soldiers, sewage workers, alcoholics, and homeless people.</p> Signup and view all the answers

    What is the occupation most commonly associated with erysipeloid?

    <p>Handling fish, shellfish, meat, poultry, hides, and bones is an occupational risk factor for erysipeloid.</p> Signup and view all the answers

    What is the term for the characteristic crusts formed in impetigo?

    <p>The characteristic crusts formed in impetigo are often referred to as 'honey-crusted plaques'.</p> Signup and view all the answers

    What is the common predisposing factor for impetigo?

    <p>Crowded living conditions, poor hygiene, and neglected minor trauma are common predisposing factors for impetigo.</p> Signup and view all the answers

    What is the characteristic of the fluid found in impetigo vesicles?

    <p>The fluid found in impetigo vesicles is amber-colored.</p> Signup and view all the answers

    What is the most common location of ecthyma lesions?

    <p>Ecthyma lesions are commonly found on the ankles, dorsa of feet, thighs, and buttocks.</p> Signup and view all the answers

    What is the term for the type of cellulitis that occurs at sites of inoculation?

    <p>Erysipeloid is a type of cellulitis that occurs at sites of inoculation.</p> Signup and view all the answers

    What is the primary factor that contributes to the development of bacterial skin infections?

    <p>An increase in moisture content, which allows microbial growth</p> Signup and view all the answers

    What is the characteristic of pyodermic infections?

    <p>Crusted, oozing lesions with variable amounts of purulence and tenderness</p> Signup and view all the answers

    What is the most common bacterial cause of ecthyma?

    <p>S. aureus and Group A streptococci</p> Signup and view all the answers

    What is erysipeloid, and where does it commonly occur?

    <p>A bacterial infection that occurs in warm, moist areas of the skin</p> Signup and view all the answers

    What is the primary cause of impetigo?

    <p>S. aureus, Group A P-hemolytic streptococci, or a mixed infection</p> Signup and view all the answers

    What is a common predisposing factor for bacterial skin infections?

    <p>A break in the intact skin surface</p> Signup and view all the answers

    What is the effect of excessive scrubbing and irritation of the skin on the risk of infection?

    <p>It increases the risk of infection</p> Signup and view all the answers

    What is the age group most affected by impetigo?

    <p>Preschool children and young adults</p> Signup and view all the answers

    The term ______ refers to cutaneous bacterial infection characterized by crusted, oozing lesions with variable amounts of purulence and tenderness.

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

    Impetigo is a very superficial infection of the skin caused by either S. aureus, Group A ______ streptococci, or a mixed infection.

    <p>P-hemolytic</p> Signup and view all the answers

    The stratum corneum normally has only about 10% ______ content, which is enough to ensure elasticity but is generally below that needed to support luxuriant microbial growth.

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

    Erysipeloid is a bacterial skin infection that occurs in ______ areas of the skin.

    <p>warm, moist</p> Signup and view all the answers

    Ecthyma is a type of skin infection characterized by crusted, oozing lesions with variable amounts of ______ and tenderness.

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

    A break in the intact skin surface can increase the risk of infection by allowing ______ organisms to enter the inner layers.

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

    Excessive scrubbing and irritation of the skin can increase the risk of ______ by making the skin more susceptible to bacterial colonization.

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

    Impetigo is a skin infection that is most common in ______ children and young adults.

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

    Crowded living conditions, poor hygiene, and ______ trauma are predisposing factors of impetigo.

    <p>neglected minor</p> Signup and view all the answers

    Impetigo lesions first appear as small red ______ that may evolve into characteristic vesicles filled with amber fluid.

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

    Ecthyma refers to an ______ bacterial infection caused most frequently by Group A streptococci or staphylococci or both.

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

    Erysipeloid is an acute but slowly evolving ______ occurring at sites of inoculation, most commonly the hands.

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

    Eythema is a characteristic of the skin surrounding the ______ crusts in impetigo.

    <p>yellow or brown</p> Signup and view all the answers

    Ecthyma lesions are commonly distributed on the ______ and buttocks.

