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Published byKellen Beever Modified over 9 years ago
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OTC Products For Skin Disorders Made by alaa belal
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Secondary bacterial infections
Hyperkeratosis Fungal Infections Canker sores Disorders Viral Infections Skin Infestations Secondary bacterial infections
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Fungal Infections
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5 Tinea Types Pedis Corporis Capitis Unguium Versicolor
El slide bazet el kalam mesta5abbi mesh bayen Versicolor
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1- Tinea pedis Athlete’s foot NOT just athletes !! But also:
Weak immune system Tetla3 1 1 el weak immune system w kda Older than 60 Diabetics
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1- Tinea pedis Athlete’s foot Interdigital Moccasin Vesicular
Most common type Itching Scaling Maceration & Foul odour Between two smallest toes Burning
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1- Tinea pedis Athlete’s foot Interdigital Moccasin Vesicular Itching
Scaling Dryness Absence of vesicles Involve the entire sole of the foot and extend onto the sides
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1- Tinea pedis Athlete’s foot Interdigital Moccasin Vesicular
Least common Fluid-filled blisters Patient can not walk Itching Scaling
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Differential diagnosis
Tinea pedis Eczema Inflammation, endogenous cause Differences: Redness 1) Edema 2)Oozing Blister 3)No foul odour Similarities: Itching Crusting
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3- Tinea corporis Ringworm 1)Anywhere except face, feet, hands, groin
2)Outer part of the sore can be raised, scally red, may contain vesicles, middle part normal Grows outwards, may overlap Scaling Itching
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Differential diagnosis
Tinea corporis Discoid eczema Differences : 1)Occurs on arms, hands & feet 2)smaller 3)Middle part is not normal 4)Rare in patients under 20 years
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Differential diagnosis
Tinea corporis Psoriasis Immunological problem Differences: Not contagious Red plaques covered with silvery-white scales Painful and sometimes crack &bleed Similarities: Itching Scaling
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4- Tinea capitis Ringworm of the scalp Round, bald patches
More common in children Scaling, itching
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Onycholysis, fungal nail infection
5- Tinea unguium Onycholysis, fungal nail infection 1)Turn yellow or white 2)Get thicker
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Pityriasis versicolor
6- Tinea versicolor Pityriasis versicolor Yeast pitysporum orbiculare Common in oily surfaces teenagers Cosmetic concern Not contagious
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Differential diagnosis
Tinea versicolor Vitiligo Flat Hypo- or hyperpigmentation Slight itching and scalling Not painful Found on fingers, toes, knees, and around the eyes and mouth Loss of all color (depigmentation) No scaling
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Transmission of tinea Water Prevention 1. Dry off well 2. Do not wear
occlusive clothes Wear shower sandals at public showers and Yetla3 el items 1 1 (animation ) bas ka speed fast please swimming pools Water
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Transmission of tinea Indirect contact Prevention
Do not share clothes, socks, towels, nail clippers Indirect contact
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Transmission of tinea Direct contact Prevention
Avoid contact with infected people or animals Direct contact
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Transmission of tinea Yetla3 el points 1 1 animation Autoinfection
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Treatment
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Treatment of all fungal infections
Objective Prevent recurrence Inhibit the growth of fungus Relieve itching, burning and other symptoms
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Pharmaceutical Treatment
Most fungal infections Topical OTC cream, solution, spray, powder Scalp Except Oral prescription Nail Most fungal infections topical OTC cream , solution ,spray , powder But : 1) nail 2)scalp oral prescription Example :itraconazole (sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal: 1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems.
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Oral prescription Itraconazole Most fungal infections topical OTC
cream , solution ,spray , powder But : 1) nail 2)scalp oral prescription Example :itraconazole (sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal: 1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems.
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Oral prescription Fluconazole Most fungal infections topical OTC
cream , solution ,spray , powder But : 1) nail 2)scalp oral prescription Example :itraconazole (sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal: 1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems.
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Oral prescription Disadvantages Very expensive Side effects
Most fungal infections topical OTC cream , solution ,spray , powder But : 1) nail 2)scalp oral prescription Example :itraconazole (sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal: 1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems.
