Skin Conditions and Diseases

eczema and other acute dermatitis

• urticaria (hives)
• contact dermatitis
• erythema multiforme
• psoriasis
• seborrheic dermatitis
• lichen planus
• lupus erythematosus
• acne

Pigmented Lesions

• melanoma
• nevi
• halo nevi
• lentigo

vesicular and bullous diseases

 

autoimmune

• pemphiguS - Superficial
• bullous pemphigoiD - dermis
• dermatitis herpetiformis

 

• porphyria
• bullous impetigo - S. aureus
  • infants and youn children; can cause scaled skin syndrome if extensive
• bullous erysepilys

Warty Papules

• warts
• squamous cell carcinoma
• basal cell carcinoma
• actinic keratosis
• seborrheic keratosis

wounds

• venous stasis ulcers
• arterial ulcers
• neuropathic ulcers

burns

Skin Infections

Skin is a natural barrier to infection. However, it frequently succumbs to attack by bacteria, viruses, parasites, and insects.

 

Skin infections are more common in people with:

• young or elderly age
• at-risk environment
• lowered immune system
• concurrent diseases or conditions
• medications (antibiotics, corticosteroids)

 

Infection History and Physical

history:

• time and course
• preveious skin disease and trauma
• contact with infected individuals
• recently used medications
• other symptoms (fever, malaise, etc)

physical exam:

• anatomical location and distribution
• follicular or non-follicular
• concurrent cutaneous or systemic disease
• constitututional symptoms
• lymphadenopathy, lymphangiitis, or edema

 

Bacterial Skin Infections

 

• Staphylococcus aureus
  • most likely to cause disease
  • local infections: folliculitis, furuncles, carbuncle, impetigo, ecthyma, cellulitis
  • toxin related: scalded skin syndrome
  • secondary infections
• Streptococcus
  • local infections: impetigo, cellulitis, erysiplas, NF
  • toxin related: scarlet fever, toxic shock syndrome

 

common viral skin infections

• herpes simplex virus
• varicella (chickenpox)
• herpes zoster (shingles)

 

 

scabies

 

fungal infections (tinea)

affinity for keratin of skin, hair, and nails

named for site of involvement - tinea capitis, pedis, cruris, manum, facei, corporis, barbae, unguim (aka onychomycosis)

various species

yeast infections include Candidiasis and tinea versicolor

often scaling, with occasional pustules

 

tinea capitis can be varied in what it looks like

• alopecia (hair loss) is a good clue its a fungus
• have a high index of suspicion

management of fungal infections

• establish correct diagnosis
• KOH exam (easy to do where you are)
• Wood's light (a single wavelength) that lights up porphyrin
  • negative doesn't exclude fungi
• fungal culture (takes a couple of weeks)

treatment of fungal infections

• topical antifungals (limited infections)
• clotrimazole, econazole, ketaconazole, terbenafine, ciclopirox)

 

 

onychomycosis

lamisil is taken systemically for 3 mothns, with ~80% experiencing cure

 

hand, foot, and mouth disease

warts

molluscum contagiosum