1. DISEASES OF THE SKIN AND EYES;WOUNDS AND BITES
CHAPTER 19
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2. Anatomy Review - Skin Epidermis Cellular Thick Waterproof Dead surface
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3. Mucous Membranes Epithelium Mucus Protective features Lysozyme
Chemicals
Antibodies
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4. Eyes Conjunctiva Cornea Glands Protective features Lashes
Blinking reflex
Tear flow
Molecules
IgA
Lysozyme
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5. Additional Defenses Microflora Salt tolerance Skin cell shedding
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6. Bacterial Skin Diseases – Staphylococcus aureus
Folliculitis (Pimples)
Invasion of hair follicles
Eyelash infection - Sty
Multiple follicles – Carbuncle
Many carriers
Low bacterial counts needed to infect wounds
Scalded skin syndrome
Exfoliative exotoxins
Infants most affected
Outer skin layers shed
High fever
Septicemia and shock may occur
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7. Staphylococcal Impetigo
Impetigo of Newborn
Crusting vesicles on skin surface
Antimicrobial lotions needed
Carriers need to be careful in hospitals and at home
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8. Bacterial Skin Diseases – Streptococcus pyogenes
Scarlet Fever
Bacteriophage toxin causes rash
Strep. throat often also seen
Complications – glomerulonephritis and rheumatic fever
Treatment should not be delayed
Many carriers
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9. Streptococcus pyogenes
Erysipelas
St. Anthony’s fire
Historically high mortality, not so now
Red raised rubbery lesion
Focal spread may occur
Septicemia
Pneumonia
Endocarditis
Abscesses
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10. Pyoderma/Impetigo Microbes involved Strep./Staph. Corynebacterium
Childhood infection
Skin depigmentation may occur
Penicillin treats most infections
Acne
Propionibacterium acnes
Adolescent condition
Careful skin washing
Antibiotics, Acutane
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11. Burn Infections Pseudomonas aeruginosa
Common in pools and improperly chlorinated hot tubs
Dermatitis
Ear infections
Severe respiratory infections in burn victims
Serratia
Providencia
Treatments
Debridement
Skin cell replacement
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12. Viral Skin Diseases - Rubella
German Measles
The disease
Systemic with skin rash, joint pain
Mild but can cause birth defects
Stillbirth
Deafness, heart and liver problems
Respiratory transmission
Immunity and Prevention
MMR vaccine, all preadolescent girls
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13. Viral Skin Diseases - Rubeola
Measles
The disease
Lymphatic tissue affected
Rash and fever develop, cough and conjunctivitis
Middle ear infections and URT infections may occur
Incidence and transmission
Respiratory route of transmission
Immunity and Prevention
MMR vaccine, target for global eradication
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14. Vaccination Success
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15. Herpesviridae Skin Diseases
Roseola
HHV-6, fever and rash
Self-limiting but latent
Shed in saliva of most adults
Chickenpox/ Shingles
Varicella zoster virus (VZV)
Respiratory route of infection
Systemic symptoms accompanied by vesicular rash
May be fatal in adults, childhood vaccination provides 20 years immunity
Latent virus, shingles vaccine is newly available
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16. Other 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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17. Warts Human Papilloma virus (HPV)
Affect skin and mucus membranes (Dermal. STD)
May require excision, freezing
Link between some strains and cervical cancer
Gardasil vaccine
Now recommended for young girls and boys
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18. Fungal Skin Disease - Dermatomycoses
Ringworm
Tinea cruris (groin)
Tinea capitis/barbae (head/ beard)
Tinea pedis/ unguium (foot/ toenails)
Very contagious
Secondary bacterial infections may occur
OTC medications available
Triazoles
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19. Subcutaneous Fungal Disease
Sporotrichosis
Sporothrix schenkii
Gardeners, farmers
Transmitted from animals or humans
Ulceration and inflammation at puncture site
KI treats subcutaneous lesions
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20. Opportunistic Mycoses
Candidiasis (Candida albicans)
Oral or vaginal infections common
May cause systemic infections in immunocompromised (AIDS)
Aspergillus may also cause skin and respiratory disease
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21. Bacterial Eye Diseases
Opthalmia neonatorum
Neisseria gonorrheae
Transmission via birth canal
Routine antibiotics or silver nitrate
Reduced incidence of blindness
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22. 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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23. Viral Eye Diseases Epidemic Keratoconjunctivitis
Adenovirus (Shipyard Eye)
Virus carried in dust
Cornea may be cloudy for up to 2 years
Sometimes nosocomial
HSV Keratoconjunctivitis
Complication for cold sore sufferers
Leading cause of non-retinal blindness in U.S.A.
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