Institute for Microbiology, Medical Faculty of Masaryk University and St. Anna Faculty Hospital in Brno Miroslav Votava, Vladana Woznicová Skin infections Infections with skin symptoms •primary skin infections •secondary infections of already diseased skin •skin symptoms of systemic infections Etiology: - bacterial - viral - fungal - parasitic Bacterial skin infections Primary acute bacterial skin infections – I Propionibacterium acnes – acne vulgaris Staphylococcus aureus - folliculitis Primary acute bacterial skin infections – II - local redness, heat, swelling, and a highly characteristic raised, indurated border, no localized purulence - the legs and face are the most frequently affected sites - on the face is a butterfly distribution involving the cheeks and the bridge of the nose erysipelas – Streptococcus pyogenes (GAS) Primary acute bacterial skin infections – III hordeolum (stye) – Staph. aureus Impetigo ! - Staph. aureus, - Str. pyogenes lymphangoitis – Strept. pyogenes Stye Primary acute bacterial skin infections – IV Panaritium (whitlow) Staphylococcus aureus paronychium Staphylococcus aureus Primary acute bacterial skin infections – V erythema migrans – Borrelia burgdorferi - ticks (Ixodes ricinus) - serology, PCR - doxycycline in adults http://images.google.cz Primary chronic bacterial skin infections - actinomycosis ! - Actinomyces israelii - chronic subcutaneous abscesses - A. israelii, Nocardia asteroides, Rhodococcus equi - skin granulomas - Mycobacterium marinum, M. haemophilum, M. chelonae - leprosy - Mycobacterium leprae - Mycobacterium tuberculosis – lupus vulgaris actinomycosis – Actinomyces israelii Skin symptoms of systemic bacterial infections roseola (rash in typhoid fever) – Salmonella Typhi disseminated gonorrhoea – Neisseria gonorrhoeae infective endocarditis – splinter haemorrhages meningococcemia – Neisseria meningitidis scarlatina (scarlet fever) – Streptococcus pyogenes toxic shock syndrome – S. aureus, S. pyogenes syphilis – Treponema pallidum Infective endocarditis – splinter haemorrhages hopkinsvasculitis.org Rash - meningococcemia – Neisseria meningitidis scarlatina (scarlet fever) – Streptococcus pyogenes Fungal infections cutaneous mycoses Etiology of cutaneous mycoses Tinea pedis – Trichophyton rubrum, Trich. mentagrophytes var. interdigitale, Epidermophyton floccosum Onychomycosis – T. rubrum, E. floccosum Tinea corporis – T. rubrum, Microsporum canis, M. gypseum, E. floccosum Tinea capitis – M. gypseum, M. canis, M. audouinii Viral infections Fifth Disease/Erythema infectiosum - Erythrovirus (Parvovirus) B19 Sixth Disease/ Exanthem subitum, Roseola infantum, "Sudden Rash", rose rash of infants, 3-day fever Skin symptoms in viral diseases – I Macular (spotted) exanthem: morbilli – morbilli virus, Morbillivirus genus rubella – rubella virus, Rubivirus genus erythema infectiosum (the fifth disease) – parvovirus B19, Erythrovirus genus exanthema subitum (roseola infantum, the sixth disease) – HHV 6, Roseolovirus genus Umbiliform papulae: molluscum contagiosum – molluscum contagiosum virus, Molluscipoxvirus genus cdc.gov Typical molluscum bumps. Note the pearly appearance and the dimple in the center of the bumps. http://img405.imageshack.us Fifth Disease/Erythema infectiosum Skin symptoms in viral diseases – II Vesicles: herpes simplex (cold sore) – HSV 1 herpes genitalis – HSV 2 varicella (chicken pox) – varicella-zoster virus, VZV herpes zoster (shingles) – VZV hand, foot and mouth disease – coxsackievirus herpes simplex (cold sore) – HSV 1, Simplexvirus genus varicella (chicken pox) – varicella-zoster virus, VZV, Varicellovirus genus Skin symptoms in viral diseases – III Petechiae: Hemorrhagic fevers – Ebola fever, Ebola virus Marburg disease, Marburg virus Lassa fever, Lassa virus Generalized congenital cytomegalic disease – cytomegalovirus, CMV Parasitic infections Skin symptoms in parasitoses – I Domestic parasitoses: scabies – itch mite, Sarcoptes scabiei pediculosis capitis – head louse, Pediculus capitis pediculosis corporis – body louse, Pediculus humanus (syn. Pediculus corporis) pediculosis pubis (phthiriasis) – pubic (crab) louse, Phthirus pubis Skin symptoms in parasitoses – II Infestation by native ectoparasites: cimicosis – bites by bedbug Cimex lectularius pulicosis – bites by human flea Pulex irritans, dog flea Ctenocephalides canis, cat flea Ctenocephalides felis, chicken flea Ceratophyllus gallinae ixodosis – bite by hard tick Ixodes ricinus Skin symptoms in parasitoses – III Tropical parasitoses: ulcus humidum (humid ulcer) – Leishmania major ulcus siccum (dry ulcer) – Leishmania tropica dermatitis cercariosa – cercariae of Schistosoma, Bilharziella andTrichobilharzia genera dracunculosis – Dracunculus medinensis filariosis – filariae Loa loa and Onchocerca volvulus en.wikipedia.org Leishmaniasis www.vet.uga.edu Edvard Munch (1863-1944): Death in a Room