Transcript bacterial skin infection

BACTERIAL AND VIRAL INFECTION
IN DERMATOLOGY
Dr. H. NUR HIDAYAT, SpKK
DEPARTMENT OF DERMATOLOGY & VENEREOLOGY
UNDATA REGIONAL GENERAL HOSPITAL
/ FACULTY OF MEDICINE & HEALTH SCIENCE
TADULAKO UNIVERSITY
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October, 2014
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BACTERIAL SKIN INFECTION
(PYODERMAS)
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INFECTION IN DERMATOLOGY
Objectives :
Comprehend the epidemiology,
clinical manifestation, diagnosis and
management of bacterial and viral
infection diseases in dermatology
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BACTERIAL INFECTION CAN DIVIDED
IN FOUR MAJOR CATEGORIES:
• 1. primary skin infection
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2. secondary infection of a primary skin disease
(e.g. infected atopic dermatitis)
• 3. skin lesions as manifestations of primary infection
in some other organ system, usually the blood
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4. reactive skin conditions resulting from bacterial
infection (e.g., erythema nodosum due to
streptococcal pharyngitis)
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1. PRIMARY SKIN INFECTION
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Impetigo
Superficial pustules Folliculitis
Pustules Folliculitis
Furuncle
Carbuncle
Erysipelas
Celullitis
Ecthyma
Hydradenitis Suppurativa
Abscess
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IMPETIGO
Crust on the face
Yellow Color
Self limited disease
Very contagiuos
Contagious Impetigo
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BULLOUS IMPETIGO
VESICLE/BULLAE HYPOPION,
WITH ERYTHEMATOUS BASED
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FOLIKULITIS PUSTULOSA
PREDILECTION: HAIRY AREA
CLINICAL SIGN : PUSTULE , ABCESS.
RECCURENT
ETIOLOGI : S. AUREUS.
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FURUNCLE
PERYFOLLICULAIR ABSCESS,
Clin. Exam.: well define induration
with erythematous.
Predil.: neck, axilla, buttock
Predisposition : poor higyene, DM
Etiology: S.aureus
FURUNCLE
(SINGLE)
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CARBUNCLE
CARBUNCLE
(CONFLUENCE
FROM FURUNCLE)
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Celullitis
Erysipelas
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Hidradenitis suppurativa
•Hidradenitis suppurativa is a chronic condition of the
sweat glands (apocrine).
•The sweat glands become clogged due to a variety of
reasons, leading to enlargement (dilatation) of the ducts
behind them.
•Starts soon after puberty and continues into adult life.
•more common in women
•Hair removal (shaving or using depilatories), deodorants,
and irritation from anything rubbing
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Predilection
The groin and armpits
Clinical manifestations:
noduls, firm tender,
red bumps with extensive scar and
sinus tracking under the surface of
the skin.
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Management
•topical antibiotic solution for mild areas
•oral antibiotics to treat more severe areas
•injection of steroids into the deep, painful
lesions
•hormonal therapy
•Oral tretinoin
•Surgical removal (excision)
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Abscess
An infection characterized by a collection of pus
underneath a portion of the skin.
Etiology: Staphylococcus aureus and Streptococcus.
Predispose factors :
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Any untreated skin infection
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Diabetes
Obesity
Intravenous drug abuse
Weakened immune system ( illness or medication)
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Signs and Symptoms
•A worsening red, tender swelling that
arises over a period of 1–2 weeks.
•The pus underneath the skin
• a fever or a general sense of not
feeling well.
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Management
1. Drain the pus and fluid collection by making a
small incision in the skin after it has been numbed.
2. Oral antibiotics aimed at treating the most common
bacteria that cause abscesses.
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2. Secondary infection of a primary skin disease
(e.g. infected atopic dermatitis)
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3. Skin lesions as manifestations of primary infection
in some other organ system
(Staphylococcal Scaled Skin Syndrome /SSSS)
•Etiology: Staphylococcus
•Immun reaction for exotoxin
(exfoliatin)
•Clinical sign: Exfoliative in whole
of the body
•Management:
Hospitalization,
Antibiotica (dikloksasilin)
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Staphylococcal scaled skin syndrome (S4)
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4. reactive skin conditions resulting from
bacterial infection
•Erythema nodosum :
nodular, acute erythematous eruption
Predilection: extensor aspects of the lower legs
Delayed hypersensitivity reaction
Caused by streptococcal infection
Women more often than men,
male-to-female ratio of 1:4.
aged 18-34 years
The eruptive phase : flulike symptoms of fever, generalized aching.
