1. SKIN AND SOFT TISSUE CONDITIONS
LESSON 4
SKIN AND SOFT TISSUE CONDITIONS
Traumatic injuries, infections

2. OBJECTIVES By the end of this lesson, you should be able to:
Indentify tissues involved in skin and soft tissue conditions
Classify skin and soft tissue conditions
Describe traumatic conditions of the skin and their management
Describe the clinical presentation and management of different types of infective disorders of the skin

3. INTRODUTION
Skin and soft tissue conditions are conditions that affect the integumentary and fascial systems of the body as well as the underlying soft tissue.
They are therefore conditions involving epithelial and connective tissues
The structures involved include: -
Skin and its derivatives
Superficial fascia
deep fasciae
muscles

4. CLASSIFICATION They can be classified depending on: -
Anatomical structures the involved
Underlying pathophysiological process

5. Classification depending on underlying Pathophysiological process
Traumatic injuries
Infections
Inflammatory conditions
Neoplastic conditions
Others

6. Skin and soft tissue infections
Etiology
Viruses, bacteria, and fungi generally cause skin and soft tissue infections by entering the body at a spot where a cut, scrape, bite, or other wound has broken the skin;
some infections are even the result of bacteria that normally live on the body.
These infections can affect the layers of the skin or deeper tissues, such as muscle and connective tissue (the interlacing framework of tissue that forms ligaments, tendons, and other supporting structures of the body), and they may bring about symptoms in other parts of the body.
Many infections like varicella (chicken pox) and measles (rubeola) affect the skin, but these infections involve the whole body and do not primarily arise within the skin or soft tissues.

7. SKIN LESIONS
Skin is the largest organ in the body – 15% of Bwt, to 18000cm2
Functions – protection, immunological, Vit D synthesis, sensory, thermoregulation, excretion, psychological expression
Aging process – drying, wrinkles, effect by UV light
Affected by drug reactions and other hypersensitivity conditions (allergies)
Exposed to trauma and infections

8. Infections of the skin
1.Staphylococcal infections – Due to staph aureus, present with acute inflammation with supuration, most settle without intervention or with, use of antiseptics, if severe can lead to lymphagitis, cellulitis and abscesses. Pus swab for c/s to diagnose, treat with appropriate antibiotics and painkillers

9. Boils (furuncle)
Infection of sebaceous or pilosebaceous unit with folliculitis which is usually preceded with suppuration and central necrosis.
A blind boil heals without suppuration.
Usually occur on the head, neck and face.
Related to overwork, debility, stress or diabetes.
Furunculosis of the external auditory meatus is very painful due to attachment of the skin to the cartilage

10. Style (hordeolum) – infection of eyelash follicle usually by staph aureus. May suppurate. Removal of the eyelash may allow the pus to escape Carbuncle – infective gangrene of the subcutaneous tissue cased by coalescing of furuncle and tension of the skin inflammatory process and suppuration. Often occurs at the nape of the neck.

11. Impetigo
Often an infection by staph aureus, occassionally by beta haemolytic streptococcus pyogenes
Intradermal infection first forming a bullous which then ruptures and forms a crust.
Appears as a dirty looking crusted, it is contagious in children and can cause epidemics in crowded houses

12. Sycosis Barbae – infection of beard
Sycosis Barbae – infection of beard. Presents with erythma on background. It is initiated by shaving
Toxic epidermal necrolysis (Scalding skin syndrome - SSS) – Caused by strep pyogenes, usually in infants, clinically mimics boiling water burns, rare but life threatening
Erysipelas – superficial sharply marginate lesions, red oedematous area, red streaks of lymphagitis, patients feel ill and feverish

13. Cellulitis – deeper infection involving subcutaneous tissue
Cellulitis – deeper infection involving subcutaneous tissue. On observation has got no sharpness. Treat vigorously with parenteral antibiotics, elevate the limb
Acne valgaris – caused by propionibacterium acnes, papulo-pastule and cystic lesion on the face (mainly the cheeks). Disease of the sebaceous gland in adolescents
Erythrasma – Patches of erythma, usually affecting the axillary and groin, may be mistaken for tenia infection

14. Fungal infections of the skin
Tenia capitis – Large patchy areas with crusted and scaling. Has areas showing hair loss
Tenia Barbae – Multiple folliculo-pastules with scaling. Infection occurs in adult males
Tenia corporis – Raised plaques of tenia corporis which often became lichenified
Tenia unguim – sub ungual hyperkelatosis with destruction of nail plate and lingitudinal striations of nails and white spots.
Tenia cruris – Multiple circinate lesions with erythmatous active borders and central clearing

15. Tinea Pedis – characteristic macerations scaling and peeling of the webs of the toes. Usually takes a chronic cause.
Candidal intertrigo – maceration and whitish and erythematous finger web infection. Burning sensation and itchy. Common in housewives and kitchen employees.
Valvovaginitis – Due to candida albicans
Tenia versicolor – Multiple irregular hyperpigmented lesions on the skin. Usually on the neck and trunk

16. Viral infections Herpes zoster Herpes libialis Herpes genitalis
Varicella – Chicken Pox
Measles

17. Conclusion Classification of skin and soft tissue injuries
Presentations of specific conditions
Infections of the skin
Diagnosis of infections of the skin
Management of infections of the skin

18. 4/20/2017