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

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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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