Xem 1-20 trên 94 kết quả Skin infections
  • Harrison's Internal Medicine Chapter 131. Diphtheria and Other Infections Caused by Corynebacteria and Related Species Diphtheria Diphtheria is a nasopharyngeal and skin infection caused by Corynebacterium diphtheriae. Toxigenic strains of C. diphtheriae produce a protein toxin that causes systemic toxicity, myocarditis, and polyneuropathy. The toxin is associated with the formation of pseudomembranes in the pharynx during respiratory diphtheria. While toxigenic strains most frequently cause pharyngeal diphtheria, nontoxigenic strains commonly cause cutaneous disease.

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  • (BQ) Part 1 book "Dermatology at a glance" presents the following contents: Principles of dermatology, the patient consultation, basic procedures, treatments, inflammatory diseases, ER dermatology, skin infections.

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  • (BQ) Part 1 book "Manual of dermatologic therapeutics" presents the following contents: Acne, alopecia areata, androgenetic alopecia, aphthous stomatitis, bacterial skin infections, bites and stings, corns and calluses, diaper dermatitis, dry skin and ichthyosis vulgaris, erythema nodosum, fungal infections,...

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  • This account is confined to therapy directed primarily at the skin. • Pharmacokinetics of the skin • Topical preparations:Vehicles for presenting drugs to the skin; Emollients, barrier preparations and dusting powders;Topical analgesics; Antipruritics; Adrenocortical steroids; Sunscreens • Cutaneous adverse drug reactions • Individual disorders: Psoriasis.Acne, Urticaria, Skin infections It is easy to do more harm than good with potent drugs, and this is particularly true in skin diseases.

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  • Tzanck Smear A Tzanck smear is a cytologic technique most often used in the diagnosis of herpesvirus infections [herpes simplex virus (HSV) or varicella zoster virus (VZV)] (see Figs. 173-1 and 173-3). An early vesicle, not a pustule or crusted lesion, is unroofed, and the base of the lesion is scraped gently with a scalpel blade. The material is placed on a glass slide, air-dried, and stained with Giemsa or Wright's stain. Multinucleated epithelial giant cells suggest the presence of HSV or VZV; culture or immunofluorescence testing must be performed to identify the specific virus.

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  • Absence of melanocytes. b Normal number of melanocytes. c Platelet storage defect and restrictive lung disease secondary to deposits of ceroid-like material; one form due to mutations in β subunit of adaptor protein. d Giant lysosomal granules and recurrent infections. The differential diagnosis of localized hypomelanosis includes the following primary cutaneous disorders: idiopathic guttate hypomelanosis, postinflammatory hypopigmentation, tinea (pityriasis) versicolor, vitiligo, chemical leukoderma, nevus depigmentosus (see below), and piebaldism (Table 54-9).

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  • Table 54-12 Causes of Vesicles/Bullae I. Primary cutaneous diseases A. Primary blistering diseases (autoimmune) 1. Pemphigusa 2. Bullous pemphigoidb 3. Gestational pemphigoidb 4. Cicatricial pemphigoidb 5. Dermatitis herpetiformisb,c 6. Linear IgA bullous dermatosisb 7. Epidermolysis bullosa acquisitab,d B. Secondary blistering diseases 1. Contact dermatitisa 2. Erythema multiformea,b 3. Stevens-Johnson syndrome 4. Toxic epidermal necrolysisb C. Infections 1. Varicella/zoster virusa,e 2. Herpes simplex virusa,e 3. Enteroviruses, e.g., hand-foot-and-mouth disease 4.

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  • Diphtheria is a nasopharyngeal and skin infection caused by Corynebacterium diphtheriae. Toxigenic strains of C. diphtheriae produce a protein toxin that causes systemic toxicity, myocarditis, and polyneuropathy. The toxin is associated with the formation of pseudomembranes in the pharynx during respiratory diphtheria. While toxigenic strains most frequently cause pharyngeal diphtheria, nontoxigenic strains commonly cause cutaneous disease.

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  • Both measles and rubella are seen in unvaccinated young adults, and an atypical form of measles is seen in adults immunized with either killed measles vaccine or killed vaccine followed in time by live vaccine. In contrast to classic measles, the eruption of atypical measles begins on the palms, soles, wrists, and knuckles, and the lesions may become purpuric. The patient with atypical measles can have pulmonary involvement and be quite ill.