    <p>ankles, dorsa of feet, thighs</p> Signup and view all the answers

    Erysipeloid is often associated with handling ______, shellfish, meat, poultry, hides, and bones.

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

    Impetigo is a skin infection that commonly affects the ______, arms, legs, and buttocks.

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

    Chronic cases of skin lesions should be referred to a ______ for evaluation of a possible underlying disease.

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

    Erythrasma is a chronic ______ infection that is caused by Corynebacterium minutissimum and affects the intertriginous areas of the toes, groin, and axillae.

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

    For the treatment of primary impetigo, a ______ or topical prescription antibiotic is indicated.

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

    Erythrasma skin lesions are sharply ______, brownish red, scaly eruptions that may last for months to years.

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

    Coral red fluorescence is seen with a ______ lamp in patients with erythrasma.

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

    Furuncles and carbuncles may be resolved with ______, drainage, and the prescription of systemic antibiotics by a physician.

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

    Erysipeloid is a bacterial infection that affects the ______ areas of the skin.

    <p>warm, moist</p> Signup and view all the answers

    Cleaning the area with ______ soap and water and gently removing loose crusts should improve response to topical therapy.

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

    Match the following skin lesions with their characteristics:

    <p>Furuncles = Painful, associated with skin symptoms of throbbing pain and exquisite tenderness Erythrasma = Sharply marginated, brownish red, scaly eruptions that may last for months to years Impetigo = Superficial, crusty lesions that can occur in other tissues Ecthyma = Crusted, oozing lesions with variable amounts of purulence and tenderness</p> Signup and view all the answers

    Match the following bacterial skin infections with their characteristics:

    <p>Impetigo = Very superficial infection of the skin Erysipeloid = Occurs in warm, moist areas of the skin Ecthyma = Characterized by crusted, oozing lesions with variable amounts of purulence and tenderness Furuncles and carbuncles = Types of skin lesions caused by S. aureus</p> Signup and view all the answers

    Match the following bacterial infections with their primary causes:

    <p>Impetigo = S. aureus and Group A streptococci Erysipeloid = Erysipelothrix rhusiopathiae Erythrasma = Corynebacterium minutissimum Furunculosis = S. aureus</p> Signup and view all the answers

    Match the following skin lesions with their causal organisms:

    <p>Impetigo = S. aureus, Group A P-hemolytic streptococci Erysipeloid = Erythrasma bacterial Ecthyma = P. aeruginosa Furuncles and carbuncles = S. aureus</p> Signup and view all the answers

    Match the following skin lesions with their common locations:

    <p>Erythrasma = Intertriginous areas of the toes, groin, and axillae Ecthyma = Legs and arms Impetigo = Face and extremities Furuncles = Buttocks, thighs, and neck</p> Signup and view all the answers

    Match the following bacterial infections with their treatment options:

    <p>Impetigo = Topical or systemic antibiotic Erysipeloid = Systemic antibiotic Erythrasma = Topical antibiotic Furuncles and carbuncles = Incision, drainage, and systemic antibiotic</p> Signup and view all the answers

    Match the following bacterial skin infections with their risk factors:

    <p>Impetigo = Direct contact with infected exudate Erysipeloid = Excessive exposure to water, prolonged occlusion Ecthyma = Excessive scrubbing and irritation of the skin Furuncles and carbuncles = Local injury, excessive moisture content</p> Signup and view all the answers

    Match the following skin lesions with their associated symptoms:

    <p>Furunculosis = Recurrent skin lesions, throbbing pain, and exquisite tenderness Erysipeloid = Redness, swelling, and tenderness Erythrasma = Irritation may be the only symptom Impetigo = Itching, burning, and crusting</p> Signup and view all the answers

    Match the following skin lesions with their common locations:

    <p>Impetigo = Preschool children and young adults Erysipeloid = Warm, moist areas of the skin Ecthyma = Axillae, ear canals, and interdigital spaces Furuncles and carbuncles = Face, neck, and buttocks</p> Signup and view all the answers

