Pyoderma
Definition
Pus in the skin
Suppurative lesions of the skin
Suppurative Lesions of the skin
Superficial bacterial infection :
Impetigo
Impetigo contagiosa
Ecthyma
Superficial folliculitis (Bockhart's impetigo
Carbuncle
Tropical ulcer
Autoimmune disorders :
Pyoderma gangrenosum
Parasitic infestations secondarily infected :
Scabies
Tineasis of the skin
Lesions, Causes & Features
Impetigo - staphylococci, streptococci or multiple bacteria.
Pediculosis - head lice
Scabies - Sarcoptis scabiei
Herpes simplex
Insect bites
Eczema
Chronic health problems
Poor hygiene
Malnutrition
Some people are asymptomatic carriers of Staphylococcua aureus in the nasal passages.
Bullous impetigo - S.aureus - bullae form - bullae rupture → ulcers - covered by honey- yellow colored crust.
Occurs on exposed areas of the body, face, hands, neck and limbs. -
Contagious and spreads to other parts and to other members of the family. -
Spreads by using others clothes or combes contaminated with exudates from the lesion Common in children living in poor hygienic conditions
Complication : acute glomerular nephritis.
Treated with systemic & topical antibiotics (Penicillin, cloxacillin, dicloxacillin, erythromycin, azithromycin. Mupirocin oint.
Folliculitis, Furuncles & Carbuncles
Folliculitis - infection and inlammation of the hair follicles - bacterial or fungal origin
Supereficial or deep
Single or multiple papules close to the hari follicles
Commonly in beard area in men who shave and wonen's legs
Ohter areas ; axillae, trunk and buttocks
Treatment : avoid shaving. antibiotic lotions. depilatory cream or electric razor may be used
Furuncle - boil - starts in hair follicle and spreads. deeper form of folliculitis - more in areas subjected to irritation, pressure, friction and excessive perspiration
small, red, raised, painful pimple like - involves skin and subcutaneous tissue
Tender, painful
Surrounding induration +
Pointing may occur
Carbuncle - an abscess of the skin and subcutaneous tissute - an extension of a furuncle -- commonly in areas where the skin is thick and inelastic - back of neck and the buttocks
fever, pain, leukocytosis, septicemia
Furuncles and carbuncles more likely in DM, hematologic malignancies, immunosuppression - in hot climates
Management
Do a C&S
Cloxacillin, dicloxacillin, flucloxacillin, cephalosporins, erythromycin
When fluctuant a small incision
Management of the underlying disorders
Complications
Squeezing the lesion causes spread. Dangerous area of the face - brain abscess due to spread thru veins to the venous sinuses of the brain.
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