1. ASSISTANT PROFESSOR & CONSULTANT
Common skin infection
Dr GHADA BIN SAIF
ASSISTANT PROFESSOR & CONSULTANT
DERMATOLOGIST
KSU & KKUH

2. Bacterial: Impetigo, Erysipelas, Cellulitis, Erythrasma
Mycobacterial: TB
Viral: Warts, Molluscum contagiosum, H.simplex, H.zoster
Fungal: Candida, Dermatophyte inf., Pityriasis versicolor
Protozoal: Leishmaniasis

3. Bacterial

4. Impetigo
Superficial cut. Inf.
Staph, gp A strept or both
Child, AD

5. Mx:
Remove crust
Localized:Topical Abx (bacroban)
Severe or Strept (prevent post strept. Glomerulonephritis):
Semisynthetic Penicillin : 7-10 d
Erythromycine (sensitive)
Augmentin (face)
1st generation cephalosporin

6. Erysipelas Sharply demarcated unilateral, red oedematous. Face
Beta hemolytic gp A Strept.
Minor abrasion—
sup. Lymph vessels
+-Leucocytosis & fever

7. Mx
Swab
Cold compressor
Oral penicillin
Erythromycin
Augmentin
1st generation cephalosporin

8. Cellulitis Deeper involvement of the SC
Raised, hot, tender, erythematous
Strept. Pyogenes, staph.aureus
Cut , abrasion or ulcer
Palpable, tender LN
Fever, leucocytosis

10. Treat according to culture & patient Strept:Mx
Swab +- Bl culture
Treat according to culture & patient
Strept:
Semisynthetic Penicillin
Erythromycin
Augmentin ( face : H. influenzae)

11. Erythrasma Corynebacterium minutissimum
Red, brown, asymptomatic, flexoral

12. Mx
Swab
wood’s lamp: coral-red fluorescence
Topical: imidazoles (miconazole) or
erythromycin
Oral erythromycin X 7 d

13. Mycobacterial Tuberculosis

14. Lupus vulgaris Commonest 1ry inf., good natural immunity
Heamatogenous spread
Apple jelly nodule--scar
Tuberculoid granuloma
Mx: bx, AFB
Local ttt
Anti TB

15. Viral

16. Wart
HPV (DNA)
Common wart
Hand
Child
Koebner phenomenon

17. Plane wart Plantar wart
Face , back of hands sole

18. Genital wart
Condylomata accuminata
Penile, vulvar skin, mm, perianal area
Sexual partner
Child---sexual abuse
Some: oncogenic:16, 18

20. Mx :
Involute spontaneously
Cryotherapy
Topical: SA, TCA
Electrocautary
Laser

22. Molluscum contagiosum
Pox virus
Child
Face, neck
Central punctum
Hunderson-patterson bodies
Mx: curettage, cryotherapy

23. Herpes simplex Group of small blister HSV-1- H. labialis
HSV-2- genital herpes
Herpetic whitlow—(? pyogenic lesion)
Eczema herpeticum

27. Mx:
Smear---viral particles
Topical
Acyclovir (early) :Genital, Recurrent, immune suppressed, neonatal, Ecz.H.

28. Herpes zoster Chickenpox virus Adult
Prodromal pain—dermatomal (blisters)—post-herpetic neuralgia
Ramsey-Hunt syndrome : Ophth div. + Geniculate ganglia---Ear pain + blisters
Mx:
Smear
Analgesia, drying agent
Acyclovir: immune suppressed, wide spread

31. Superficial mycosis Deep mycosis
Fungal
Superficial mycosis
Deep mycosis

33. Candidiasis Candida albican (normal commensal of GIT)
Napkin candidosis & Intertrigo (satellite lesions)
Paronychia
Chronic candidal granuloma
MM: Oral
Vulvovaginitis-irritation, discharge
Systemic
Chronic mucocutaneous candidiasis

35. Mx:
Swab
Alter moist warm environment
Nystatin-containing cream
Imidazole (Daktarin, canastein)
Oral antifungal (itraconazole): immune suppressed

36. Dermatophyte infection
Skin
Hair
Nails

37. Tinea pedis
Adult (athlete’s)
Toe webs , instep
T.rubrum, T.mentagrophytes

39. Tinea ungum T.rubrum, T.mentagrophytes

40. Tinea corporis:
Trunk
Active edge
T.rubrum

41. T.cruris

42. T.manun

43. Tinea capitis Well circumscriped pruritic scaling area of hair loss
Black dot (T.tonsurans)
Gray patch (M.audouinii),
Kerion (T.verrucosum)
Favus (T.schoenleinii)

45. Mx:
Scraping, hair plug---KOH
Education
Topical (terbinafine, daktarin)
Oral (Griseofulvin, terbinafine, itraconazole): extensive, Hair, nail

46. Pityriasis versicolor
Malassezia furfur (hyphea)
Pityrosporum orbiculare (yeast)
Trunk
Hypopig. (in dark skin)
Mx:
Wood’s lamp
Scraping
Topical imidazol (nizoral)
Recurrence

47. Protozoal Leishmaniasis

48. Transmit: sand fly
Painful nodule—ulcer
Exposed site

50. Mx:
Leishmanin test, Bx
Cryotherapy
Pentavalnt antimony local injection
Systemic pentavalent antimony

51. Questions ? ?