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  • Table 54-14 Causes of Urticaria and Angioedema I. Primary cutaneous disorders A. Acute and chronic urticariaa B. Physical urticaria 1. Dermatographism 2. Solar urticariab 3. Cold urticariab 4. Cholinergic urticariab C. Angioedema (hereditary and acquired)b II. Systemic diseases A. Urticarial vasculitis B. Hepatitis B or C infection C. Serum sickness D. Angioedema (hereditary and acquired) a A small minority develop anaphylaxis. b Also systemic. The common physical urticarias include dermographism, solar urticaria, cold urticaria, and cholinergic urticaria.

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  • Palpable purpura are further subdivided into vasculitic and embolic. In the group of vasculitic disorders, cutaneous small-vessel vasculitis, also known as leukocytoclastic vasculitis (LCV), is the one most commonly associated with palpable purpura (Chap. 319). Underlying etiologies include drugs (e.g., antibiotics), infections (e.g., hepatitis C virus), and autoimmune connective tissue diseases. Henoch-Schönlein purpura is a subtype of acute LCV that is seen primarily in children and adolescents following an upper respiratory infection.

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  • Harrison's Internal Medicine Chapter 55. Immunologically Mediated Skin Diseases Immunologically Mediated Skin Diseases: Introduction A number of immunologically mediated skin diseases and immunologically mediated systemic disorders with cutaneous manifestations are now recognized as distinct entities with consistent clinical, histologic, and immunopathologic findings. Many of these disorders are due to autoimmune mechanisms.

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  • More common than tunnel infections are exit-site infections, often with erythema around the area where the line penetrates the skin. Most authorities (Chap. 129) recommend treatment (usually with vancomycin) for an exit-site infection caused by a coagulase-negative Staphylococcus. Treatment of coagulasepositive staphylococcal infection is associated with a poorer outcome, and it is advisable to remove the catheter if possible. Similarly, many clinicians remove catheters associated with infections due to P.

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  • Tuberculosis Important measures for the control of tuberculosis (Chap. 158) include prompt recognition, isolation, and treatment of cases; recognition of atypical presentations (e.g.

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  • Employee Health Service Issues An institution's employee health service is a critical component of its infection-control efforts.

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  • Infections of the Ear and Mastoid Infections of the ear and associated structures can involve both the middle and external ear, including the skin, cartilage, periosteum, ear canal, and tympanic and mastoid cavities. Both viruses and bacteria are known causes of these infections, some of which result in significant morbidity if not treated appropriately. Infections of the External Ear Structures Infections involving the structures of the external ear are often difficult to differentiate from noninfectious inflammatory conditions with similar clinical manifestations.

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  • A similar problem can affect patients whose lymph node integrity has been disrupted by radical surgery, particularly patients who have had radical node dissections. A common clinical problem following radical mastectomy is the development of cellulitis (usually caused by streptococci or staphylococci) because of lymphedema and/or inadequate lymph drainage. In most cases, this problem can be addressed by local measures designed to prevent fluid accumulation and breaks in the skin, but antibiotic prophylaxis has been necessary in refractory cases.

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  • Figure 82-1 A. Papules related to Escherichia coli bacteremia in a neutropenic patient with acute lymphocytic leukemia. B. The same lesion the following day. Candidemia (Chap. 196) is also associated with a variety of skin conditions and commonly presents as a maculopapular rash. Punch biopsy of the skin may be the best method for diagnosis. Cellulitis, an acute spreading inflammation of the skin, is most often caused by infection with group A Streptococcus or Staphylococcus aureus, virulent organisms normally found on the skin (Chap. 119).

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  • Virus-Associated Malignancies In addition to malignancy associated with gammaherpesvirus infection (EBV, KSHV) and simple warts (HPV), other tumors that are virus-associated or suspected of being virus-associated are more likely to develop in transplant recipients, particularly those who require long-term immunosuppression, than in the general population. The interval to tumor development is usually 1 year. Transplant recipients develop nonmelanoma skin or lip cancers that, in contrast to de novo skin cancers, have a high ratio of squamous cells to basal cells.

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  • Other Nondiphtherial Corynebacteria C. xerosis is a human commensal found in the conjunctiva, nasopharynx, and skin. This nontoxigenic organism is occasionally identified as a source of invasive infection in immunocompromised or postoperative patients and prosthetic joint recipients. C. striatum is found in the anterior nares and on the skin, face, and upper torso of normal individuals. Also nontoxigenic, this organism has been associated with invasive opportunistic infections in severely ill or immunocompromised patients. C.

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