What is a skin infection?

Your skin is the largest organ of the body. Its function is to

protect your body from infection. Skin infections are
caused by a wide variety of germs, and symptoms can vary
from mild to serious. Mild infections may be treatable with
over-the-counter medications and home remedies,
whereas other infections may require medical attention.
Different types of skin lesions/rashes
1. MACULES

FLAT LESIONS CHARACTERIZED

BY CHANGE IN COLOR OF THE
AFFECTED SKIN
2. PAPULES

RAISED LESIONS, SOLID IN

CONSISTENCY OF LESS THAN 5 MM
IN DIAMETER
 3. NODULES

ROUNDED RAISED LESIONS

MORE THAN 5 MM IN
DIAMETER
4. PLAQUES

FLAT WITH ELEVATED SURFACE

(PLATEAU-LIKE) WITH MORE THAN 5
MM IN DIAMETER
5. URTICARIA (WHEALS OR HIVES)

ANNULAR OR RING-LIKE PAPULES

OR PLAQUES WITH PINKISH COLOR
 6. VESICLES

CIRCUMSCRIBED, FLUID-FILLED LESIONS

LESS THAN 5 MM IN DIAMETER
7. BULLAE

circumscribed, fluid-
filled lesions more than
5 mm in diameter
8. Pustules
circumscribed,
exudate-filled lesions
 9. PURPURA
SKIN LESIONS DUE TO BLEEDING INTO SKIN

A. PETECHIAE B. ECCHYMOSIS

less than 3 mm diameter more than 3 mm diameter

10. ULCER
crater-liker lesion that may involve the deeper
layers of the epidermis and dermis

 11. ESCHAR

necrotic ulcer covered with

a blackened scab or crust
Different types of Skin Infections

Bacterial Skin Viral Skin Fungal Skin

Infection Infection Infection
 Bacterial Skin Infection
Staphylococci: Staphylococcus Aureus
>a common pathogen in humans. They are gram-positive cocci usually arranged in pairs,
short chains or in grape like clusters.
- found in skin and nasopharynx
- golden yellow colonies are best produced when cultured of 20 degree celcius to 25
- it is coagulase positive

Mode of Transmission
> Skin Infections are transmitted through direct contact with a person having
purulent lesions, from hands of health care or hospital workers, and through
formites like linens are contaminated clothing
 Clinical Findings
1. Folliculitis – a pyogenic (pus-producing) This is the infection involving the hair follicle. It is characterized by localized
painful inflammation and heals rapidly often draining the pus
2. Furuncle – This is the extension of folliculitis. Also known as boil.
3. Carbuncle – represents a coalescence of furuncles that emends into subcutaneous tissue with sinus tracts.
4. Stye or Hordeolum – folliculitis occurring at the base of the eyelids
5. Impetigo – The infection is common in young children and primarily involves the face and the limbs.
- It starts as a flattened red spot (macule) w/c later becomes a pus-filled vesicle that ruptures and forms crust (honey
colored crust)
6. Staphylococcal Scalded Skin Syndrome (Ritter’s disease)

> found in newborns and young children

> manifested by onset of perioral erythema (redness) that covers the whole body within 2 days
> When slight pressure is applied over the skin, it causes displacement of the skin.
> known as positive Nikolsky sign.
Our antibodies against the exfoliative toxin are produced 1-10 days to enable our skin to become intact
again.
Exfoliative – A toxin that responsible for manifestation.
Outer layer of gram-stained specimen (gram-positive cocci)
Culture – (gray to golden yellow colonies)
 TREATMENT AND PREVENTION

Beta-lactam antibiotics like penicillin

S. Aureus – develop resistance to penicillin
Other derivatives like methicillin and nafcillin
Oxacillin – The only penicillin – derived antibiotic that has remained active against S. Aureus
Streptococci: Streptococcus pyogenes

> gram-positive cocci arranged in pairs in chains when seen under the microscope

Mode of Transmission
>It is being acquired through direct contact with infected persons or fomites
 Clinical Findings
1. Pyoderma (Impetigo)

2. Erysipelas (St. Anthony's Fire)

Involves the skin subcutaneous
tissue.
3. Cellulitis

- a bacterial infection that’s common in

preschool and school-age children. It can
cause blisters and sores on the face, neck,
hands, or diaper area. It often happens after
the skin has been irritated by another
Follows a respiratory tract or skin infection
problem like a cut, scrape, or rash. It can be
caused by s.pyogenes
cleared up with antibiotics (in ointment, pill,
or liquid form).
4. Necrotizing Fasciitis
Also known as flesh-eating bacteria, this is a life-threatening infection that spreads quickly and kills your body’s soft tissue
(muscle, fat, and other tissue that connects muscles to bones). If you're healthy, have a strong immune system, and bathe
or shower often, you’re not likely to get it. If you do have it, you’ll need antibiotics put directly into one of your veins, and a
surgeon will remove the infected tissue.
Complications
Acute glomerulonephritis and rheumatic fever are non-suppurative, immune-mediaed
complications.

