-interdigital

-mocassin

-inflammatroy/veiculobullous

-ulcerative

- clinical signs

-skin/nail scraping/cutting

- KOH prep

- Agar plates or dermatophyte test media

- woods light (microsporum fluoresce green and pityriasis yellow)

- keratolytic (whitfields ointment - salicyclic acid and benzoic acid) to hydrate skin

- topical antifungal at night

- may need oral antifungal

Fungal tx until 2 wks after symptoms gone

may need antibiotic also 

- anti-inflam (topical steroid) and antifungal eg resolve plus, may need oral

-antibiotic for secondary infection

moisture reduction

topical antifungals

may need antibiotics for secondary bacterial infection

- calcofluor/KOH examination of nail scrapings/subungual debris

or

- PAS stain of nail clippings

- Superficial white 

-disto-lateral 

-proximal

-total dystrophic

- Oral/topical antifungal

-nail lacquer

-chemical destruction

- laser, PDT

-Avulsion

- traumatic inoculation of skin with fungus (esp fonsecaea pedrosi or cladophialophora carionii in aus)

- mainly occurs in limbs esp in agricultural work or tropics

-cauliflower like mass, may spread up leg. Scales, crusts, ulcerations, nodules as well as pus may be seen.

-Complications: haematogenous spread, brain abscess, lymphatic obstruction

- microscopy of scrapings and pus

- itraconazole/posaconazole, voriconazole maybe with terbinafine, SKKI (potassium iodide), cold, heat, surgical 

- actino: dapsone, cotrim, rifampicin, streptomycin, amikacin

-Eumycete:azoles, griseofulvin, terbinafine. More prone to requiring surgery, sometimes even amputation

- children

-women who shave their legs

- users of potent topical steroids for fungal infections  

- tx is oral terbinfaine

Tinea that has its appearance altered by incorrect treatment, eg topical steroids believeing it is dermatitis. This stops itch, but when cream stopped itch comes back however fungus still growing, but they put more cream on to stop the itch increasing spread.

- has less raised and less scaly, but more pustular and irritable look

- scraping of skin for microscopy and culture. Should be done after stopping steroid for a few days since this will minimise the surface of the rash otherwise. 

- treatment bland antipruritic lotions and standard fungal treatment

-continue for 2 weeks after s and s gone, 1 week for terbinafine

- prescribe by generic rather than brand name

-caution with azoles in pregnancy, lactation, warfarin

- keratolytics

-systemic retinoids

-vaccines

-target immune system or virus itself

-keratolytic

-intralesional bleomycin

-hypnosis

-min humidity, prevent spread

-natural remedies like marigolds or bananas

-multiple and grouped discrete pearly, pink, umbilicated, dome shaped papules - few mm in diameter. Contain cheesy material. 

- Affect face, neck, trunk of children and young adults

-spread by contact

- none

- chemical

-surgical curette

-laser

Acute vesicular eruption affecting lips and mucous membranes

- crusts form within 24-48 hours

-infection fades in about a week

-sensory nerve cell bodies

-decreased immunity, respiratory infection esp

-poor hygiene

-crowding

-high humidity/temp

-with other skin conditions

-mostly in children

-topical a/b: muupirocin, fusidic acid cream

-oral a/b: ampicillin, erthromycin, cephalosporin

-bulla 1-2cm in diameter, erosion when deroofed

-toxin a from staph

-oral/topical antibiotics

- well circumscribed, advancing erythema, odema, tenderness

-face, lower extremities

-malaise, shivering, fever

- bumpy red, pus filled lump (pea to golf ball size) that may be tender/warm/very painful.

-yellow/white centre means its ready to drain pus

-may be fever, swollen lymph nodes or fatigue if systemic

-dermis and subcutaneous fat infected with strep and/or staph

- older or immunocompromised

- swelling, redness, local pain

-fever and malaise

-admit, oral/iv a/b: penicillin, cephalosporins

- red line that follows lymph vessels from entry site to lymph nodes

-lymph nodes are enlarged and tender

-impaired lymphatic drainage sometimes

-oral penicillin

- mixed bacterial infection of the superficial fascia

- secondary to surgeries like intestinal, alcoholism, drug abuse, DM

-antifungals (imidazole)/antibiotics (erythromycin/fusidic acid)

- min sweating

-advise footwear and socks

-topical and/or oral a/b and antifungals

infection of axillary or pubic hair by corynebacterium, presents with concretions on hair shaft

tx shave, benzoyl peroxide wash, topical a/b solution or cream

- sweet freshly mowed grass odour

- swab

- vinegar soak

-condys soak

-a/b beta lactam, fluoroquinolones, aminoglycosides

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Which type of tinea pedis is this?

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What tinea pedis is this?

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Which type of tinea is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

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What condition is this?