    Match the following bacterial skin infections with their predisposing factors:

    <p>Impetigo = Break in the intact skin surface Erysipeloid = Local injury, excessive moisture content Ecthyma = Excessive scrubbing and irritation of the skin Furuncles and carbuncles = Excessive exposure to water, prolonged occlusion</p> Signup and view all the answers

    Match the following bacterial infections with their predisposing factors:

    <p>Erythrasma = Diabetes and a warm, humid climate Impetigo = Poor hygiene and crowded living conditions Furunculosis = Obesity and poor skin care Erysipeloid = Occupational exposure to infected animals</p> Signup and view all the answers

    Match the following skin lesions with their characteristic features:

    <p>Erysipeloid = Violaceous, sharply marginated lesion composed of macules and plaques Folliculitis = Superficial, often bacterial inflammation of hair follicles Furuncles = Acute, deep-seated, tender, erythematous, inflammatory nodule Carbuncles = Conglomerate of multiple coalescing furuncles</p> Signup and view all the answers

    Match the following skin lesions with their characteristic symptoms:

    <p>Impetigo = Crusted, oozing lesions with variable amounts of purulence and tenderness Erysipeloid = Hot and tender to the touch Ecthyma = Itchy and painful lesions Furuncles and carbuncles = Superficial skin lesions</p> Signup and view all the answers

    Match the following skin lesions with their diagnostic tools:

    <p>Erythrasma = Wood lamp Impetigo = None, diagnosed clinically Ecthyma = Gram stain and culture Furunculosis = None, diagnosed clinically</p> Signup and view all the answers

    Match the following bacterial infections with their complications:

    <p>Impetigo = Post-streptococcal glomerulonephritis Erysipeloid = Septicemia Erythrasma = None, usually self-limiting Furunculosis = Recurrent skin lesions and cellulitis</p> Signup and view all the answers

    Match the following bacterial infections with their common locations:

    <p>Erysipeloid = Hands of individuals who handle organic material Folliculitis = Skin areas regularly exposed to tar, grease, mineral oil, and adhesive plaster Impetigo = Face and legs Ecthyma = Lower legs and arms</p> Signup and view all the answers

    Match the following bacterial skin infections with their treatment approaches:

    <p>Impetigo = Topical antibiotics, mild soap and water Erysipeloid = Antibiotic treatment, avoiding warm, moist areas Ecthyma = Topical antibiotics, avoiding excessive scrubbing Furuncles and carbuncles = Antibiotic treatment, avoiding local injury</p> Signup and view all the answers

    Match the following skin lesions with their associated bacteria:

    <p>Erysipeloid = Erysipelothrix rhusiopathiae Folliculitis = S. aureus Impetigo = S. aureus and Group A streptococci Ecthyma = S. aureus</p> Signup and view all the answers

    Match the following skin lesions with their effects on the skin:

    <p>Impetigo = Break in the intact skin surface, increased risk of infection Erysipeloid = Increased risk of infection in warm, moist areas Ecthyma = Disruption of skin's defensive properties Furuncles and carbuncles = Increased risk of infection in areas with excessive moisture content</p> Signup and view all the answers

    Match the following skin lesions with their associated symptoms:

    <p>Erysipeloid = Itching, burning, throbbing, and pain Folliculitis = Tenderness and scarring Impetigo = Crusting and oozing Furuncles = Tenderness and erythema</p> Signup and view all the answers

    Match the following skin lesions with their affected populations:

    <p>Erysipeloid = Adult men during summer and early fall Folliculitis = Individuals who shave regularly Impetigo = Children and young adults Furuncles and Carbuncles = Children, adolescents, and young adults</p> Signup and view all the answers

    Match the following skin lesions with their complications:

    <p>Erysipeloid = Lymphangitis or lymphadenitis Folliculitis = Scarring and hyperpigmentation Impetigo = Infection of other tissues Furuncles and Carbuncles = Furunculosis</p> Signup and view all the answers

    Match the following skin lesions with their characteristics:

