BACTERIAL INFECTIONPYODERMATUBERCULOSIS CUTISMORBUS HANSEN

PYODERMADef : Skin diseases that caused by staphylococcus and/or streptococcus

Etiol: staphylococcus aureus streptococcus B hemoliticus

Predisposisi : less hygiene low immunity (poor nutrition, anemia, etc)underlying disease (dermatitis etc)

PYODERMA1. Impetigo2. Folliculitis3. Furuncle/carbunkle4. Ectima5. Erysipelas6. Celullitis7. Staphylococal Scalded Skin Syndrom

IMPETIGODef : Superficial pyoderma (limited on epidermis) caused by staphylococcus and/or streptococcus

Classification :1. IMPETIGO CRUSTOSA= impetigo contagiosa = impetigo vulgaris = impetigo Tillbury fox

Etiololgy : staphylococ aureus and/or streptococ pyogene

Manifestation :- most patients are children- Location : face, nose and mouth, body, extremities- efloresence : transient superficial small vesicles or pustules rupture, resulting erosions and gold/brown-yellow crustDD : ectima

2. IMPETIGO BULOSA= impetigo vesiko-bulosa = simean varicella

Etiology : staphylococ aureus

Manifestation :- not related to age- location : face, axilla, chest, back, hand and foot palm, commonly along with milliaria- efloresence : small blisters (vesicle) rapidly enlarge, explode sirsiner macule

- DD : Dermatofitosis, varicella, ectima, pemfigus, dermatitisLaboratory : bullous fluid swab gram staining staphylococ, bacterial cultureComplication : glomerulo nephritis, pneumonia, sepsis, meningitisTherapy: - prevention : daily bath - minimal lesion : topical AB: fucidic acid, mupirocin- more lesion : sistemic AB : first-generation cephalosporins, erythromycin, dicloxacillin, clindamycin, azythromycin

ECTIMA= Impetigo crustosa, often close to basal membraneClinicaly : red/black crust (dried blood)Treatment : = impetigo

FOLLICULITISDef : hair follicle infection = Bochart impetigo Etiology : staphylococcus aureusClinical features : tiny pustules with erythematous border, superficial (infundibulum) of follicleLocation : - Children : scalp- Adult : beard area, trunk, buttocksTherapy := Impetigo, according to predispotition factor

FURUNCLE/CARBUNCLEDefinition : deep follicular inf.(1 hair follicle ,>1 hair follicle carbuncle). Start as firm red nodule, painful then after a few days, fluctuant.

Predisposition : - furuncle : atopic dermatitis, malnutrition, DM, iatrogenic, alcoholoism. - Carbuncle : DM, malnutrition, heart failure, erythroderma

Clinical features : nodule pustule (core) cicatrix. Location : neck,face, groin, upper back

Laboratory : swab of pus, gram staining, blood glucose

DD : acne, hydradenitis, herpes simplex, scrofuloderma

Complication : sepsis, meningitis, trombosis sinus cavernosum

Therapy : Topical : shower with povidone iodine or benzoil peroxide soap, mupirocinSyst. AB : first generation cephalosporin, erythromycin, azythromycinRecurrent : clindamycin 300mg q.i.d, 7-10 days

ERISIPELASDef : dermal and upper subcutaneus infection mostly caused by streptococcus pyogenes (group A) = acute superficial cellulitis

Symptom :- fever, chills headache, malaise and nause vomiting Clinical Features: bright red, sharply demarcated, rapidly spreading erythematous patch, often come along with blisters above, hit and pain on palpation

Location : lower extremity, face (ussually symetrical)

DD : cellulitis, contact dermatitis, acute tuberculoid leprosy

Complications : elephantiasis nostra, glomerulo nephritis, subcutaneus abces, septicemia

Therapy : Antibiotic : High dose Penicillin i.v, Eritromisin, Lincomisin.Local : raise limb, cool compresses, Neocitrin oint if dry skin lession

CELLULITIS Definition : deep infection involving dermis and subcutaneous fat, and often extending to muscles or boneClinical features : subcutaneus diffuse infiltrate with acute inflamatory signsTherapy := erysipelas

STAPHYLOCOCAL SCALDED SKIN SYNDROME(SSSS)

Def : infection of staphylococ aureus typically as widespread superficial skin loss caused by exfoliationEpidemiology : commonly in children

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