Bacterial Infections Diseases Picture Cause Basic Lesion
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Smelly Foot Rash
CLINICAL Smelly foot rash Paulo Morais Ligia Peralta Keywords: skin diseases, infectious Case study A previously healthy Caucasian girl, 6 years of age, presented with pruritic rash on both heels of 6 months duration. The lesions appeared as multiple depressions 1–2 mm in diameter that progressively increased in size. There was no history of trauma or insect bite. She reported local pain when walking, worse with moisture and wearing sneakers. On examination, multiple small crater- like depressions were present, some Figure 1. Heel of patient coalescing into a larger lesion on both heels (Figure 1). There was an unpleasant ‘cheesy’ protective/occluded footwear for prolonged odour and a moist appearance. Wood lamp periods.1–4 examination and potassium hydroxide testing for fungal hyphae were negative. Answer 2 Question 1 Pitted keratolysis is frequently seen during What is the diagnosis? summer and rainy seasons, particularly in tropical regions, although it occurs Question 2 worldwide.1,3,4 It is caused by Kytococcus What causes this condition? sedentarius, Dermatophilus congolensis, or species of Corynebacterium, Actinomyces or Question 3 Streptomyces.1–4 Under favourable conditions How would you confirm the diagnosis? (ie. hyperhidrosis, prolonged occlusion and increased skin surface pH), these bacteria Question 4 proliferate and produce proteinases that destroy What are the differential diagnoses? the stratum corneum, creating pits. Sulphur containing compounds produced by the bacteria Question 5 cause the characteristic malodor. What is your management strategy? Answer 3 Answer 1 Pitted keratolysis is usually a clinical Based on the typical clinical picture and the negative diagnosis with typical hyperhidrosis, malodor ancillary tests, the diagnosis of pitted keratolysis (PK) (bromhidrosis) and occasionally, tenderness, is likely. -
What Certified Athletic Trainers and Therapists Need to Know Thomas M
PHYSICIAN PERSPECTIVE Tracy Ray, MD, Column Editor Sports Dermatology: What Certified Athletic Trainers and Therapists Need to Know Thomas M. Dougherty, MD • American Sports Medicine Institute, Birmingham AL OST SPECIAL SKIN problems of athletes are ting shoes for all athletes and gloves for weight lifters M easily observable and can be recognized and racket-sport players can help. and treated early. Proper care can prevent Occlusive folliculitis, also known as acne mechanica disruption of the training or competition schedule. or “football acne,” is a flare of sometimes preexisting Various athletic settings expose the skin to a multi- acne caused by heat, occlusion, and pressure distrib- tude of infectious organisms while increasing its vul- uted in areas under bulky playing equipment (e.g., nerability to infection. A working knowledge of skin shoulders, forehead, chin in football players; legs, arms, disorders in athletes is essential for athletic trainers, trunk in wrestlers). Inflammatory papules and pustules who are often the first to evaluate athletes for medi- are present. A clean absorbent T-shirt should be worn cal problems. under equipment, and the affected areas should be cleansed after a workout. Direct Cutaneous Injury Follicular keloidalis is seen mostly in African-Ameri- can athletes and is a progression of occlusive folliculi- Calluses are the skin’s compensatory, protective re- tis with nontender, firm, fibrous papules around the sponse to friction, most commonly seen on the feet edges of the football helmet, especially at the posterior but also on the hands of golfers and in oar and racket neck and occipital scalp. Surgical treatment, if indicated, sports. -
Bacterial Skin Infections an Observational Study
