Skin infestations and infections 4 Flashcards

1
Q

How many different types of HPV (warts) are there?

A

> 200 subtypes of HPV

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2
Q

What are examples of superficial fungal infections?

A
  1. Candida
  2. Malassezia
  3. Dermatophytes
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3
Q

What are examples of deep/soft tissue fungal infections?

A
  1. Chromomycosis

2. Madura foot

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4
Q

What are examples of disseminated fungal infections?

A
  1. Candida
  2. Aspergillus
  3. Fusarium
  4. Histoplasma
  5. Coccidiodes
  6. Blastomycosis
  7. Mucormyocis
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5
Q

What is pityriasis versicolor?

A

Hypopigmented, hyperpigmented or erythematous macular eruption +/- fine scale

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6
Q

When does pityriasis versicolor begin? What is it caused by?

A
  • Malassezia spp.

* Begins during adolescence (when sebaceous glands become active)

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7
Q

When does pityriasis versicolour flare up?

A

when temperatures and humidity are high – Immunosuppression

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8
Q

What is the treatment for pityriasis versicolour?

A

Topical azole

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9
Q

What are dermatophytes?

A

fungi that live on keratin

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10
Q

What causes the most fungal infections?

A

Trichophyton rubrum

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11
Q

What causes the most tinea capitis?

A

Trichophyton tonsurans

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12
Q

What is kerion?

A
  1. an inflammatory fungal infection that may mimic a bacterial folliculitis or an abscess of the scalp
  2. scalp is tender and patient usually has posterior cervical lymphadenopathy
  3. Frequently secondarily infected with Staphylococcus aureus
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13
Q

What is tinea pedis Trichophyton rubrum?

A

scaling and hyperkeratosis of plantar surface of food

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14
Q

What is tinea pedis Trichophyton mentagrophytes (interdigitale)?

A

sometimes vesiculobullous reaction on arch or side of foot

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15
Q

What is an Id reaction?

A

Dermatophytid reactions

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16
Q

What happens in an Id reaction?

A
  1. inflammatory reactions at sites distant from the associated dermatophyte infection
  2. may include urticaria, hand dermatitis, or erythema nodosum
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17
Q

What can an id reaction be secondary to?

A

to a strong host immunologic response against fungal antigens

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18
Q

What is majocchi granuloma?

A

Follicular abscess produced when dermatophyte infection penetrates the follicular wall into surrounding dermis; tender

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19
Q

What is the usual culprit for majocchi granuloma?

A

Trichophyton rubrum or mentagrophytes

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20
Q

What is candidiasis predisposed by?

A
  • Candida albicans

* by occlusion, moisture, warm temperature, diabetes mellitus

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21
Q

What do most sites of candidiasis show?

A

erythema oedema, thin purulent discharge

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22
Q

Where does candidiasis usually happen?

A

an intertriginous infection (affecting the axillae, submammary folds, crurae and digital clefts) or of oral mucosa

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23
Q

What can candidiasis affect?

A
  1. common cause of vulvovaginitis
  2. can affect mucosae.
  3. become systemic (immunocompromise)
24
Q

What are deep fungal infections?

A
  • Capacity for deep invasion of skin or production of skin lesions secondary to systemic visceral infection
  • Subcutaneous fungal infections – infections of implantation (inoculation)
25
Q

What can cause deep fungal infections?

A
  • Sporotrichosis
  • Phaeohypomycosis
  • Chromomycosis
  • Mycetoma (Madura foot)
  • Lobomycosis
  • Rhinosporidiosis
26
Q

What do systemic respiratory endemic fungal infections include?

A
  1. blastomycosis
  2. histoplasmosis
  3. coccidiodomycosis
  4. paracoccidoiodomycosis
  5. penicillinosis
27
Q

When can you get systemic fungal infection?

A

in both immunocompetent and immunosuppressed

28
Q

What are the risk factors for aspergillosis?

A
  • neutropaenia

- corticosteroid therapy

29
Q

What is aspergillosis primarily?

