Other Skin Infections

Other Infections

Paronychia

·        Loss of cuticle (due to eczema, wet work, etc) allows growth of organisms beneath the proximal nail fold ® inflammation and nail dystrophy. Acute usually staph, chronic usually candida

·        Differential:

o   Onychomycosis

o   Lupus, psoriasis, chilblains

·        Treatment: avoid wet work, treat eczema, dying agent, systemic antibiotic if bacterial

Pitted Keratolysis

·        Small craters in the sole of the foot.  Asymptomatic.  Foot odour

·        Variously attributed to Corynebacteria, Dermatophilus, Micrococcus

·        Treatment: keep feet dry, topical erythromycin, systemic tetracyclines

Pityriasis Rosea

·        Usually 10 – 35. Starts with herald patch (larger than later lesions). After 5- 15 days general eruption begins. Oval, dull pink, with marginal scale. Itch varies. On trunk, rarely on face

·        Was thought to be viral, but erythromycin effective

·        Fades after 3 – 6 weeks

·        Differential: eczema, psoriasis, seborrheic dermatitis, tinea versicolor

Candidiasis

·        Yeast infection

·        Common in infants – either mouth (esp inside checks) and in nappy area, maybe on hands if sucked.

·        More common in damp areas.  Need to treat Mum‟s nipple as well.

·        Lesions whitish with satellite lesions characteristic

·        Also with oral/inhaled steroids or broad spectrum antibiotics

·        Systemic spread in immuno-compromised is nasty

o   Treatment: see Antifungals,

Scabies

·        Irritation from hypersensitivity after 4 weeks of scabies mite burrowing

·        Papular vesicular lesions

Headlice *

·        The insect: 2 – 3 mm long, breeds all year round. They live in the scalp and suck blood for food 5 or 6 times a day. They are only transmitted through close head contact. They don‟t come off with swimming or washing. The eggs are a similar colour to scalp skin. The empty egg shells, known as nits, are white 

·        Life cycle: female lice lay about 7 – 10 eggs each night, these hatch in 9 days. A louse will live for 40 days

·        Where to find them: around the hairline at the back of the neck, behind the ears, on the crown 

·        Treat if you find a live insect or an egg within 1 cm of the scalp (hair grows 1 cm a month, so more than 1 cm from head means they‟re dead) 

·        Use special shampoo from the chemist. Leave on scalp for 5 – 10 minutes. Don‟t use too much water. Repeat a week later

·        Don‟t need to wash bedclothes: lice only lay eggs on hair.  Instead check kid‟s heads once a week

·        Prevention: regular hair brushing, don‟t share brushes, keep clothes separate, contact tracing