RESEARCH Geoffrey Spurling Deborah Askew David King Geoffrey K Mitchell MBBS, DTM&H, FRACGP, is Senior PhD, is Senior Research Fellow, MBBS, MPH, FRACGP, is Senior Lecturer, MBBS, PhD, FRACGP, FAChPM, Lecturer, Discipline of General Practice, Discipline of General Practice, Discipline of General Practice, University is Associate Professor, Discipline University of Queensland. g.spurling@ University of Queensland. of Queensland. of General Practice, University of uq.edu.au Queensland. Bacterial skin infections An observational study Bacterial skin infections such as impetigo and boils are Background common, contagious, often painful, and have the potential to We aimed to determine the feasibility of measuring resolution rates of recur. They are caused by Staphylococcus aureus and bacterial skin infections in general practice. occasionally by Streptococcus pyogenes, and are transmitted Methods by skin-to-skin contact, fomite contact or contact with nasal Fifteen general practitioners recruited patients from March 2005 to carriers.1 In the United Kingdom, incidence of skin infections October 2007 and collected clinical and sociodemographic data at in children in 2005 was approximately 75 per 100 000.2 Skin baseline. Patients were followed up at 2 and 6 weeks to assess lesion infection rates are likely to be higher in warmer climates. The resolution. only Australian data we found were for one Northern Territory Results Aboriginal Medical Service (Danila Dilba), which recorded 7.5 Of 93 recruited participants, 60 (65%) were followed up at 2 and 6 per 100 consultations for localised skin infections.3 weeks: 50% (30) had boils, 37% (22) had impetigo, 83% (50) were prescribed antibiotics, and active follow up was suggested for 47% Suggested risk factors for impetigo include: household crowding, (28). -
Current Microbiological, Clinical and Therapeutic Aspects of Impetigo Lior Zusmanovich, Lior Charach and Gideon Charach*
ISSN: 2378-3656 Zusmanovich et al. Clin Med Rev Case Rep 2018, 5:205 DOI: 10.23937/2378-3656/1410205 Volume 5 | Issue 3 Clinical Medical Reviews Open Access and Case Reports CASE REPORT Current Microbiological, Clinical and Therapeutic Aspects of Impetigo Lior Zusmanovich, Lior Charach and Gideon Charach* Department of Internal Medicine “C”, Affiliated to Tel Aviv University, Israel *Corresponding author: Gideon Charach, Department of Internal Medicine “C”, Tel Aviv Sourasky Check for Medical Center, Sackler Medical School, Affiliated to Tel Aviv University, 6 Weizman Street, Tel Aviv updates 6423906, Israel, Tel: +972-3-6973766, Fax: +972-3-6973929, E-mail: [email protected] nonpurulent and purulent cellulitis, and treatment is Abstract based on extent of infection and risk factors. Abscesses Impetigo is a highly contagious infection of the epidermis, involve the dermis and deeper skin tissues as a result of seen especially among children, and transmitted through direct contact. Two bacteria are associated with impetigo: pus formation. S. aureus and GAS. Over 140 million people are suffering Impetigo is observed most frequently among chil- from impetigo at each time point, over 100 million are chil- dren. Two forms of impetigo exist, namely impetigo conta- dren 2-5 years of age and is transmitted through direct giosa, known as the non-bullous form and the second one contact [1]. Risk factors for impetigo include poor hy- being bullous impetigo which presents with large and fragile giene, low economic status, crowding and underlying bullae. Treatment options for impetigo include systemic an- scabies [2,3]. Important consideration is carriage of tibiotics, topical antibiotics as well as topical disinfectants. -
Inflammatory Or Infectious Hair Disease? a Case of Scalp Eschar and Neck Lymph Adenopathy After a Tick Bite
