6. Local antibiotic on the beard and nose General : - Cloxacillin ( anti- staph )
7. Def : superficial mild chronic infection of the skin Etiology :coryneobactriumminutissimum Site : feet, groins, axillae, and submammary areas, which mimics epidermal dermatophyte infections Predisposing factor : Obisity , DM occlusive clothing/shoes Anaemia Hyperhydrosis Increased humidity Erythrasma(Greek, "red spot")
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10. Erythrasma: groins Sharply marginated, brownish-red, slightly scaling macular patch on the medial thigh (infectious intertrigo) appears bright coral-red when examined with a Wood's lamp.
12. DD : intertrigo Pitryasisversicolar Taeniacruris : erythematous scaly patch with active border Seborrheic dermatitis Psoriasis Candidal dermatitis
13. Laboratory Examinations Wood'sLamp demonstration of the characteristic coral-red fluorescence DirectMicroscopy Negative for fungal forms on KOH preparation of skin scraping. In the webspaces of the feet, concomitant interdigitaltineapedis may also be present. Gram or Giemsa stains may show fine bacterial filaments. BacterialCulture Heavy growth of Corynebacterium. Staph aureus, group A strep, and Candida infection. In some cases, concomitant Pseudomonas aeruginosawebspace infection (feet) is also present. Diagnosis Clinical findings, absence of fungi on direct microscopy, positive Wood's lamp examination.
14. Treatment : General : Erythromycin 1gm daily for 2w , Local : local antifungal : e g Tolnaftatetwice daily for 2-3w Imidazole derivative cream twice daily for 2-3w Sodium fusidate ointment, Benzoylperoxide (2.5%) gel daily after showering for 7 days
15. Pitted Keratolysis (Keratolysis Sulcata) (PK) presents as defects in the thickly keratinized skin of the plantar foot with eroded pits of variable depth, caused by Kytococcussedentarius. AgeYoung adults & Sex Males > females Predisposing Factors as erythrasma K. sedentarius produces proteases which digest keratin. Skin Symptoms Usually asymptomatic. Foot odor, sliminess of feet. Uncommonly, itching, burning, tenderness. Often mistaken for tineapedis. Skin Lesions Crater-like pits in stratum corneum Involved areas are white when stratum corneum is fully hydrated Symmetric or asymmetric involvement of both feet
16. Pitted keratolysis: plantar The stratum corneumshows loss of keratinization with well-dermarcatedmargins, Pitted keratolysis: toePitted epidermis of an intertriginous toe, associated with hyperhidrosis
17. Abscess, Furuncle, andCarbuncle Def : abscessis an acute or chronic localized inflammation, associated with a collection of pus and tissue destruction A furuncle is an acute, deep-seated, red, hot, tender nodule or abscess that evolves from a staphylococcal folliculitis A carbuncleis a deeper infection composed of interconnecting abscesses usually arising in several contiguous hair follicles.
18. Etiology : Causativeorganism : staph aureus Predisposingfactors: Pressure ,friction ,irritation of skin in exposed areas and extensor surface Chronic S. aureuscarrier state (nares, axillae, perineum, vagina) Diabetes mellitus Obesity Poor hygiene & Bactericidal defects (e.g., chronic granulomatous disease) Chemotactic defects Hyper-IgE syndrome (Job's syndrome) HIV disease, especially MRSA infection
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20. Furuncle: S. aureus Soft-tissue swelling of the forehead with central abscess formation, nearing rupture Furuncles: S. aureusMultiple areas of folliculitisin the moustache extending to become furuncles
21. Carbuncle: S. aureusA very large, inflammatory plaque with pustules, on the neck. Infection extends down to the fascia and has formed from a confluence of many furuncles. Multiple furuncles: Multiple, painful ulcerated nodules on the buttocks of a 20-year-old male, occurring during hospitalization for ulcerative colitis.
22. DD : Acne vulgaris Bockhart impetigo Herpes simplex Sweat rash Treatment : Local measures : - hot compressing - pirecing the pointed surface to discharging pus - cleaning the area by local antibiotic - a void occlusive dressing 2. General : antibiotic as penicillin & flucloxacillin .