Skin infectionsShayan behnammanesh

1/3/2015

Skin is one the most and is the first line agaisnt bacterial infections.

The most common cause of skin and soft tissue infection involves a breach in this barrier.

These conditions are different in depth and extent of skin involvment.

Different types

Non bullous impetigo bullous impetigo

impetigo

Common causes of alterations in the normal skin flora:

Abrasions Trauma Insect bite Eczema Scabies

impetigo

Most common cause:1- group A hemolytic streptococci2-staphylococcus aureus

Bullous vs. non bullous

Good skin hygiene+ removal of crusted lesions in non bullous type.

Topical if lesions are local (<5), if the lesions are not local or there is fever and regional lymphadenopathy use systemic antibiotics.

Topical: mupirocin tds for 3 to 5 days Systemic: cephalexin 250-500 qid Systemic mrsa: Clindamycin 300-450 qid

Management

Infections involving upper dermis

Distinct margins.

b-hemolytic strep is the main cause.

Erysipelas

Management: Elevation if applicable Control predisposing conditions Hydrate the skin Compression stocking and diuretic therapy to

improve edema

Erysipelas

Oral therapy: amoxicillin 500mg tds Parenteral therapy: Ceftriaxone 1g iv daily Improvement in 24 to 72 hrs.

Erysipelas

Infection of deeper dermis and subcutaneous fat.

The most common cause:

1- S aureus(50%)2-GAS(27%)

cellulitis

History and exam: Localized erythema and confluent Blanching and swelling Warmth Tenderness Lymphangitis with tender regional

lymphadenopathy

cellulitis

History and physical exam: Determine the extent of disease. Search for breaches and fungal infections. Mark the affected area. Purulent or non purulent???

Cellulitis

And classify the severity of cellulitis:

cellulitis

Risk factors for MRSA: Recent hospitalization Recent antiobiotic therapy Hemodialysis Military service Daibetes Hiv Injection drug Prolonged hospitalization

cellulitis