Case Report ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2021.35.005688 Adherent Serous Crust of the Scalp: Inflammatory or Infectious Hair Disease? A Case of Scalp Eschar and Neck Lymph Adenopathy after a Tick Bite Starace M1, Vezzoni R*2, Alessandrini A1 and Piraccini BM1 1Dermatology - IRCCS, Policlinico Sant’Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Italy 2Dermatology Clinic, Maggiore Hospital, University of Trieste, Italy *Corresponding author: Roberta Vezzoni, Dermatology Clinic, Maggiore Hospital, University of Trieste, Italy ARTICLE INFO ABSTRACT Received: Published: April 17, 2021 The appearance of a crust initially suggests inflammatory scalp diseases, although infectious diseases such as impetigo or insect bites should also be considered among April 27, 2021 the differential diagnoses. We report a case of 40-year-old woman presentedB. Burgdorferi to our, Citation: Starace M, Vezzoni R, Hair Disease Outpatient Service with an adherent serous crust on the scalp and lymphadenopathy of the neck. Serological tests confirmed the aetiology of while rickettsia infection was excluded. Lyme borreliosis can mimic rickettsia infection Alessandrini A, Piraccini BM. Adherent and may present as scalp eschar and neck lymphadenopathy after a tick bite (SENLAT). Serous Crust of the Scalp: Inflammatory Appropriate tests should be included in the diagnostic workup of patients with necrotic or Infectious Hair Disease? A Case of Scalp scalpKeywords: eschar in order to promptly set -
Coexistence of Antibodies to Tick-Borne
Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 98(3): 311-318, April 2003 311 Coexistence of Antibodies to Tick-borne Agents of Babesiosis and Lyme Borreliosis in Patients from Cotia County, State of São Paulo, Brazil Natalino Hajime Yoshinari/+, Milena Garcia Abrão, Virginia Lúcia Nazário Bonoldi, Cleber Oliveira Soares*, Claudio Roberto Madruga*, Alessandra Scofield**, Carlos Luis Massard**, Adivaldo Henrique da Fonseca** Laboratório de Investigação em Reumatologia (LIM-17), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 455, 3º andar, 01246-903 São Paulo, SP, Brasil *Embrapa Gado de Corte, Campo Grande, MS, Brasil **Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brasil This paper reports a case of coinfection caused by pathogens of Lyme disease and babesiosis in brothers. This was the first case of borreliosis in Brazil, acquired in Cotia County, State of São Paulo, Brazil. Both children had tick bite history, presented erythema migrans, fever, arthralgia, mialgia, and developed positive serology (ELISA and Western-blotting) directed to Borrelia burgdorferi G 39/40 and Babesia bovis antigens, mainly of IgM class antibodies, suggestive of acute disease. Also, high frequencies of antibodies to B. bovis was observed in a group of 59 Brazilian patients with Lyme borreliosis (25.4%), when compared with that obtained in a normal control group (10.2%) (chi-square = 5.6; p < 0.05). Interestingly, both children presented the highest titers for IgM antibodies directed to both infective diseases, among all patients with Lyme borreliosis. Key words: lyme borreliosis - lyme disease - spirochetosis - borreliosis - babesiosis - coinfection - tick-borne disease - Brazil Babesiosis is a tick-borne disease distributed world- The first case of babesiosis in a healthy person, with wide, caused by hemoprotozoans of the genus Babesia, intact spleen, was reported in 1969 in a woman from Nan- which infects wild and domestic animals, promoting eco- tucket Island (Massachusetts, USA)(Wester et al. -
WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA). -
An Update of Pitted Keratolysis: a Review
Journal of Current and Advance Medical Research January 2017, Vol. 4, No. 1, pp. 27-30 http://www.banglajol.info/index.php/JCAMR ISSN (Print) 2313-447X Review Article An Update of Pitted Keratolysis: A Review Tania Hoque; Bhuiya Mohammad Mahatab Uddin 1Assistant Professor, Department of Dermatolgy and Venereology, Gonoshasthaya Somaj Vittic Medical college and Hospital, Savar, Dhaka, Bangladesh; 2Assistant Professor, Department of Microbiology, Enam Medical College, Savar, Dhaka, Bangladesh [Reviewed: 30 September 2016; Accepted on: 1 October 2016; Published on: 1 January 2017] Abstract Pitted keratolysis is a bacterial infection of the soles of the feet or less commonly, the palms of the hands. Pitted keratolysis is easily identified by its shallow, crater-like pits. Collection of specimen using swab may be helpful to identify causative bacteria and skin scraping is often taken to exclude fungal infection. The diagnosis is sometimes made by skin biopsy