Laboratory findings
1. Microscopy – gram-stain of sample of infected tissue will show gram-positive cocci in pairs and chains associated
with leukocytes.

2. Culture – positive beta hemolysis in blood sugar.

3. Bacitracin test – antibiotic susceptibility test with (+) zone of inhibition of growth around bacitracin disc.

Treatment and Prevention

The drug of choice penicilin
 Pseudomonas Aeruginosa
> A gram-negative bacilli arranged in pairs that are encapsulated.
> It is capable of producing water soluble pigments (e.g pyocyanin
- blue).
> This is being hospital acquired
> Resistant to most antibiotic
MODE OF
TRANSMISSION

> Through the colonization of previously

injured skin
CLINICAL FINDINGS
P. Aeruginosa associated with colonization or burned wounds
characterized by blue-green pus that exudes a sweet-like odor.

>Osteochondritis - inflammation of the bone and cartilage of

the foot
> It is a gram-negative bacilli
> oxidase test is positive

TREATMENT AND PREVENTION

>It is resistant to most antibiotic

> P. Aeruginosa should be focused on preventing contamination of sterile hospital equipment and instruments and
cross-contamination of patients by hospital personnel.
 CLOSTRIDIUM PERFRINGENS

> Gram-positive bacilli that are anaerobic and rarely produce endospores.
> Produces lethal toxins namedly alpha, iota and epsilon toxins.

MODE OF TRANSMISSION

> It is commonly transmitted by the colonization o the skin following physical

trauma or surgery
CLINICAL FINDINGS

C. perfringens causes soft tissue infections

like cellulitis, suppurative myositis, and
myonecrosis or gas gangrene.
> Gas gangrene is a life threatening infection
 LABORATORY DIAGNOSIS

>BASED ON MICROSCOPIC DETECTION OF GRAM POSITIVE BACILLI IN

PAIRS AND GROWTH IN CUTURE UNDER ANAEROBIC CONDITION.

TREATMENT AND PREVENTION

>SURGICAL WOUND DEBRIDEMENT AND HIGH-DOSE PENICILLIN THERAPHY

ARE THE MAIN APPROACHES TO THE MANAGEMENT OF THE DISEASE.
 BACILLUS ANTHRACIS
>GRAM POSITIVE BACCILLI ARRANGE INDIVIDUALLY IN PAIRS.
>BAMBOO-FISHING ROD OR MEDUSA HEAD APPPEARANCE.
>IT IS ALSO USED IN BIOTERRORISM.

MODE OF TRANSMISSION

>IT IS TRANSMITTED THROUGH INOCULATION INTO OPEN SKIN FROM EITHER THE SOIL
OR INFECTED ANIMAL PRODUCTS,INGESTION OF INFECTED MEAT OR MILK AND
INHALATION OF AEROSOLIZED SPORES.
CLINICAL FINDINGS

>ANTHRAX IS A DISEASE OF HERBIVORES

>3 FORMS OF ANTHRAX : CUTANEOUS, GASTROINTESTINAL, OR PULMONARY ANTHRAX
>ALSO ASSOCIATED WITH PAINFUL LYMPHADENOPATHY AND EDEMA.

LABORATORY DIAGNOSIS

>PERIPHERAL BLOOD CONTAINS A LARGE NUMBER OF B. ANTHRACIS WHICH IS

EASILY SEEN IN GRAM STAIN.

TREATMENT AND PREVENTION

>ANTIBIOTIC LIKE PENICILLIN OR DOXYCYLINE, DRUG OF CHOICE

 FUNGAL INFECTION

SUPERFICIAL MYCOSES

TINEA VERSICOLOR(PITYRIASIS VERSICOLOR

>CAUSED BY MALASSEZIA FURFUR>M. FURFUR -IT IS ANIRMAL FLORA OF THE SKIN
PARTICULARLY IN AREAS RICH I SEBACEOUS GLANDS.
>THE LESIONS ARE SCALY WITH DRY ,CHALKY APPEARANCE,USUALLY APPEAR ON
THE FACE,NECK,TRUNK AND ARMS
DIAGNOSIS

>MADE BY MICROSCOPIC VISUALIZATION OF(SPAGHETTI AND MEAT BALLS)

> 10% OF KOH OR NAOH
>PERIODIC ACID SCHIFF STRAIN (PAS STAIN)

