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7 th semester dermatology lectures
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7102008
1
Bacterial infections of Skin
Dr Sudha AgrawalBPKIHS Dharan
7102008
2
DEFENSES 1048715 Dry
1048715 1048715 Acidic (pH 54)
1048715 Temperature less than 37oC
1048715 1048715 Lysozyme and lipids
1048715 1048715Skin-associated lymphoid tissue (SALT)
Resident microflora1048715
7102008
3
Skin and infection
1048715 Entry Skin (pores hair
follicles) Wounds (scratches
cuts burns) Insect amp animal bites
1048715 Diseases Localized infections
with localandor systemic effect
Systemic infections
Multiplication Extracellular Intracellular ()
1048715 Damage Toxin Host immune response
7102008
4
Normal flora of skin
Classification
1 Resident flora grow on skin amp relatively
stable in no and composition at particular sites
2 Transient flora lie on skin surface without attachment unable to multiply amp
disappear within short time
3 Transient or temporary residents
7102008
5
Normal Skin Flora
Major bacterial groups
Coryneforms (Gram +ve pleomorphic rods)
Corynebacterium (Aerobic amp
lipophilic)
Brevibacterium (Aerobic amp non-
lipophilic)
Propinobacterium (Anaerobic)Contdhellip
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
2
DEFENSES 1048715 Dry
1048715 1048715 Acidic (pH 54)
1048715 Temperature less than 37oC
1048715 1048715 Lysozyme and lipids
1048715 1048715Skin-associated lymphoid tissue (SALT)
Resident microflora1048715
7102008
3
Skin and infection
1048715 Entry Skin (pores hair
follicles) Wounds (scratches
cuts burns) Insect amp animal bites
1048715 Diseases Localized infections
with localandor systemic effect
Systemic infections
Multiplication Extracellular Intracellular ()
1048715 Damage Toxin Host immune response
7102008
4
Normal flora of skin
Classification
1 Resident flora grow on skin amp relatively
stable in no and composition at particular sites
2 Transient flora lie on skin surface without attachment unable to multiply amp
disappear within short time
3 Transient or temporary residents
7102008
5
Normal Skin Flora
Major bacterial groups
Coryneforms (Gram +ve pleomorphic rods)
Corynebacterium (Aerobic amp
lipophilic)
Brevibacterium (Aerobic amp non-
lipophilic)
Propinobacterium (Anaerobic)Contdhellip
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
3
Skin and infection
1048715 Entry Skin (pores hair
follicles) Wounds (scratches
cuts burns) Insect amp animal bites
1048715 Diseases Localized infections
with localandor systemic effect
Systemic infections
Multiplication Extracellular Intracellular ()
1048715 Damage Toxin Host immune response
7102008
4
Normal flora of skin
Classification
1 Resident flora grow on skin amp relatively
stable in no and composition at particular sites
2 Transient flora lie on skin surface without attachment unable to multiply amp
disappear within short time
3 Transient or temporary residents
7102008
5
Normal Skin Flora
Major bacterial groups
Coryneforms (Gram +ve pleomorphic rods)
Corynebacterium (Aerobic amp
lipophilic)
Brevibacterium (Aerobic amp non-
lipophilic)
Propinobacterium (Anaerobic)Contdhellip
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
4
Normal flora of skin
Classification
1 Resident flora grow on skin amp relatively
stable in no and composition at particular sites
2 Transient flora lie on skin surface without attachment unable to multiply amp
disappear within short time
3 Transient or temporary residents
7102008
5
Normal Skin Flora
Major bacterial groups
Coryneforms (Gram +ve pleomorphic rods)
Corynebacterium (Aerobic amp
lipophilic)
Brevibacterium (Aerobic amp non-
lipophilic)
Propinobacterium (Anaerobic)Contdhellip
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
5
Normal Skin Flora
Major bacterial groups
Coryneforms (Gram +ve pleomorphic rods)
Corynebacterium (Aerobic amp
lipophilic)
Brevibacterium (Aerobic amp non-
lipophilic)
Propinobacterium (Anaerobic)Contdhellip
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
6
Staphylococci (Gram +ve cocci aerobs)
S epidermidis S hominis Shemolyticus
Ssaprophyticus
Minor bacterial groups Acinetobacter (25) Micrococci
Fungal group Pityriasporum
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
7
Bacterial infection of the skin (Pyoderma)
Classification of pyodermas1 Primary
Impetigo Ecthyma Folliculitis
Superficial Deep
Folliculitis of leg Furuncle Carbuncle Sycosis Barbae
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
8
Cellulitis Erysipelas Pyonychia SSSS TSS
2 SecondarySecondary infection of preexisting dermatoses
eg Atopic dermatitis Scabies
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
9
Impetigo (contagious superficial infection)
Non-bullous Bullous1 Cause
- Streptococcal (Group A) Staph aureus- Staph aureus (Phage Groups II)
2 Pre-school and young school age All ages3 Very thin walled vesicle on an erythematus Bullae of
base 1-2cm4 Transient Persist for 2-3
day5 Yellowish-brownish crusts (thick) Thin flat
brownish crust Contdhellip
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
10
6 Irregular peripheral extension without Central healing with healing peripheral extension
7 Regional adenitis Rare
8 Constitutional symptoms present Absent
9 Face (around the nose mouth amp limbs) occur anywhere
10 Palms amp sole spared May involved
11MM very rare May involved
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
11
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
12
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
13
Malnutrition Diabetes Immuno-compromise status
Complications
PSGN (strep M-type 49) Scarlet fever Urticaria Erythema mutiforme
Predisposing factors
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
14
Ecthyma
Streptococcal amp staph
Common in children
Small bullae or pustules on erythematous base
Formation of adherent dry crusts
Beneath which ulcer present
Indurated base Heals with scar and pigmentation
Buttocks thighs and legs commonly affected
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
15
