Bacterial infections

  • Acne

    • Treatment based on the type of lesions

      • Comedones (Blackheads)

        • retinoid, benzoyl peroxide, azelaic acid, or salicylic acid

        • Benzoyl peroxide with a topical ABX

      • Pus-filled pimples (Acne Vulgaris)

        • Topicals and benzoyl peroxide, retinoid, and azelaic acid

        • benz peroxide plus retinoid or topical abx

        • oral contraceptive pills or patch

      • Acne Nodules and Cysts

        • prescription topical plus ABX

        • hormone replacement therapy or contraceptive

        • isotretinoin

  • Folliculitis

    • characteristics - Erythema, inflammation, pustules or papules surrounding hair follicles

    • caused by Gram-positive bacteria

    • There will be signs around every single hair

  • Erysipelas

    • characteristics

      • erythema

      • pain and itching

      • sharp edges that are raised

    • Risk factors - obesity and diabetes, or venous disease

    • Physical exam

      • Inspection of plaques

      • palpation for warmth

      • Evaluation of systemic involvement

    • Treatment

      • oral ABX - penicillin, erythromycin

        • because this is caused by group A strep (GAS)

  • Hidradenitis Suppurativa - the dark spots I tell Tatum about

    • characteristics- tenderness, nodules that grow and coalesce,

      • typically where there are hair follicles and sweat glands like groin, armpits, butt.

    • Treatment

      • exact cause is unknown

      • patient education, hygiene, smoking cessation

      • topical clindamycin

      • topical corticosteroids

  • Impetigo

    • HONEY CRUSTING, erythemous, pus-filled, typically found in the pediatric population

    • caused by Gram-positive bacteria

    • treatment

      • topical mupirocin

  • Paronychia - erythema, edema at nail fold with pain and tenderness

    • Typically has a history of trauma, like a hangnail

    • Treatment

      • warm soaks

      • oral amoxicillin-clavulanic acid, clindamycin

      • incision and drainage for a fluctuating area

  • Cellulitis

    • characteristics - erythema, warmth, pitting

    • Differential

      • erysipelas, but the difference is that erysipelas has well-demarcated borders, which cellulitis does not

    • Treatment

      • Oral ABX for a minimum of 5 days, cephalexin or clindamycin

      • IV ABX if needed

  • Carbuncle

    • characteristics

      • erythema, tenderness, fluctuance

      • An infection around the hair follicle goes deeper

    • Assessment

      • Look for multiple draining sinuses

      • palpate for fluctuance and tenderness

    • Treatment will be treating the cause of bacteria, which is gram-positive, known as Staphylococcus Aureus

      • Oral Cephalexin

      • incision and drainage

  • Scarlet Fever Rash

    • characteristics

      • raised sandpaper-like rash

        • appears 12-48 hours after the sore throat

      • pustules

      • erythema

  •    Oral penicillin, amoxicillin