revealing characteristic histopathological feature of Pitted Keratolysis. Treatment generally consists of hygienic measures, sometimes supplemented by medication and perhaps on oral medication. This review is aimed to consolidate present information about aetiopathogenesis, diagnosis and management of Pitted Keratolysis. It is worth mentioning that Pitted Keratolysis is non-contagious. [Journal of Current and Advance Medical Research 2017;4(1):27-30] Keywords: Pitted keratolysis; bacterial infection; non-contagious Correspondence: Dr. Tania Hoque, Assistant Professor, Dept of Dermatolgy and Venereology, Gonoshasthaya Somaj Vittic Medical college and Hospital, Savar, Dhaka, Bangladesh Cite this article as: Hoque T, Uddin BMM. An Update of Pitted Keratolysis: A Review. Journal of Current and Advance Medical Research 2017;4(1):27-30 Conflict of Interest: All the authors have declared that there was no conflict of interest. -
022291S015 Eltrombopag Clinical BPCA
CLINICAL REVIEW Application Type sNDA Application Number(s) 022291, S-015 Priority or Standard Priority Submit Date(s) December 19, 2014 Received Date(s) December 19, 2014 PDUFA Goal Date June 19, 2015 Division / Office Division of Hematology Products/OHOP Reviewer Name(s) Lori A. Ehrlich Review Completion Date May 26, 2015 Established Name Eltrombopag Trade Name Promacta® Therapeutic Class Thrombopoietin Agonist Applicant Glaxo SmithKline Formulation(s) Tablet Dosing Regimen 50 mg once daily Indication(s) Chronic ITP Intended Population(s) Pediatric patients ≥6 years old with chronic ITP Template Version: March 6, 2009 Reference ID: 3765521 Clinical Review Lori A. Ehrlich, MD, PhD NDA 022291, S-015 Promacta® (eltrombopag) tablets Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT ......................................... 8 1.1 Recommendation on Regulatory Action ............................................................. 8 1.2 Risk Benefit Assessment.................................................................................... 9 1.3 Recommendations for Postmarket Risk Evaluation and Mitigation Strategies . 11 1.4 Recommendations for Postmarket Requirements and Commitments .............. 11 2 INTRODUCTION AND REGULATORY BACKGROUND ...................................... 11 2.1 Product Information .......................................................................................... 12 2.2 Tables of Currently Available Treatments for Proposed Indications ................. 12 2.3 Availability of Proposed Active Ingredient -
Pseudomonas Skin Infection Clinical Features, Epidemiology, and Management
Am J Clin Dermatol 2011; 12 (3): 157-169 THERAPY IN PRACTICE 1175-0561/11/0003-0157/$49.95/0 ª 2011 Adis Data Information BV. All rights reserved. Pseudomonas Skin Infection Clinical Features, Epidemiology, and Management Douglas C. Wu,1 Wilson W. Chan,2 Andrei I. Metelitsa,1 Loretta Fiorillo1 and Andrew N. Lin1 1 Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada 2 Department of Laboratory Medicine, Medical Microbiology, University of Alberta, Edmonton, Alberta, Canada Contents Abstract........................................................................................................... 158 1. Introduction . 158 1.1 Microbiology . 158 1.2 Pathogenesis . 158 1.3 Epidemiology: The Rise of Pseudomonas aeruginosa ............................................................. 158 2. Cutaneous Manifestations of P. aeruginosa Infection. 159 2.1 Primary P. aeruginosa Infections of the Skin . 159 2.1.1 Green Nail Syndrome. 159 2.1.2 Interdigital Infections . 159 2.1.3 Folliculitis . 159 2.1.4 Infections of the Ear . 160 2.2 P. aeruginosa Bacteremia . 160 2.2.1 Subcutaneous Nodules as a Sign of P. aeruginosa Bacteremia . 161 2.2.2 Ecthyma Gangrenosum . 161 2.2.3 Severe Skin and Soft Tissue Infection (SSTI): Gangrenous Cellulitis and Necrotizing Fasciitis. 161 2.2.4 Burn Wounds . 162 2.2.5 AIDS................................................................................................. 162 2.3 Other Cutaneous Manifestations . 162 3. Antimicrobial Therapy: General Principles . 163 3.1 The Development of Antibacterial Resistance . 163 3.2 Anti-Pseudomonal Agents . 163 3.3 Monotherapy versus Combination Therapy . 164 4. Antimicrobial Therapy: Specific Syndromes . 164 4.1 Primary P. aeruginosa Infections of the Skin . 164 4.1.1 Green Nail Syndrome. 164 4.1.2 Interdigital Infections . 165 4.1.3 Folliculitis . -
