Bacterial skin Infection

 University of Hargeisa Medical Faculty

(UoH-MF)

Dermatology Department
Dr. Ismail Adam Abdilahi
2008
 Predisposing factors
Trauma or abrasion of the skin
Viral disease .
Primary dermatoses e.g. Eczema .
Poor hygiene and overcrowding
Staph. infections
Impetigo contagiosum .
Boils .
Impetigo contagiosum
Definition :
 Acute
contagious superficial
pyogenic infection of the skin.
Types :
 Non-bullous
 bullous
Non-bullous impetigo
Caused by staph. in
association with strep.
or by strep alone.
Clinical features:
Age : mainly preschool
Sites : face,limbs and
scalp are common.
Palms and soles are not
affected.
There is thin-walled vesicles
on erythematous base that
soon rupture→ yellowish
brown crusts that dry and
separate → erythema which
fades without scarring.
Complication : post-strep.
acute glomerulonephritis .
Bullous impetigo
Caused by staph through
staph toxin (exfoliatin)
Clinical features:
Age : all ages
Site : face is often
affected but may
occur any where
including palms and
soles.
The bullae are less rapidly
ruptured( persistent for 2-3
days) and become much
larger. When rupture →thin
brownish crust.
Treatment of impetigo
Use antiseptic e.g. potassium
permanganates.
Topical antibiotic .
Systemic antibiotics .
Treatment of predisposing
factors: e.g. Scabies.
Boils
Painful erythematous tender
papular lesions which are
related to infection of hair
follicles .
Sites: neck, axillae, buttocks,
and thighs.
If infection spreads to
involve several follicles→
carbuncle.
Screen for diabetes
mellitus in case of
recurrent boils.
Treatment of boils:
Is similar to that of
impetigo but systemic
antibiotics are often
necessary.
Surgical incision may be
needed.
Streptococcal
infections
Erysipelas.
Ecthyma.
 Erysipelas
Widespread erythema and
cellulitis due to infection of the
dermis and upper cutaneous
tissue by group A strep reaching
the dermis through a wound or a
small abrasion→ red, swollen and
tender skin
Lymphangitis and
lymphadenitis are frequent.
Common sites are legs and
face.
Complications:
lymphedema, subcutaneous
abscess, septicemia, nephritis
and meningitis.
Treatment :
Penicillin1 g/day or
Erythromycin .
Treatment of any
underlying skin disease e.g.
chronic fissuring.
Ecthyma
 Chronic ulceration due to
infection of the dermis by staph
and strep.
 Often prolonged so needs
intensive local antiseptic
treatment combined with
systemic antibiotics.
 Mycobacterial
infections
-Cutaneous tuberculosis
.
-Leprosy .
Cutaneous
tuberculosis
Lupus vulgaris
Most common form of
skin tuberculosis.
Infection through
hematogenous spread or
primary inoculation of the skin
with mycobacterium
tuberculosis.
Histopathology : granulomas
with central caseation and the
organism can be
demonstrated.
Clinical features:
Erythema, scaling and
scarring plaques.
Treatment : multi-drug
therapy for 6-9 months :
Rifampicin 600mg daily (450mg
for body wt less than 55kg)
INH 300mg daily
Both half an hour before breakfast
for 6 month
Pyrazinamide 1.5-2gm daily for 2
months only
 TREATMENT OF
LEPROSY
PAUCIBACILLARY : for
6 month .
Rifampicin 600 mg monthly
Dapsone 100 mg daily .
MULTIBACILLARY :
for 2 years .
Rifampicin 600 mg +
clofazimin 300 mg
monthly .
Dapsone 100 mg +
clofazimin 50 mg daily .