DISEASES OF THE SKIN AND EYES; WOUNDS AND BITES
CHAPTER 19
Anatomy Review
Skin
Thick Cellular 2 layers
Mucus Membranes
Structure
Simple epithelium
Defenses
Mucus Lysozyme Chemicals Antibodies
Eyes
Protective structures
Lashes, blinking reflex, tear flow
Molecules Lysozyme, IgA
Bacterial Skin Disease Staphylococcal
Minor Infections Folliculitis (Pimples)
Invasion of hair follicles Eye infection - Sty Multiple follicles Carbuncle Many carriers Low bacterial counts needed to infect wounds
Staphylococcal Infections (cont.)
Scalded Skin Syndrome
Exfoliative exotoxins Infants most affected Outer skin layers shed High fever Septicemia and shock may occur
Impetigo of Newborn
Crusting vesicles on skin surface Antimicrobial lotions needed
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Bacterial Skin Disease Streptococcal
Scarlet Fever
Bacteriophage toxin causes rash Strep. throat often also seen Complications glomerulonephritis and rheumatic fever Many carriers
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Streptococcal Disease
Erysipelas
St. Anthonys fire Historically high mortality, not so now Red raised rubbery lesion Focal spread may occur Septicemia Pneumonia Endocarditis Abscesses
Bacterial Skin Disease Nonspecific
Pyoderma/ Impetigo
Strep./Staph. Corynebacterium Childhood infection Skin depigmentation may occur Penicillin treats most infections
Gram negative skin pathogens
Pseudomonas aeruginosa
Common in pools and improperly chlorinated hot tubs Dermatitis Ear infections Severe respiratory infections in burn victims
Also Serratia marcescens
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Viral Skin Diseases
Rubella German measles
Systemic with skin rash, joint pain Mild but can cause birth defects Stillbirth Deafness, heart and liver problems
Measles
Lymphatic tissue affected Rash and fever develop, cough and conjunctivitis Middle ear infections and URT infections may occur Respiratory route of transmission
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Vaccination Success
12
Viral Skin Diseases
Chickenpox/ Shingles
Varicella zoster virus (VZS) Respiratory route of infection Systemic symptoms accompanied by vesicular rash May be fatal in adults but childhood vaccination programs provide 20 years immunity Recurrences in elderly patients cause a painful disease shingles Latent virus, shingles vaccine is newly available
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Chickenpox virus lesions
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Other Viral Pox diseases
Smallpox
Eradicated Virus reserves exist ? Bioterrorism
Cowpox
Milder disease Similar lesions Led to vaccine for smallpox
Monkeypox
Similar to smallpox virus ? Species barrier? Vaccination precaution in endemic areas
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Viral Skin Diseases Warts
Human Papilloma virus (HPV)
Affects skin and mucus membranes May require excision Link between some strains and cervical cancer Gardasil
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Fungal Skin Diseases
Ringworm
Tinea cruris (groin) Tinea capitis/barbae (head/ beard) Tinea pedis/ unguium (foot/t oenails) Very contagious Secondary bacterial infections may occur OTC medications available Triazoles
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Subcutaneous mycoses
Sporotrichosis
Sporothrix schenkii is pathogen Gardeners, farmers Transmitted from animals or humans Ulceration and inflammation at puncture site KI treats subcutaneous lesions
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Opportunistic Mycoses
Candidiasis (Candida albicans) Oral or vaginal infections common May cause systemic infections in immunocompromised (AIDS)
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Eye Diseases Neonatal Ophthalmia
Neisseria gonorrheae
Transmission via birth canal Routine antibiotics or silver nitrate Reduced incidence of blindness
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Eye Diseases Trachoma
Chlamydia trachomatis
Leading cause of preventable blindness worldwide 500 million affected S.W. Native Americans only at risk group in U.S.A. Flies are a vector
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Eye Diseases Viral
Adenovirus (Shipyard Eye)
Virus carried in dust Cornea may be cloudy for up to 2 years Sometimes nosocomial
Herpes Keratoconjunctivitis
Complication for cold sore sufferers Leading cause of non-retinal blindness in U.S.A.
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