    <p>Erysipeloid = Self-limited, subsiding in about 3 weeks Folliculitis = Superficial, often bacterial inflammation of hair follicles Impetigo = Crusting and oozing lesions with variable amounts of purulence and tenderness Ecthyma = Crusted, oozing lesions with variable amounts of purulence and tenderness</p> Signup and view all the answers

    Match the following skin lesions with their associated predisposing factors:

    <p>Erysipeloid = Handling organic material containing Erysipelothrix rhusiopathiae Folliculitis = Shaving and exposure to tar, grease, and mineral oil Impetigo = Break in the intact skin surface Ecthyma = Poor hygiene and excessive scrubbing</p> Signup and view all the answers

    Study Notes

    Bacterial Skin Infections

    • Chronic cases of bacterial skin infections should be referred to a physician for evaluation of possible underlying diseases.
    • Lesions associated with bacterial skin infections can last for days, accompanied by throbbing pain and exquisite tenderness.

    Erythrasma

    • Erythrasma is a chronic bacterial infection caused by Corynebacterium minutissimum.
    • It affects intertriginous areas of the toes, groin, and axillae.
    • Adults are generally affected, with a higher incidence in obese middle-aged blacks.
    • Predisposing factors include diabetes and a warm, humid climate.
    • Skin lesions are sharply marginated, brownish red, scaly eruptions that may last for months to years.

    Treatment of Bacterial Skin Infections

    • Primary impetigo is treated with systemic or topical prescription antibiotics.
    • Topical nonprescription antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate are effective for superficial lesions.
    • Cleaning the area with mild soap and water and gently removing loose crusts improves response to topical therapy.

    Impetigo

    • Impetigo is a bacterial skin infection that can occur in other tissues, such as renal and heart valves.
    • Lesions first appear as small red spots that may evolve into characteristic vesicles filled with amber fluid.
    • Exudate accumulates and forms yellow or brown crusts (scabs) on the skin surface, often surrounded by erythematous skin.

    Ecthyma (Ulcerative Impetigo)

    • Ecthyma is an ulcerative bacterial infection caused by Group A streptococci or staphylococci.
    • It is a lesion of neglect, which develops in excoriations, insect bites, and minor trauma.
    • Children, adolescents, and elderly patients are commonly affected.
    • Lesions extend deeper into the dermis than those in impetigo and have a scattered, discrete arrangement.

    Erysipeloid

    • Erysipeloid is an acute but slowly evolving cellulitis occurring at sites of inoculation, most commonly the hands.
    • It is often occupational, associated with handling fish, shellfish, meat, poultry, hides, and bones.
    • Infection follows an abrasion, scratch, or puncture wound that occurs while handling organic material containing Erysipelothrix rhusiopathiae.
    • The incubation period is 1 to 4 days.
    • The highest incidence occurs in adult men during summer and early fall.

    Folliculitis

    • Folliculitis is a superficial, often bacterial inflammation of hair follicles that heals without scarring.
    • Skin areas regularly exposed to tar, grease, mineral oil, adhesive plaster, and plastic occlusive dressings are most susceptible to folliculitis.
    • S. aureus folliculitis is aggravated by shaving (e.g., beard area, axillae, legs).

    Furuncles and Carbuncles

    • A furuncle is an acute, deep-seated, tender, erythematous, inflammatory nodule that evolves from a staphylococcal folliculitis.
    • A carbuncle is a conglomerate of multiple coalescing furuncles.
    • Children, adolescents, and young adults are frequently affected, and an increased incidence is seen in boys.

    Bacterial Skin Infections

    • Bacterial skin infections can occur secondary to a contaminated wound or as a primary pyodermic infection.
    • Pyodermic infections are characterized by crusted, oozing lesions with variable amounts of purulence and tenderness.

    Causes of Infections

    • An increase in moisture content can allow microbial growth, leading to infection.
    • Breaks in the skin surface, excessive scrubbing and irritation, exposure to water, prolonged occlusion, elevated skin temperature, and local injury can increase the risk of infection.