Skin Disease and Disorders
Sports Dermatology Robert Kiningham, MD, FACSM Department of Family Medicine University of Michigan Health System Disclosures/Conflicts of Interest ◼ None Goals and Objectives ◼ Review skin infections common in athletes ◼ Establish a logical treatment approach to skin infections ◼ Discuss ways to decrease the risk of athlete’s acquiring and spreading skin infections ◼ Discuss disqualification and return-to-play criteria for athletes with skin infections ◼ Recognize and treat non-infectious skin conditions in athletes Skin Infections in Athletes ◼ Bacterial ◼ Herpetic ◼ Fungal Skin Infections in Athletes ◼ Very common – most common cause of practice-loss time in wrestlers ◼ Athletes are susceptible because: – Prone to skin breakdown (abrasions, cuts) – Warm, moist environment – Close contacts Cases 1 -3 ◼ 21 year old male football player with 4 day h/o left axillary pain and tenderness. Two days ago he noticed a tender “bump” that is getting bigger and more tender. ◼ 16 year old football player with 3 day h/o mildly tender lesions on chin. Started as a single lesion, but now has “spread”. Over the past day the lesions have developed a dark yellowish crust. ◼ 19 year old wrestler with a 3 day h/o lesions on right side of face. Noticed “tingling” 4 days ago, small fluid filled lesions then appeared that have now started to crust over. Skin Infections Bacterial Skin Infections ◼ Cellulitis ◼ Erysipelas ◼ Impetigo ◼ Furunculosis ◼ Folliculitis ◼ Paronychea Cellulitis Cellulitis ◼ Diffuse infection of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin – Triad of erythema, edema, and warmth in the absence of underlying foci ◼ S. aureus or S. pyogenes Erysipelas Erysipelas ◼ Superficial infection of the dermis ◼ Distinguished from cellulitis by the intracutaneous edema that produces palpable margins of the skin. -
Necrotizing Fasciitis Report of 39 Pediatric Cases
STUDY Necrotizing Fasciitis Report of 39 Pediatric Cases Antonio Fustes-Morales, MD; Pedro Gutierrez-Castrellon, MD; Carola Duran-Mckinster, MD; Luz Orozco-Covarrubias, MD; Lourdes Tamayo-Sanchez, MD; Ramon Ruiz-Maldonado, MD Background: Necrotizing fasciitis (NF) is a severe, Results: We examined 39 patients with NF (0.018% of life-threatening soft tissue infection. General features all hospitalized patients). Twenty-one patients (54%) were and risk factors for fatal outcome in children are not boys. Mean age was 4.4 years. Single lesions were seen in well known. 30 (77%) of patients, with 21(54%) in extremities. The most frequent preexisting condition was malnutrition in 14 pa- Objective: To characterize the features of NF in chil- tients (36%). The most frequent initiating factor was vari- dren and the risk factors for fatal outcome. cella in 13 patients (33%). Diagnosis of NF at admission was made in 11 patients (28%). Bacterial isolations in 24 Design: Retrospective, comparative, observational, and patients (62%) were polymicrobial in 17 (71%). Pseudo- longitudinal trial. monas aeruginosa was the most frequently isolated bacte- ria; gram-negative isolates, the most frequently associated Setting: Dermatology department of a tertiary care pe- bacteria. Complications were present in 33 patients (85%), diatric hospital. mortality in 7 (18%), and sequelae in 29 (91%) of 32 sur- viving patients. The significant risk factor related to a fatal Patients: All patients with clinical and/or histopatho- outcome was immunosuppression. logical diagnosis of NF seen from January 1, 1971, through December 31, 2000. Conclusions: Necrotizing fasciitis in children is fre- quently misdiagnosed, and several features differ from those Main Outcome Variables: Incidence, age, sex, num- of NF in adults.