derm, intections

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what organism causes acne?: 1. propionibacterium acnes infxn of blocked pore
what is acne?: 1. inflamm of pilosebaceous unit caused by secondary
2. propionibacterium acnes infxn of blocked pore
what are si/sx of acne?: 1. open comedones (blackheads) and
2. closed comedones (whiteheads) on face, neck, chest, back and buttocks
3. can become inflamed and pustular
what are comedones?: 1. whiteheads and blackheads of acne
what is tx for acne?: 1. topical benzoyl peroxide
2. topical clindamycin
3. oral tetracycline
4. oral erythromycin
5. topical tretinoin
6. lart resort=oral isotretinoin (teratogienic!!)
what is the last resort for tx of acne and is teratogenic?: oral isotretinoin
what is 1% hydrocortisone potency and use?: 1. low potency
2. use for dz on:
face, genitals, skin folds (prevent atrophy/atriae), also use in children for dz on body
what is 0.1% triamcinolone potency and usage?: 1. moderal potency
2. use for dz on body/extremities or increased dz on face, genitals, and skin folds
what is fluocinonide (Lidex) potency and usage?: 1. high potency
2. use for dz on thick skin (palms/soles) or increased body dz, do not use on face!!!
where should you NOT use fluocinonide (Lidex) on?: do NOT use on face!!
what is diforasone potency and usage?: 1. very high potency
2. use for dz on thick skin or if very severe on body
what is the potency of lotion, cream and ointment?: 1. lotion=lowpotency
2. cream= mid potency
3. ointment= high potency
what is impetigo?: 1. superficial skin infxn of epidermis
2. caused by staph aureus and strept pyogenes
what are si/sx of impetigo?: 1. honey-crusted lesions or vesicles occurring most often in children around the nose and mouth
2. can be bullous or nonbullous
3. common organisms include Staph aureus and Strep pyogenes
where do you find honey-crusted leions or vesicles?: 1. impetigo!!
2. staph aureus and strep pyogenes
what is tx for impetigo?: 1. keflex (cephalexin) or
2. oxacillin for 7-10 days
what is folliculitis?: 1. erythematous pustules commonly noted around beard area
2. S. aureus m/c
3. Psedomonas causes "hot tub" folliculits
what are common organisms of folliculitis?: 1. S. aureus is m/c
2. Pseudomonas aeruginosa causes "hot tub" folliculitis (organism lives in warm water)
3. fungi and viruses
what condition is characterized by erythematous pustules commonly noted around the beard area?: folliculitis
how do you tx folliculitis?: 1. local wound care
2. Keflex only if severe (cephalexin)
what are si/sx of cellulitis?: 1. spreading subcuaneous infx c/ classic signs of inflamm
2. rubor (red)
3. calor (heat)
4. dolor (pain)
5. tumor (swelling)
what are the classic signs of inflamm?: 1. rubor (redness)
2. calor (heat)
3. dolor (pain)
4. tumor (swelling)
what are m/c etiologies of cellulitis?: 1. staph
2. strep
what is tx for cellulitis?: 1. oxacillin
2. Keflex (cephalexin)= 1st gen. cephalosporin c/ good activity against aerobic gram positive and some gram negatives
what is found with an abscess?: 1. local collection of pus
2. often with fever
3. increased white count
what is tx for an abscess?: 1. incision and drainage
2. can add Keflex (cephalexin)
what is a furuncle?: 1. boil
2. pus collection in 1 hair follicle
3. often caused by S. aureus
what is a carbuncle?: 1. pus collection involving many hair follicles
what is tx for a furuncle or a carbuncle?: 1. I&D
2. add Keflex (cephalexin)= 1st gen. cephalosporin c/ good activity against aerobic gram positive and some gram negatives or
3. oxacillin
what is paronychia?: 1. infxn of skin surrounding nail margin that can extend into surrounding skin and into tendons within hand
2. commonly caused by S. aureus, also Candida
how do you tx paronychia?: 1. warm compress
2. I&D is area is purulent
3. add Keflex if severe: Keflex (cephalexin)= 1st gen. cephalosporin c/ good activity against aerobic gram positive and some gram negatives
what is paronychia ofen caused by?: 1. S. aureus
2. Candida
what is necrotizing fasciits?: 1. infxn along fascial planes with sever pain, fever, increased white count
2. locat inflamm may be deceptively absent but pt will appear very ill
what is necrotizing fasciitis caused by?: 1. S. pyogenes (group A Strep)
2. Clostridium perfringens
what is tx for necrotizing fasciitis?: 1. immediate, extensive surgical debridement
2. add penicillin and clindamycin to help prevent further spread
what is px for necrotizing fasciitis?: 1. high mortality unless debridement is rapid and extensive
what is the cause of scarlet fever?: 1. S. pyogenes (group A Strep {GAS}!)
what are si/sx of scarlet fever?: 1. "sunburn with goose bumps"
2. rash--finely puncatate, erythematous but blanches c/ pressure, initally on trunk, generalizes within hours
3. sandpaper rough skin,
4. strawberry tongues, beefy-red pharynx, circumoral pallor
5. pastia's lines= rash, most intense in creases of axillae and groin
6. eventual desquamation of hands and feet as rash resolves
what are pastia's lines and where are they found?: 1. rash of scarlet fever
2. most intnse in creases of axillae and groin
what is found with "sunbrun c/ goose bumps", strawberry tongue, and Pastia's lines?: scarlet fever (S. pyogenes--group A strep--GAS!)
what are systemic sx of scarlet fever?: 1. fever, chills, delirium
2. sore throat, cervical adenopathy
3. all of which appear at same time as rash
what are complications of scarlet fever?: 1. rheumatic fever
2. glomerulonephritis
what are rheumatic fever and glomerulonephritis complications of?: 1. scarlet fever
what is tx for scarlet fever?: 1. penicillin
what is hidradenitis suppurativa?: 1. plugged apocrine glands presenting as inflamed masses in groin/axilla
2. becomes secondarily infected
what is tx for hidradenitis suppurativa?: 1. plugged apocrine glands presenting as inflamed masses in groin/axilla
2. surgical debridement and abx
what are Rose spots and where are they found?: 1. small, pink papules in groups of 1-2 dozen on trunk
2. found in 30% of pts with typhoid fever (Salmonella typhi)
what are si/sx of typhoid fever?: 1. rose spots
2. high fever, myalgias, abd tenderness, splenomegaly
3. classic pulse-fever dissociation= high fever c/ relative bradycardia (also seen in brucellosis)
what is classic pulse-fever dissocation and where do you find it?: 1. high fever c/ relative bradycardia
2. seen in typhoid fever and brucellosis
what is tx for chronic aSx typhoid fever?: 1. carrier state such as "typhoid Mary"
2. cholecystectomy b/c S. typhi resides in the gallbladder
where does S. typhi of typhoid fever reside?: 1. in the gallbladder
2. cholecystectomy for aSx pts
what is erythrasma?: 1. irregular erythematous rash found along major skin folds
2. axilla, groin, fingers, toes and breasts
3. commonly seen in adult diabetics, caused by Corynebacterium spp.
what does corynebacterium spp. cause?: 1. erythrasma (irregular erythematous rash found along major skin folds)
2. seen in adult diabetics
how do you dx erythrasma?: 1. Wood's lamp os skin
2. see coral red fluorescence (result of proporphyria III)
3. KOH prep negative
4. tx with erythromycin
what do you use a Wood's lamp for?: 1. dx of erythrasma
2. see coral red fluorescence (result of proporphyria III)
3. KOH prep negative
how do you tx erythrasma?: 1. erythromycin
2. Corynebacterium spp.

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