    Types of Bacterial Skin Infections

    • Impetigo (superficial infection)
    • Ecthyma (ulcerative impetigo)
    • Erysipeloid
    • Folliculitis (inflammation of hair follicles)
    • Furuncles and carbuncles (deep-seated, tender, inflammatory nodules)

    Impetigo

    • Caused by S. aureus, Group A P-hemolytic streptococci, or a mixed infection.
    • Most common in preschool children and young adults.
    • Direct contact with infected exudate can result in transmission.
    • Chronic cases may indicate underlying disease.

    Erythrasma

    • Chronic bacterial infection caused by Corynebacterium minutissimum.
    • Affects intertriginous areas of the toes, groin, and axillae.
    • Common in obese middle-aged adults, especially in warm and humid climates.
    • Skin lesions are sharply marginated, brownish red, scaly eruptions that may last for months to years.

    Treatment of Bacterial Skin Infections

    • Topical antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate are effective for primary impetigo.
    • Systemic antibiotics are usually indicated for ecthyma, folliculitis, and erysipeloid.
    • Furuncles and carbuncles may require incision, drainage, and systemic antibiotics.

    Erysipeloid

    • Caused by Erysipelothrix rhusiopathiae, a gram-positive rod.
    • Incubation period is 1 to 4 days.
    • Highest incidence occurs in adult men during summer and early fall.
    • Characteristic violaceous, sharply marginated lesions composed of macules and plaques.
    • Skin symptoms include itching, burning, throbbing, and pain.

    Folliculitis

    • Superficial, often bacterial inflammation of hair follicles.
    • Heals without scarring.
    • Skin areas regularly exposed to tar, grease, mineral oil, adhesive plaster, and plastic occlusive dressings are susceptible.
    • S. aureus folliculitis is aggravated by shaving.
    • Skin lesions commonly last for days.

    Furuncles and Carbuncles

    • A furuncle is an acute, deep-seated, tender, erythematous, inflammatory nodule that evolves from a staphylococcal folliculitis.
    • A carbuncle is a conglomerate of multiple coalescing furuncles.
    • Children, adolescents, and young adults are frequently affected, with an increased incidence in boys.

    Predisposing Factors for Bacterial Skin Infections

    • Crowded living conditions, poor hygiene, and neglected minor trauma can lead to bacterial skin infections
    • Impetigo commonly affects face, arms, legs, and buttocks

    Impetigo

    • Initial appearance: small red spots that evolve into characteristic vesicles filled with amber fluid
    • Exudate accumulates and forms yellow or brown crusts (scabs) on the skin surface, often surrounded by erythematous skin

    Ecthyma (Ulcerative Impetigo)

    • Ulcerative bacterial infection caused by Group A streptococci or staphylococci, or both
    • Commonly affects children, adolescents, and elderly patients
    • Lesions develop in excoriations, insect bites, or minor trauma, and are commonly distributed on ankles, dorsa of feet, thighs, and buttocks
    • Lesions are pruritic and tender, last for weeks, and often heal with a scar

    Erysipeloid

    • Acute but slowly evolving cellulitis occurring at sites of inoculation, most commonly the hands
    • Often occupational, associated with handling fish, shellfish, meat, poultry, hides, and bones
    • Lesions commonly last for days, with associated skin symptoms of throbbing pain and exquisite tenderness

    Erythrasma

    • Chronic bacterial infection caused by Corynebacterium minutissimum
    • Affects intertriginous areas of the toes, groin, and axillae
    • Commonly affects adults, with a higher incidence in obese middle-aged blacks
    • Predisposing factors include diabetes and a warm, humid climate
    • Skin lesions are sharply marginated, brownish red, scaly eruptions that may last for months to years

    Treatment of Bacterial Skin Infections

    • Primary impetigo: systemic or topical prescription antibiotic is indicated
    • Topical nonprescription antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate are effective for superficial and non-extensive lesions
    • Cleaning the area with mild soap and water and gently removing loose crusts improves response to topical therapy
    • Systemic antibiotics may be necessary to treat concurrent infections in other tissues (e.g., renal, heart valve)