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Treatment of nail infection (Tinea unguium)
Refer to a dermatologist if Under 18 years More than 2 infected nails peripheral circulatory disorders Unrespon-siveness treatment Nail dystrophy or destruction Pregnancy or breast feeding diabetes mellitus Deficiency in immune system
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Treatment of nail infection (Tinea unguium)
Oral lamifen Nail polish Ticonazole Surgically
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Nail polish Cleaning Cutting Apply Twice daily, for 3 months
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Treatment of scalp infection (Tinea capitis)
if Refer to a dermatologist Swollen mass discharging pus Severe alopecia Swollen tender lymphocyte of the neck
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Treatment of scalp infection (Tinea capitis)
Oral prescription Preventing reinfection Shampoo If treated early, the hair will grow back
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Treatment of tinea versicolor
Skin may not regain its normal pigmentation Commonly comes back after treatment
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Treatment of tinea versicolor
Selenium sulfide Sulfiselen® Tinasel® Areas affected lathered by selenium sulfide for about 2-5 mins then washed thoroughly Used daily for up to 2 weeks
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Tinea versicolor Tinea capitis Tinea unguium
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Miconazole nitrate 2% Thiocarbamates Allylamines Clioquinol Undecylenic acid Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Ketoconazole 2% Thiocarbamates Allylamines Clioquinol Undecylenic acid Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Available in all dosage forms Thiocarbamates Broad spectrum antifungal Allylamines Apply twice daily 2 weeks for skin infection 4 weeks for foot 6 weeks for scalp few months for nail infection Clioquinol Undecylenic acid Miconazole (Daktarin®) safe in pregnancy Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Tolnaftate 1% Thiocarbamates Allylamines Clioquinol Undecylenic acid Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Thiocarbamates Cream and solution only Allylamines Effective against most dermatophytes not only t.versicolor or candidiasis Clioquinol Undecylenic acid Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Terbinafine 1% Thiocarbamates Allylamines Clioquinol Undecylenic acid Povidone iodine
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Thiocarbamates Cream, solution, spray tablets (but not otc) Allylamines Cream 1-2 times: 1 week for T.pedis 2 weeks for T.corporis T.versicolor Clioquinol Undecylenic acid Povidone iodine Not for children <16 or breast feeding mothers
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Salt of aluminium clioquinol 3% Thiocarbamates Allylamines Clioquinol Undecylenic acid Povidone iodine Clioquinol + corticosteroid
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Thiocarbamates Lotion, cream, ointment Side effects of clioquinol: May cause itching, allergic contact dermatitis Interfere with thyroid function Allylamines Clioquinol Undecylenic acid Povidone iodine Do not use <2 years
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Treatment Azoles Allylamines Clioquinol Undecylenic acid
Thiocarbamates Undecylenic acid 10% and 25% Allylamines Fungistatic Clioquinol Undecylenic acid Ointment at nighttime Povidone iodine Powder at daytime
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Povidone iodine 10%solution (Betadaine®)
Treatment Azoles Thiocarbamates Povidone iodine 10%solution (Betadaine®) Allylamines Clioquinol Undecylenic acid Povidone iodine
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Candidiasis
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Candida albicans (Monilia)
Candidiasis Most common type of yeast infection More than 20 species Candida albicans (Monilia) Most common Oral thrush Causes Vaginal candidiasis
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Where ?? Oral candidiasis (Oral thrush) (Moniliasis) Symptoms
Thick, white lacy patches on top of a red base Where ?? Tongue Palate Or elsewhere inside the mouth
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Treatment Topical oral antifungal 1- Miconazole 2- Nystatin
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Treatment 1- Miconazole Daktarin® oral gel Miconaz® oral gel
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Treatment 2- Nystatin
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VS ?? “ ” Quiz Oral gel Suspension
Oral gel is recommended rather than suspension or drops due to longer residence on the affected area , as it adheres to the mucosal lining ”
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Dose ¼ spoonful ½ spoonful Infants Adults
Treatment is continued for at least a week after symptoms have disappeared
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Contraindication liver disfunction safety not assured
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Canker sores Aphthous stomatitis
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Symptoms 1- Size 2- Shape 3- Color 4- Where ? Minor 5-8 mm Major ????
> 1 cm 2- Shape Oval - round 3- Color White - yellow 4- Where ? Tongue, cheek and lip
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Canker sores is an idiopathic disease
Cause Unknown Canker sores is an idiopathic disease
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Triggers Risk groups Oral trauma Being female Stress Family history
Hormonal changes Smoking cessation Food Helicobacter pylori
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Treatment Then we will give our OTC consultancy
No other extreme conditions Make sure it’s canker sores
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Differential diagnosis
1- Major canker sores Greater than or 1cm 10 separate, may coalesce into a single very large ulcer May take up to six weeks to heal and leave extensive scarring
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Differential diagnosis
2- Herpetiform canker sores Clusters of 10 to 100 sores
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OTC Treatment Local anaesthetic Topical oral analgesic
Anti-inflammatory Antiseptic and disinfectant agent The magic drug
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Local anaesthetic Viscous lidocaine Oracure® oral gel
Applied directly to the lesions Spray is not suitable for children
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Topical oral analgesic
Mundisal® gel
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Topical oral analgesic
BBC® spray
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Anti-inflammatory Kenalog® in orabase
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Antiseptic and disinfectant agent
Corsodyl® dental gel as chlorhexidine digluconate
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The magic drug Self Healing
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Patient counseling Rinse your mouth with salty solution Baking soda !!
Ice !!