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
16
Folliculitis
Superficial folliculitis
Infection of hair follicles
Commonly caused by staph aureus
Children
Scalp amp limb
Rarely painful
Heals in a week
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
17
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
18
Deep Folliculitis
Deep folliculitis of leg
Chronic
Staph aureus
Hair follicles of leg
Multiple
Atrophic scar
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
19
Furuncle (Boil)
Acute
Staph aureus
Small follicular noduler -- Pustule--
necrotic--discharge pus
Painful
Constitutional symptoms
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
20
Heals with scar
Age Adult
Site Neck Wrist Waist Buttocks Face
Complication Cavernous Sinus thrombosis (upper lip amp check)
Septicemia (malnutrition)
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
21
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
22
Carbuncle
Extensive infection of a group of contagious
follicles
Staph aureus
Middle or old age
Predisposing factors Diabetes
Malnutrition
Severe generalized dermatoses
During prolonged steroid therapy
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
23
Painful hard lump
Suppuration begins after 5-7 days
Pus discharge from multiple follicular orificies
Necrosis of intervening skin
Large deep ulcer
Constitutional symptoms
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
24
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
25
Sycosis barbae
Beard region
Pustules surrounded by erythema
Males
After puberty
After trauma
Upper lip and chin
Staph aureus
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
26
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
27
Cellulitis
Inflammation of loose connective tissue
Streptococcal (Group A)
Acutesub-acutechronic
Erythematous edematous swelling
Paintenderness
Constitutional upset
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
28
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
29
Pyonychia
Acute
Erythematous swelling of proximal and lateral
nail fold
Painful
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
30
Staphylococcal scalded skin synotrane (Ritterrsquos Disease)
Exotoxin of staph (Phage Group II)
Acantholysis
Occult staph upper respiratory tract infection or
purulent conjunctivitis
Infants and children
Tender red skin
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
31
Contdhellip
Denuded skin
Heals 7 - 14 day
Donrsquot grow staph from blister fluid
Complication 2
Cellulitis
Pneumonia
Prognosis Rule
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
32
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
33
Principles of therapy of pyoderma
Good personal hygiene Management of predisposing factors
Local Attend to traumas Pressure Sweating Bites Treat pre-existing dermatosis Investigate carrier sites Nose Axilla
Perineum
SystemicTreatment of disease like DM Nutritional deficiency Immunodeficiency
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
34
Principles of therapy of pyoderma
Local therapy
Cleaning with soap-water and weak
KMN04 solution
Removal of crusts with KMN04 soluation
Application of antibacterial cream
Systemic therapy
Antibiotics
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
35
Recurrent staphylococcal infection
Persistent nasal carriage
Abnormal neutrophitic chumotaxis
Deficient intracellular killing
Immunodeficient status
DM
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
36
Tt of staph carriage elimination
Nasal amp perineal care
Rifampicin 600 mgd 7-10 days
Clindamycin 150 mgd 3 months
Topical mupirocin
Replacement of microflora with a less
pathogenic stains of S aureus (strain 502)
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
37
S aureus produces skin infection
I Direct infection of skin and adjuscent tissuesa Impetigob Ecthymac Folliculitisd Furunculosise Carbunclef Sycosis
II Secondary infectionEczema infection
IIICutaneous disease due to effect of bacterial toxina Staphylococcal scalded skin syndromeb Toxic shock syndrome
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
38
szlig-hemolytic streptococcus produces skin infection
I Direct infection of skin or subcutaneousa Impetigo (non bullous)
b Ecthyma
c Erysipelas
d Cellulitis
e Vulvovaginitis
f Blistering distal dactylitis
g Necrotizing fascitis
II Secondary infectionEczema infection
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
39
III Tissue damage from circulating toxin
Scarlet fever
IV Skin lesion attributed to allergic
hypersensitivity to streptococcal antigens
E Nodosum
Vasculitis
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
40
V Skin disease provocated or influenced by
streptococcal infection (mechanism uncertain)
Guttate psoriasis
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
41
Consider the following in relation to bacterial infection of skin
bulla Cellulitis is the inflammation of subcutaneous tissue as well as dermis caused by Streptococcus
bullb Bullous impetigo is caused by streptococci
bullc In erysipelas inflammation is limited to dermis and upper part of subcutaneous tissue
bulld Furunculosis is caused by Streptococcus
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
42
Learning objectives of bacterial infections of skin
middot 1 Define Pyoderma and classify itmiddot 2 List the normal flora of skinmiddot 3 Define impetigo List the differentiating
features of bullous and non-bullous impetigo 4 Describe the CF investigations of
impetigo Outline the management of impetigo
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
43
Learning objectives of bacterial infections of skin
middot 1 Define folliculitis classify it and describe the management of it2 Describe the CF investigations and
management of ecthyma cellulites erysipelas furuncle carbuncle SSSS
3 List the skin infection produced by B- hemolytic streptococci
middot 4 List the skin infection produced by staphylococci
7102008
44
Thank you
7102008
44
Thank you
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