    Treatment of Bacterial Skin Infections (cont)

    • Ecthyma, folliculitis, and erysipeloid: systemic antibiotic is usually indicated
    • Topical nonprescription antibiotics have a limited role in these infections
    • Furuncles and carbuncles may be resolved with incision, drainage, and systemic antibiotics

    Introduction to Bacterial Skin Infections

    • Bacterial skin infections may occur secondary to a contaminated wound or as a primary pyodermic infection
    • Pyoderma is a broad term that refers to cutaneous bacterial infection characterized by crusted, oozing lesions with variable amounts of purulence and tenderness
    • Cultures of primary cutaneous lesions most often reveal S.aureus and Group A streptococci

    Factors Contributing to Bacterial Skin Infections

    • Increased moisture content in the skin allows microbial growth, leading to infection
    • Break in the intact skin surface allows large numbers of pathogenic organisms to be introduced into the inner layers
    • Excessive scrubbing, irritation, exposure to water, prolonged occlusion, elevated skin temperature, or local injury increase the risk of infection

    Types of Bacterial Skin Infections

    • Impetigo
    • Ecthyma (ulcerative impetigo)
    • Erysipeloid
    • Folliculitis
    • Furuncles and carbuncles
    • Erythrasma

    Bacterial Skin Infections

    • Bacterial skin infections can occur secondary to a contaminated wound or as a primary pyodermic infection.
    • Pyoderma is a broad term that refers to cutaneous bacterial infection characterized by crusted, oozing lesions with variable amounts of purulence and tenderness.

    Causes of Infections

    • Normally, the stratum corneum has only about 10% water content, which is enough to ensure elasticity but is generally below that needed to support luxuriant microbial growth.
    • An increase in moisture content can allow microbial growth, leading to infection.
    • A break in the intact skin surface can allow large numbers of pathogenic organisms to be introduced into the inner layers.
    • Risk factors for infection include:
      • Excessive scrubbing and irritation of the skin
      • Excessive exposure to water
      • Prolonged occlusion
      • Excessively elevated skin temperature
      • Local injury

    Types of Bacterial Skin Infections

    • Impetigo: a very superficial infection of the skin caused by S.aureus, Group A P-hemolytic streptococci, or a mixed infection.
    • Ecthyma (ulcerative impetigo): an ulcerative bacterial infection caused most frequently by Group A streptococci or staphylococci or both.
    • Erysipeloid: an acute but slowly evolving cellulitis occurring at sites of inoculation, most commonly the hands.
    • Folliculitis: an infection of the hair follicle.
    • Furuncles and carbuncles: infections of the hair follicle that can lead to abscess formation.
    • Erythrasma: a chronic bacterial infection that affects the intertriginous areas of the toes, groin, and axillae.

    Impetigo

    • Impetigo is most common in preschool children and young adults.
    • Predisposing factors include:
      • Crowded living conditions
      • Poor hygiene
      • Neglected minor trauma
    • Lesions first appear as small red spots that may evolve into characteristic vesicles filled with amber fluid.
    • Exudate accumulates and forms yellow or brown crusts (scabs) on the skin surface, often surrounded by erythematous skin.
    • Face, arms, legs, and buttocks are common affected areas.

    Ecthyma (ulcerative impetigo)

    • Ecthyma is a lesion of neglect, which develops in excoriations, insect bites, minor trauma in elderly patients, soldiers, sewage workers, alcoholics, and homeless people.
    • These lesions extend much deeper into the dermis than those in impetigo.
    • They have a scattered, discrete arrangement and are commonly distributed on ankles, dorsa of feet, thighs, and buttocks.
    • Lesions are pruritic and tender; they last for weeks and often heal with a scar.

    Erysipeloid

    • Erysipeloid is often occupational, associated with handling fish, shellfish, meat, poultry, hides, and bones.
    • Chronic cases should be referred to a physician for evaluation of a possible underlying disease.
    • These lesions commonly last for days, with associated skin symptoms of throbbing pain and exquisite tenderness.
    • Some patients are subject to recurrent furunculosis.