Arthralgia.
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erythema nodosum
nodular red swellings over the
shins.
MANAGEMENT
•cool wet compresses, elevation, and bed rest.
•symptomatic relief using NSAIDs
•Corticosteroids
.evaluation of the underlying cause
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VIRAL INFECTION
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VIRAL INFECTION
Herpes virus:
1. Herpes labialis
2. Herpes genitalis
3. Varicella
4. Herpes zoster
Pox virus :
1. Variola
2. Moluscum contagiosum
Human papilloma virus:
1. Verucca vulgaris
2. Condyllomata accuminata
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Pox virus :
1. Variola
Varicella (chiken pox)
Smallpox was globally eradicated in the 1970s.
Any case of smallpox means a bioterrorism event.
Blisters (vesicles) develop all at the same stage,
in contrast to chickenpox, where lesions are in
different forms at the same time.
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Human papilloma virus (HPV):
1. Verucca vulgaris (common wart)
2. Condylomata acuminata (genital wart)
Common warts (verruca vulgaris):
Growths on the skin, caused by human papillomavirus (HPV).
Clinical manifest: circular raised flesh-colored growths , roughened, irregular surface.
Predilection: fingers, backs of the hands, face, knees, and elbows.
They are usually not painful and are harmless
Genital warts (condyloma acuminata)
Caused by more than 30 types (strains) of human papillomavirus (HPV).
Transmission: skin-to-skin contact during sexual activity (not need to be
vaginal or anal penetration)
Some of the virus types may cause cervical cancer.
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Signs and Symptoms
Singly or in multiples and often have multiple small black
"dots" at the surface from tiny blood vessels.
Common warts are rough, thick, and either skin-colored,
pink, or white bumps (1 mm to over 10 mm).
Filiform warts are long and narrow, like tufts of thread, and
usually small at the base (1–3 mm).
Thank you
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Thank you
Signs and Symptoms
Singly or in multiples and often have
multiple small black "dots" at the surface
Common warts are rough, thick, and either
skin-colored, pink, or white bumps (1 mm
to over 10 mm).
Filiform warts are long and narrow, like
tufts of thread, and usually small at the
base (1–3 mm).
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Thank you
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Signs and Symptoms Genital warts
•Small 1–2 mm smooth bumps or larger warty, cauliflower-like lesions.
•White, gray, or skin-colored.
•Predilection: labia, vagina, penis, scrotum, anus, skin around the anus,
and groin folds.
•They do not cause any symptoms.
Thank you
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Genital warts (condyloma), can
appear anywhere in the genital
region.
Thank you
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TREATMENT
1.
2.
3.
4.
Destruction with freezing (cryosurgery); burning (electrocautery); laser
Injection of chemotherapy drugs
Application of imiquimod, an immunotherapy agent,
Chemicals to destroy the wart such as podophyllin solution,
Caution:
1. Partner should be checked for infection.
Thank
2. For women, a Pap
smear isyou
done to look for any signs of
abnormal cervical cells, which can be the first sign of cervical
cancer.
3. For men, the genital area is visually inspected.
4. Even if that check is normal, may still get warts or cervical cancer
in the future.
5. Genital warts cannot be cured, lesions can recur frequently.
6. Wait to have sex for at least 2 weeks, after the areas are well
healed and you can see no warts.
7. Consult if patient will be pregnant.
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REFERRENCES
Elston DM.,2009, Infectious Diseases of the Skin, 1st ed.,
manson Publishing Ltd. London UK
http://www.visualdxhealth.com
ThankEA,
you
JawetzMelnick JL. Adelberg
Brokks GF, Butel JS and
Ornston LN 2004 Medical Microbiology, 20 th ed. Simon and
Schuster Asia Pte Ltd, Singapore
Odom,.R., James,W., Berger,T., 2000. Andrews’ Diseases of
the skin, 9 th ed., WB Saunders Company
Tyring SK, Lupi O.,Hengge UR. 2006, Tropical dermatology,
1 st ed. Elsevier Churchill, Livingstone
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2011
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2012
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2013
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2014
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2015 WCD
(VANCOUVER, CANADA)
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