Impetigo

(must culture)

Contagious bacterial infection often found in children. Causes: break in skin, dermatitis, warm climates, poor hygiene.

S&S: red patches that fill with yellow fluid, then crusts or erorsions. 

DX: culture or gram stain

TX: Antibiotics (PCN or derivative) unless MRSA. Mupirocin ointment. Avoid scratching!

Non-genital cold sore or mucus membrane with painful vesicles that erupt. Can be transmitted by respiratory droplets or fluid. Often reoccurs.

Virus is latent in cells of nose or lips.

Reactivates in illness or stress.

TX: Zovirax (Acyclovir) 

ointments, avoid contact, analgesics for pain.

Herpes Zoster

"Shingles"

Highly contagious acute viral infection. Produces painful eruptions around nerves. 

Caused by Varicella Zoster (chicken pox)

S&S: painful, burning, vesicles on trunk, depression common. 

Post-herpetic neuralgia-older patients.

Acyclovir started within 3 days.

Traimcinolone topical cortisone decreases inflammation. l

A= assymetry

B= border irregularity

C= color variation within one lesion

D= diameter > 6 mm

E= elevation

DX: biopsy by shaving, excisional cuts. Culture the wound and drainage. Wood's Light - ultraviolet light to detect. 

Diascopy - glass slide on top of raised lesion.

Pruritus

Most common complaint in Dermatology

Sunburn

First degree or superficial

Inflammatory response. S&S: erythema & pain.

TX: comfort measures, antibiotic if blistering, topical corticosteroids for severe inflammation.  Benzocaine and Lidocaine. 

Uticaria

"Hives"

Caused by exposure to allergens.

TX: Antihistamines like Benadryl. Avoid warm environments and exposure to allergens. 

Measuer size and depth. 

Chart location, odor, drainage, color also.

Monitor VS!! and labs.

Note necrotic or granulation tissue.

Stage II-IV are contaminated or contain bacteria.

TX: duoderm, wet to dry dressings, enzymes, debridement, antibiotics. 

1. Passive.

2. Interactive.

3. Active.

Dressings: 

Occlusive= Tegaderm or Duoderm

Moisture Rententive

Bacterial infection of skin. Staph or Strep.

Skin is red, hot, painful, edematous, shiny.

TX: rest, moist heat, PCN derivative(except MRSA), elevation, stockings. 

Infection in hair follicles or oil glands.

Caused by physical injury-shaving or occlusion hair bearing areas. Bacteria is usually staph. 

S&S: pustule at hair follicle, ingrown hairs, loss of hair. 

TX: no shaving, use soap, topical or systemic antibiotics. 

Candidiasis (oral)

Candidiasis albicans

Acute or chronic yeast-like fungal infection of mouth or GI tract. Overgrowth associated with immunity suppression or antibiotic therapy. S&S: white-like plaques, bleed and leave erosion when removed. Thrive in warm environments. Poor appetite, difficulty swallowing. 

TX: nystatin, fluconazole or clotrimazole (Mycelex).

Keep area dry. 

Tinea cruris

"jock itch"

Ringworm type fungal infection of the groin or scrotum area.

Most people also have Tinea pedis (athlete's foot). 

S&S: itching, gray patches, moist skin.

TX: Anti-fungal (Lotrimin) or Griseofulvin (PO).

Avoid tight fitting clothes, maintain good personal hygiene, wear shower shoes. Reocurrence is common. 

Tinea corpus is fungal infection of arms & legs. 

Pediculosis

(Lice)

Parasite that feeds on scalp & leaves nits. Transmit disease.

DX: hand-held lens.

S&S: pinpoint erythema, itching, crawling, biting.

TX: Kwell, special comb, vinegar solution. 

Contagious skin disease caused by mites.

Transmitted  by close contact with infective person or bedding. 

Curved or linear ridges in skin.

Itching, itching, itching!!!

CONTACT PRECAUTIONS!

Chronic inflammatory disease of the skin. 

Probably autoimmune, some genetic component.

S&S: scaly patches, nail pitting, ,psoriatic arthritis.

TX: moisturizers, steroids, coal tar, UV light, topical meds, natural sunlight, METHYTREXATE!

Chronic, no cure, provide psychological care.