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Chapter 30 Skin Infection and Infestations
ATI Pediatrics
35
Nursing
Undergraduate 4
12/02/2013

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Term
Bacterial skin infections
Definition
Impetigo contagiosa
Pyoderma
Folliculitis
Furuncle
Carbuncle
Cellulitis
Staphylococcal scalded
Term
Viral skin infections
Definition
verruca
verruca plantaris
herpes simplex
varicella-zoster
molluscum contagiosum
Term
fungal skin infections
Definition
tinea capitis
tinea corporis
tinea cruris
tinea pedia
candidiasis
Term
Imetigo contagiosa causative agent
Definition
bacterial: staphylococcus and spread peripherally and by direct contact
Term
Imetigo contagioso presentation and care
Definition
Reddish macule becomes vesicular and erupts easily leaving moist erosion on the skin that dries as crusty secretions, pruritis is common

- Use compresses of 1:20 aluminum acetate in water (Burow's solution) to remove crusted
- topical antibacterial
Term
Pyoderma causitive agent
Definition
Bacterial caused by staphylococcus or streptococcus
Term
Pyoderma CM/care
Definition
A deeper infection into the dermis with psosible systemic effects like fever and lymphangitis

- Cleanse with soap and water and apply wet compress
- Launder washloths/towels
- Bathe with antibacterial soap
- Mupirocin (Bactroban) to lesions
Term
Folliculitis
Definition
pumple caused by staphyloccocus infection of hair follicle
Term
Furuncle
Definition
a boil caused by staph aureus infection - larger swollen, red lesion of a single hair follicle
Term
Carbuncle
Definition
staph aureus infection causing multiple boils
Term
Cellulitis
Definition
infection by streptococcus, staph or H flu causing firm, swollen red area of the skin and subcutaneous tissue and possible systemic effects

- warm, moist compresses
- antibiotics
- rest/immobilization
Term
folliculitis, furuncle, carbuncle care
Definition
- warm, moist compresses
- clean skin often
- incision, draining and irrigation of lesion if severe
- topical antibiotics
Term
Staph scalded skin syndrome
Definition
infection of staph aureus causing rough textured skin with macular erythema and epidermis that becomes wrinkled within two days of large bullae appearing

- systemic antibiotics
- gentle cleaning with saline, Burow's solution or .25% silver nitrate compresses
Term
Verruca
Definition
Human papillovirus causing warts or elevated, rough, gray-brown firm papules single or in groups, anywhere

- individualized destructive therapy
Term
verruca plantaris
Definition
plantar warms or flat wards on the plantar surface of the feet possibly surrounded by hyperkeratosis

- causitive solution applied
- soak for 20m
- repeat treatment until wart falls off
- insoles with holes to decrease pressure 2-3 days
Term
Herpes Simplex
Definition
group of vesicles that itch and burn near a mucocutaneous area. After drying they form a crusty area followed by exfoliations.
Healing occurs in 8-10 days

- Weeping stage: Burows
- Penciclovir (Denavir) to oral
- antiviral Acyclovir to reduce duration
- antiviral Valacyclovir for genital herpes
Term
Molluscum contagiosum
Definition
pox virus of asymptomatic flesh colored papules on stalks that resolves spontaneously in 18 months

if complicated, remove pox
Term
Tinea Capitas
Definition
Fungal infection caused by Trichophyton tonsurans, microsporum audouinii or microsporum canis resulting in sxaly, circumscribed lesion with alopecia on the scalp

- Use selenium sulfide shampoo
- Topical antifungal Clotrimazole
- Oral griseofulvan
- Treat pets if needed
Term
Tinea Corporis
Definition
Fungal infection resulting in round erythematous scaling patch that spreads peripherally and clears centrally
Term
Tinea Cruris
Definition
Fungal infection also known as jock itch with round erythematous scaling patch thats pruritic in the medial and proximal aspect of the thigh and crural folds and may include the scrotum. spreads peripherally and clears centrally
Term
Tinea pedis
Definition
Fungal infection also known as athletes foot that occurs between the toes or on the plantar surfact of the feet. A maceration and fissuring lesion between toes and patches with tiny vesicles on the plantar surface of foot
Term
Tinea corporis/cruris/pedia care
Definition
Oral griseofulvin
Topical antifungal
Wet compresses of sitz bath
Light colored socks, well vented shoes
Treat infected pets of corporis
Term
Candidiasis (moniliasis)
Definition
pruritic fungal infection of white exudate, peeling inflamed areas the bleed easily found in moist areas of skin surface

- topical antifungal ointment: Amphotericin B or nystatin
Term
Brown recluse spider
Definition
mild sting leads to transient erythema and to blister with pain 2-8 hours following the bite.
3-4 days: star shaped purple area
7-14 days: necrotic ulceration

- cool compresses
- antibiotics and steroids
- possible skin graft
Term
Scorpion
Definition
Bite leads to intense pain, erythema, burning, numbess, restlessness, vomiting

Ascending paralysis
Death in children less than 4 in first 24 hours

- Position dependant
- Administer antivenom
- Pain management
- ICU
Term
Lyme Disease Stage 1
Definition
3 to 31 days following the bite - erythema migrans at site

- chills, fever, itching, headache, fainting, stiff neck, muscle weakness
- bull's eye rash at site
Term
Lyme Disease Stage 2
Definition
systemic involvement begins and occurs several weeks following the bite

- paralysis or weakness in the face
- muscle pain
- heart problems
- swelling in large joints
Term
Lyme Disease Stage 3
Definition
systemic involvement is advanced - musculoskeletal pain that includes the muscles, tendons, bursae and synovia - possible arthritis, deafness and encephalopathy

- abnormal muscle movement and weakness
- numbness and tingling
- speech issues
Term
Lyme Disease Care
Definition
- Observe those bitten for 30 days
- single dose antibiotic if meet criteria
- 2-3 week course for confirmed disease

Doxycycline for over 8
Amoxicillin under 8
Cefuroxinr or Eryhtromycin with penicillin allergy
Term
Scabies mite
Definition
Spread by direct contact. Mite burrows and lays eggs that matures in 21 days.

- Itchy, especially at night
- Rash, between the fingers
- Thin, pencil marks lines on the skin

Infant: widespread, pimples on trunk, blisters on palms and soles
Children: most common on hands, wrists, genitals and abdomen
Term
Scabies mites intervention
Definition
5 % permethrin cream (Elimite) over entire body as one time treatment that may need to be repeated in one week

- treat entire family/contact during and 60 days after
- wash things in hot water
Term
Pediculosis capitis
Definition
Head lice. Life span of the adult louse life is 1 month and can live up to 48 hours without a host. Eggs are layed at night close to the skin surface at junction of hair shaft. Nits hatch in 7-10 days.
Term
Pediculosis capitis interventions
Definition
- Shampoo's containing 1% permethrin
- Wash things in hot water
- hygiene
Term
Pediculosis corporis
Definition
Body lice that is spread by direct contact where the louse feeds on human blood and can live in folds of clothing for 1 month and die at room temperature in 5-7 days

- itching worse around the waist and under the arms or where clothes are tight
Term
Pediculosis pubis
Definition
Pubic lice - intense itching, sores and bluish-gray skin

- remove nits with a comb and repeat in 7 days after shampoo treatment
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