- it has thicker cell wall

-is alcohol and acid fast

-TB verrucosa cutis

-lupus vulgaris

-scrofuloderma

-miliary TB

-tuberculid

- direct inoculaion with tb into skin of someone who has previously been infected with mycobacteria

-purplish/brownish red warty groeth esp on knees/elbows/hands/feet/butt

- can clear without tx

- small sharply defined reddish brown lesions with gelatinous consistency

- persist yrs, can lead to disfigurement or cancer

-result from direct extension of underlyin tb infection of lymph nodes/bone/joints/lungs

- firm painless lesions that ulcerate, may heal themselves afters yrs

- chronic tb infection spread from primary infection via bloodstream esp in immunocompromised

- small red spots that develop ulcers and abscesses, pt generally sick

-prognosis: likely to die even if treated

- generalised widespread rash or high degree of immunity to TB because of previous infection

-Erythema induratum (nodules on backs of legs that ulcerate), papulonecrotic (crops of recurrent crusted skin papules), lichen scrofulosorum (extending eruption of small follicular papules in young persons)

- living or travelled to endemic area

-hx of trauma

-past or fam hx

- lack of a/b response, chronic and non healing (slow growing patch/plaque on exposed site)

- hx

-signs and symptoms

examine Lymph nodes/liver/spleen

- chest xray

-mantoux test/quantiferon gold

-biopsy (HistoPathological Examination/special stains/culture in Lowenstein jensen medium/PCR)

-Ancillary evidence

What are the main drugs taken for TB?

How are they taken?

- Rifampin

-isoniazid

-pyrazinamide

-ethambutol

- taken in combination regime (depends on how resistant bacteria are), taken for months at a time

-can use DOTS program to have someone supervise taking meds to prevent missing it

-can also have surgery

- bites of infected aquatic insects esp rural wetlands in qld and vic

- firm painless non tender movable subcutaneous papules or nodules on arms or legs. Pt may complain of itching

- nodule ulcerates within 4-8 wks, is undermining 15cm

or more.

-is panniculitis

- May cause osteomyelitis

- contact with organism in salt/fresh water pools/aquariums/lakes (grows at 30-33c, cooler at extremities)

- in 3-5 weeks lesions are baout 1-2.5cm. 

- typically solitary or multiple nodules that are painless on limbs, may appear verrucous looking

- can lead to OM, septic arthritis, tenosynovitis

Primary chancre 10-90 days after exposure

Secondary eruptins 6 weeks to 6 mths after primary chancre

10 -30 years later is tertiary disease

- hookworm larvae (anclostoma spp.)

- esp on sole of foot, butt, back and thighs, is a pruritiic erythematous, serpiginous burrow

- tx: self healing, liqui nitorgen of leading edge, topical/oral albendazole, oral ivermectin

- close, frequent contact

- age 10-14 or 30-40, genetics, malnutrition, socio economic status, immune status, males more than females, heat/humidity, overcrowding, endemic area

-contact

-needle

inhalation of droplets

-arthropods

-ingestion

-zoonoses like armadillo (eg in texas, mississippi), chimp, monkey

- borderline tuberculoid disease

- borderline borderline disease

- borderline leprosy

TT : High resistance, few well defined assym sensory/autonomic impairment, ive systemic, +/- organisms, epitheliod cell granulomas, early asymmetrical nerve involvement. self cure, persist, short treatment, children affected, blacks, PB, 80% distribution

LL: Low resistnace, multiple variable symmetrical asymptomatic lesions, systemic involvement, +++ organisms, foamy macrophages, late symm nerve involvement, persist progressive prolonged treatment, adults affects, asians, MB, 20% distribution

- hypopigmented or reddish skin

-lesions with loss of sensation

-peripheral nerve thickening, sensory or motor loss

- m.leprae in lesions

- sensory, motor, autonomic dysfunction

-enlargement can be palpable, feeling for irregularity like abscess

-symmetry or asymmetry

- record pain or tenderness

Clinical: pedal edema, nasal stuffiness, skin lesion, nerve thickening

Biopsy of skin or nerve stained

Slit and smear taken from ear lobe stained with ZN

Serology - fluorescent antibody absorption

-histamine test

-sweat test

-lepromin test

- density of bacilli in smears

- 6+ means more than 1000 bacilli in average field

-falls +1 per year

- percentage of live bacteria as a measure of total count - percentage of solid staining bacilli after examining 200 red staining elements ling singly

- untreated : reactions, disabilities, deformities, reservoir of infection

- during rx: reactions and consequent disability/deformity

-Post rx: relapse, disabilities and deformities

Type 1 occurs earlier after treatment than type 2, it causes changes in or additional lesions, nerve pain with loss of function occasionally. It is precipitated also by pregnancy or parturition

Type 2 doesnt affect lesions, but causes systemic features like fever, malaise, myalgia, jt swelling and pain, and other organ dysfunction. Is also precipitated by infection, injury, stress, vaccine, pregnancy, parturition.

- continue multi drugs + NSAIDs, steroids, thalidomide

-referral, prevention, follow up

- gynocomastia

-histoids

-leonine facies

-ear lobe infiltration

-trophic ulcer

-odema of feet

symmetrical glove and stocking anaesthesia - lepromatous leprosy

asymmetrical numb feet - tuberculoid leprosy

neuropathic ulceration

sensory, motor, autonmoic dysfunction = dry skin

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Skin lesions that result from direct extension of underlying TB infection of lymph nodes bone or jts are called?

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Chronic tb infection that has spread from the primary infection to other organs via the bloodstream causes these small red spots. What type of cutaneous tb is it?

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Occurs after direct inoculation into skin of someone who has been previously infected with tb. What type of cutaneous tb is this?

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What condition is this?

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Name this condition?

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Name this condition?

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What condition is this?