TREATMENT

>INCLUDES APPLICATION OF KERATOLYTIC AGENTS CONTAINING SELENIUM DISULFIDEOR

SALICYLIC ACID AND TOPICAL ANTIFUNGAL DRUGS LIKE KETOCONAZOLE
TINEA NIGRA

>IS CAUSED BY HORTAEA WERNECKII (FORMERLY EXOPHIALA WERNECKII)-

A DEMATIACEOUS FUNGUS THAT PRODUCES MELAMIN AND GROWS AS
MOLD PRODUCING ANNELIDS OR ANNELLOCONIDIA .
>LESIONS INVOLVE IN THE PALM AND SOLES AND AS DESCRIBED AS GRAY
TO BLACK.
>COMMONLY SEEN IN ADOLESCENTS,YOUNNG ADULTS AND FEMALE.
DIAGNOSIS

>IT IS MADE BY DIRECT MICROSCOPIC EXAMINATION OF DKIN SCRAPINGS WITH

POTASSIUM HYDROXIDE AND CULTURE USING SABOURARAUD'S DEXTROSE AGAR
MEDIUM.

TREATMENT

>INCLUDES APPLICATION OF KERATOLYTIC AGENTS CONTAINING SELENIUM

DISULFIDEOR SALICYLIC ACID AND TOPICAL ANTIFUNGAL DRUGS LIKE
KETOCONAZOLE
CUTANEOUS MYCOSES ON DERMATOPHYTOSIS

>FUNGAL INFECTIONS INVOLVING THE KERATINIZED STRUCTURES OF THE

BODY LIKE SKIN, HAIR, AND NAILS CAUSED BY FUNGI DERMATOPHYTES.
>DERMATOPHYTES- IT PRODUCE KERATINASE, AN ENZYME CAPABLE OF
BREAKING DOWN KERATIN
>3 GENERA CAUSES INFECTIONS
1. MICROSPORUM- WHICH INFECT HAIR AND NAILS ONLY.
2. TRICHOPHYTON- WHICH INFECT THE SKIN, HAIR AND NAILS.
3. EPIDERMOPHYTON- WHICH INFECT ONLY THE SKIN AND NAILS.
NAME OF INFETCION REFLECTS THE ANATOMIC SITE

1.TINEA PEDIS-KNOWN AS ATHLETE'S FOOT

2. TINEA CAPITIS -(SCALP)
3.TINEA CORPORIS-(BODY)
4.TINEA CRURIS OR JOCK ITCH(GROIN)
5.TINEA MANUS-
6.TINEA BARBAE-
7.TINEA UNGUIUM- KNOWN AS ONYCHOMYCOSIS(NAILS)
DIAGNOSIS

>IS BASED ON THE CLINICAL APPEARANCE OF THE LESIONS DIRECT

MICROSCOPIC EXAMINATION CULTURE.

TREATMENT

>ADMINISTERING ANTIFUNGAL DRUGS SUCH AS AZOLES

(MICRONAZOLE, CLOTRIMAZOLE, ECONAZOLE)
 SUBCUTANEOUS MYCOSES

>INITIALLY INVOLVES THE DEEPER LAYER OF TE DERMIS AND

SUBCUTANEOUS TISSUE THEN LATER THE BONES

MODE OF TRANSMISSION

>THROUGH TRAUMATIC INOCULATION INTO THE SKIN

SPOROTRICHOSIS
> KNOWN AS ROSE GARDENERS'S DISEASE CAUSED BY DIMORPHIC FUNGUS ,
SPOROTHRIX SCHENCKII
>FOUND IN SOIL AND DECAYING VEGETATION.

CHROMBOBLASTOMYCOSIS
>CHARACTERIZED .Y VERRUCOUS NODULES OR PLAQUES.
>THE INFECTION IS INSIDIOUS, AND BECOME CHRONIC.
>THE ETIOLOGIC AGENTS ARE ALL DEMATIACEOUS FUNGI NAMELY:
EXOPHIALA, FONSECA, CLADOSPORIUM, PHIALOPHORA AND
RHINOCLADIELLA.
MYCETOMA OR MADURA FOOT

>MAY BE CAUSED BY FUNGI

>COMMON CAUSED OF EUMYCOTIC MYCETOMA OR ACTINOMYCETES(
ACTINOMYTIC MYCETOMA) ARE PHAEOACREMONIUM, MADURELLA, CURVULARIA
AND FUSARIUM.
>INVOLVES THE FEET AND HANDS.
>CHARACTERIZED BY THE CLINICAL TRIAD OF TUMEFACTION,GRANULES AND
DRAINING SINUS

DIAGNOSIS
>PRIMARILY BASED ON THE CHARACTERISTICS OF THE GRANULES.