    Erythrasma

    • Erythrasma is a chronic bacterial infection that affects the intertriginous areas of the toes, groin, and axillae.
    • Adults are generally affected, with a higher incidence in obese middle-aged blacks.
    • Predisposing factors include diabetes and a warm, humid climate.
    • The skin lesions are sharply marginated, brownish red, scaly eruptions that may last for months to years.
    • Irritation may be the only skin symptom.

    Treatment of Bacterial Skin Infections

    • For the treatment of primary impetigo, a systemic or topical prescription antibiotic is indicated.
    • Topical nonprescription antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate seem to be most effective when lesions are superficial and are not extensive.
    • Cleaning the area with mild soap and water and gently removing loose crusts should improve response to topical therapy.
    • For the treatment of ecthyma, folliculitis, and erysipeloid, a systemic antibiotic is usually indicated.
    • The role of topical nonprescription antibiotics in these infections is very limited.
    • Furuncles and carbuncles may be resolved with incision, drainage, and the prescription of systemic antibiotics by a physician.

    Bacterial Skin Infections

    • Bacterial skin infections can occur secondary to a contaminated wound or as a primary pyodermic infection.
    • Pyodermic infections are characterized by crusted, oozing lesions with variable amounts of purulence and tenderness.

    Causes of Infections

    • An increase in moisture content can allow microbial growth, leading to infection.
    • Breaks in the skin surface, excessive scrubbing and irritation, exposure to water, prolonged occlusion, elevated skin temperature, and local injury can increase the risk of infection.

    Types of Bacterial Skin Infections

    • Impetigo (superficial infection)
    • Ecthyma (ulcerative impetigo)
    • Erysipeloid
    • Folliculitis (inflammation of hair follicles)
    • Furuncles and carbuncles (deep-seated, tender, inflammatory nodules)

    Impetigo

    • Caused by S. aureus, Group A P-hemolytic streptococci, or a mixed infection.
    • Most common in preschool children and young adults.
    • Direct contact with infected exudate can result in transmission.
    • Chronic cases may indicate underlying disease.

    Erythrasma

    • Chronic bacterial infection caused by Corynebacterium minutissimum.
    • Affects intertriginous areas of the toes, groin, and axillae.
    • Common in obese middle-aged adults, especially in warm and humid climates.
    • Skin lesions are sharply marginated, brownish red, scaly eruptions that may last for months to years.

    Treatment of Bacterial Skin Infections

    • Topical antibiotic preparations with neomycin, bacitracin, and polymyxin B sulfate are effective for primary impetigo.
    • Systemic antibiotics are usually indicated for ecthyma, folliculitis, and erysipeloid.
    • Furuncles and carbuncles may require incision, drainage, and systemic antibiotics.

    Erysipeloid

    • Caused by Erysipelothrix rhusiopathiae, a gram-positive rod.
    • Incubation period is 1 to 4 days.
    • Highest incidence occurs in adult men during summer and early fall.
    • Characteristic violaceous, sharply marginated lesions composed of macules and plaques.
    • Skin symptoms include itching, burning, throbbing, and pain.

    Folliculitis

    • Superficial, often bacterial inflammation of hair follicles.
    • Heals without scarring.
    • Skin areas regularly exposed to tar, grease, mineral oil, adhesive plaster, and plastic occlusive dressings are susceptible.
    • S. aureus folliculitis is aggravated by shaving.
    • Skin lesions commonly last for days.

    Furuncles and Carbuncles

    • A furuncle is an acute, deep-seated, tender, erythematous, inflammatory nodule that evolves from a staphylococcal folliculitis.
    • A carbuncle is a conglomerate of multiple coalescing furuncles.
    • Children, adolescents, and young adults are frequently affected, with an increased incidence in boys.

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    Description

    This quiz covers the characteristics and symptoms of skin infections, including furunculosis and erythrasma, and their treatment.

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