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Skin infestations
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Scabies A very common skin infection affects people of all races and social classes. Cause: called Microscopic mite Sarcoptes scabei
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4 Symptoms Itching Scabies Red papular rash
Rash can also include vesicles Secondary bacterial infection Greyish “pencil-like” burrows to appear in Take from 4 to 8 weeks patients who have not been infected previously to appear in Take from 1 to 4 days Patients who have scabies before
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Transmission ( Why do you think? ) Direct way Indirect way
Scabies Transmission Direct way Indirect way Prolonged skin-to skin contact By sharing articles Scabies spreads rapidly in crowded places As: hospitals, schools and prisons. Animals such as dogs and cats are not a source of spread of human scabies. ( Why do you think? )
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Pediculus humanus capitis
Head lice ( Pediculosis) Cause: Small wingless parasitic insect Pediculus humanus capitis
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4 Symptoms Head lice Feeling of something moving in the hair.
Itching due to allergic reaction because of lice saliva. Irritability and diffulity sleeping. Sores on the head caused by scratching. (Secondary bacterial infection?!)
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Transmission Common way Uncommon way By person-to-person contact.
Head lice Transmission Common way Uncommon way By person-to-person contact. By contact with clothes or other personal items used by infected persons. Most common among preschool children, elementary school children and between household members. Animals such as dogs and cats do not play a role in transmission of human head lice.
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Pediculicides/scabicides
Treatment Pediculicides/scabicides Antipruritics Permethrin Topical antipruritics Malathion Systemic antihistaminics Piperonal d-phenothrine
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Permethrin Scabies Pediculosis 2.5-5% Permethrin Up to 1% Permethrin
Treatment Permethrin Scabies Pediculosis 2.5-5% Permethrin Up to 1% Permethrin Permethrine® Ectomethrine® licid®
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Malathion 0.5 lotion d-phenothrine 0.4%
Treatment Malathion 0.5 lotion (Ovide®) d-phenothrine 0.4% (Item shampoo) Eradication of lice & nits from the scalp (head lice).
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Treatment Precautions 1- Avoid application to wounded skin or scalp to avoid systemic absorption 2- Avoid scratching rash or vesicles & keep open sores clean
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Pediculicides/scabicides
Treatment Treatment Pediculicides/scabicides Antipruritics Permethrin Topical antipruritics Malathion Systemic antihistaminics Piperonal d-phenothrine
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Antipruritics Helping provide relief of itching Topical
Treatment Antipruritics Helping provide relief of itching Topical Systemic antihistaminic Calamine lotion Crotamitone lotion Atrax Zyrtec Phenergan
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Viral Cutaneous Infections
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Herpes simplex (Cold sores or sun blisters)
HSV-1causes: Herpetic labialis (cold sores) Herpetic whitlow Herpetic keratitis HSV-2 causes: Genital lesions genital lesions and the virus is never eliminated from the body because The virus stays in the ganglia in an inactive form.
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Prevention A vaccine called Zostavax to reduce the risk of shingles in people ages 60 and over. Varivax is the live attenuated vaccine that produces persistent immunity against chicken pox. Killed and sub unit vaccine may be used to prevent recurrence of herpes simplex virus.
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Treatment Acyclovir Zovirax Penciclovir
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Hyperkeratotic disorders
Hypertrophy of the horny layer of the skin (excessive development of keratin) Hyperkeratotic disorders
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Callus Excess friction Skin lesions caused by
Over a broad area of skin
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Callus Hand callus Feet callus
Repeated handling of an object that puts pressure on the hand Pressure from footwear Lack a central core
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Warts Skin growth caused by HPV Very contagious
Go away on their own within months or years
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Warts Common Plantar Grow most often on the hands
Grow on the soles of the feet Rough, shaped like a dome, and greyish-brown in color. Hard, thick patches of skin with dark specks
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Treatment ??
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Refer to a dermatologist
diabetes mellitus oozing purulent materials Refer to a dermatologist peripheral circulatory disease rheumato-id arthritis hemorrha-ging Hair growth
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?? Treatment Salicylic acid Freezing method (keratolytic agent )
Mechanism of action : ?? Salicylic acid It decreases keratinocyte adhesion It increases water binding ,which leads to a hydration of keratin Freezing method Dimethyl ether (freezed)
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NSAIDs Precautions Avoid using salicylic acid, if you are allergic to
(aspirin, ibuprofen, ….); or if you have any other allergies
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Secondary Bacterial Infection
SBI
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Which bacteria causes SBI
Staphylococcus aureus Streptococcus pyogenes
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Staphylococcus aureus
Impetigo (school sores)
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Staphylococcus aureus
Folliculitis
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Staphylococcus aureus
Furunculosis (boils)
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Which bacteria causes SBI
Staphylococcus aureus Streptococcus pyogenes
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Streptococcus pyogenes
Cellulitis
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Streptococcus pyogenes
Erysipelas
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Streptococcus pyogenes
Necrotising fasciitis
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Treatment Bacitracin Zinc Neomycin Polymyxin B Sulfate Tetracycline
Fusidic acid
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Tetracycline Fusidic acid Terramycin Fucidin
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Thanks
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