A

respiratory pathogen

30
Q

What does aspergillosis look like?

A
  1. Cutaneous lesions being as well-circumscribed papule with necrotic base and surrounding erythematous halo,
  2. Propensity to invade blood vessels causing thrombosis and infarction
31
Q

What can the lesions be like in aspergillosis?

A
  • Lesions destructive – may extend into cartilage, bone and fascial planes
  • Should be considered in differential of necrotisiing lesions
32
Q

What is fusarium?

A

causes similar illness and cutaneous lesions both clinically and histologically – (septate hype with acute angle branching)

33
Q

What is primary cutaenous aspergillosis characterised by?

A
  • hyperpigmented plaques with brown–black scale-crusts at the site of intravenous catheters on the arm
  • (A);Necrotic hemorrhagic bulla due to embolus of Aspergillus flavus (D)
34
Q

What is mucormycosis caused by?

A

Apophysomyces, Mucor, Rhizopus, Absidia, Rhizomucor

35
Q

What are the associations with mucormycosis?

A
  1. 1/3 of patients have diabetes, those in DKA are at particularly high risk
  2. malnutrition
  3. uraemia
  4. neutropaenia
  5. steroid therapy
  6. burns
  7. antibiotic therapy
  8. neonatal prematurity
  9. deferoxamine therapy
  10. HIV
36
Q

What is the presentation of mucormycosis?

A
  1. fever, headache, facial oedema, proptosis, facial pain, orbital cellulitis, cranial nerve dysfunction
  2. +/- nerve dysfunction due to retinal artery thrombosis
37
Q

What is the treatment of mucormycosis? When is the culture positive?

A
  1. aggressive debridement and antifungal therapy

2. Culture positive in only 30% of cases

38
Q

What is scabies caused by?

A

contagious infestation caused by Sarcoptes species

39
Q

What happens in scabies?

A

Female mates, burrows into upper epidermis, lays her eggs and dies after one month.

40
Q

How does scabies present?

A
  • Insidious onset of red to flesh-coloured pruritic papules

- diagnostic burrow consisting of fine white scale is often seen

41
Q

What does scabies affect?

A
  • interdigital areas of digits
  • volar wrists
  • axillary areas
  • genitalia
42
Q

What is Norwegian scabies?

A
  1. Crusted or ‘Norwegian’ scabies - hyperkeratosis

2. Often asymptomatic; found in immunocompromised individuals

43
Q

What is the treatment of scabies?

A
  1. permethrin, oral ivermectin

2. two cycles of treatment are required

44
Q

What is head louse caused by?

A

Pediculus humanus capitis

45
Q

What is head louse?

A
  • Entire live cycle spent in hair

- 2ndary infection common

46
Q

What is the treatment of head louse?

A

malathion, permethrin, or oral ivermectin

47
Q

What is body louse?

A

Pediculus humanus corporis

48
Q

What does body louse look like?

A
  • Lives and reproduces in clothing – leaves to feed; rarely found on skin
  • Pruritic papules & hyperpigmentation
49
Q

When is body louse common?

A

vercrowding, poverty & poor hygiene

50
Q

How do you treat body louse?

A

thorough cleaning or discarding clothes

51
Q

What is pubic louse?

A

Phithrus pubis aka crabs; three pairs of legs

52
Q

Where are eggs found in pubic louse?

A

hair shaft, also found in occipital scalp, body hair, eyebrow and eyelash, axillary hair

53
Q

What is the treatment for pubic louse?

A

malathion / permethrin, oral ivermectin

54
Q

What are bedbugs?

A
  1. Cimex lectularius – reddish-brown, wingless insect resembling size and shape of ladybird
  2. Itchy weals around a central punctum
55
Q

Where are bedbugs?

A
  • Dine alone at night, rapidly and painlessly

* Live behind wallpaper, under furniture

56
Q

How do you treat bedbugs?

A
  • Fumigation of home is necessary to get rid of pest

* Treatment of patient is symptomatic