Bacterialskindiseases

Bacteriaontheskinresidentflora:staphylococcusepidermidistransientflora：staphylococcusaureusBacteriaandskindirectinfectionImpetigo（膿皰瘡）Folliculitis（毛囊炎）Furuncle（癤腫）Carbuncle（癰）Erysipelas（丹毒）indirectimmunologicalinductionpsoriasis,atopicdermatosisIntroduction

Impetigo（膿皰瘡）

BigpustleCrustPathogen:staphylococcusaurous（金葡菌）50%-70%，and

betahemolyticstreptococcus(乙型溶血性鏈球菌）environment:

Higherhumidityof

skin,theskinmaceration,prevalentinsummer/fall.

humanbody:scratching

because

of

pruriticskindiseaseTransmissionpathway:contactinfection,autoinoculationEtiologyImpetigocontagiosa(impetigovulgaris):接觸性膿皰瘡（尋常型膿皰瘡）Ecthyma（深膿皰瘡）Impetigo

bullosa(大皰性膿皰瘡）Impetigo

neonatorum(新生兒膿皰瘡）Staphylococcal

scalded

skin

syndrome(葡萄球菌性燙傷樣綜合征，ssss)ClinicaltypesChildrenpredilectiononexposed

areas,such

as

face

,neckRed

papule

,thendepvelop

into

pustle

with

thin

wall

and

flush

around

the

pustle,which

are

easy

to

broke

out

and

form

erosions

and

yellow

crusts.Extension

after

scratching.1.ImpetigovulgarisChildren

and

old

person

with

malnutritiion.predilectiononlegs

or

buttocksPustle,develop

into

deeper

partof

skin,and

then

skinnecrosis

and

crust

with

redandswollen

around

the

lesions.

Deep

and

sharp

ulcers

could

be

seen

after

moving

the

crusts.More

painful.2.EcthymaPhageII,type71staphylococcusaurous

Children

or

adult

with

deficency

of

immunity.predilectiononface

,trunck

and

limbsVesicle

or

pustle,

then

develop

into

bullae，which

is

characterized

by

half

moon

like

empyema..The

wall

of

bullae

is

thinner

and

easy

to

broke

outandform

curst

and

pigmentation.3.Impetigo

bullosaHalf

moon

like

empyema

ImpetigobullosaontrunkHappen

in

neonatorum.Acute,

generalized

and

more

infectious

with

mutipleempyema,erosionsandcrusts.

Normally

have

sever

systemic

symptoms

such

as

high

fever

and

systemictoxemicsymptoms.4.ImpetigoneonatorumInduced

by

toxins

produced

by

PhageII,type71staphylococcusaurous

.Children

in

5

years

old.Prodrome

include

respiratoryskin

infectionserythema

starts

from

mouth

or

around

eyes,and

further

develops

into

all

over

body,

which

are

characterized

by

exfoliations

and

erosions.5.Staphylococcal

scalded

skin

syndrome，ssss)

Prevalentseason:summer/fallOnsetage:infant/oldindividualDiseasedpart:facial/hipSkinrashcharacteristic:blister、pustule、honeygoldcrust.BacterialtestDiagnosisNonimpetigobullosadifferentialdiagnosiswithvaricella、papularurticariaDifferentialdiagnoseprevention:PersonalHygiene,keepskindry,cureitchskindisease.systemictherapy:skinlesionsextensivewithfeverandlymphnoditisorweaknessinfantdrugsensitivetestsensitiveantibiotictopicaltherapy：calaminelotion，1：5000

potassiumpermanganate

solution

,and

mupirocinointmentetal.

TherapyFolliculitis(毛囊炎）

，F(xiàn)uruncle（癤）

and

Carbuncle（癰）AsetofdiseasesinvolvingthehairfollicleandsurroundingtissueinfectionsPathogen:Staphylocoagulase(+)staphylococcusaurous

suppurativeinfectionlimitedtofollicularorificePredilectiononface、neck、hip、vulvarClinicalmanifestation:1week,with

slight

painRedhairfolliclespapule-pustule-drycrust

Folliculitis

FolliculitisFolliculitisFolliculitissuppurativeinfectionindeepofhairfolicalandsurroundingtissuesPredilectiononface、hip、neckClinicalmanifestation:Hairfolliclesinflammatorypapules—Redhardnodules(painful)—abscess,puspluginthecenter—crustComplication:fever,headache,lymphadenectasisFuruncleFuruncleFuruncleSkindeepinfectioninmultipleadjacenthairfolliclesandthetissuesaroundthehairfolliclesPredilectiononneck、back、hip、thigh。Manifestation:Diffuseinflammationknot—centerforsoftening,multiplepusplugappearonthesurface—cellulardeepulcerNormally

accompanied

by

systemic

symptoms.CarbunclecarbunclecarbunclePrinciple:topicaltreatment,systemtreatmentformultiplefolliculitisandseverefuruncleandcarbuncle.Topical:20%ichthammolOintment,MupirocinOintmentSystemtreatment:Penicillin,cephalosporinslargeringlactoneclass,

quinolonePhysiotherapy：hotcompress、InfraredSurgery:forfuruncleandcarbuncleatlatestageTherapyErysipelas

Acuteinfectioncaused

by

Hemolyticstreptococcus

attheshallowskinoflymphaticvesselsandsurroundingtissuesErysipelasPathogen:beta-hemolyticgroupA

Streptococcus

bacteriaInvade

the

skin

by

slight

trauma,or

skin

diseases

such

as

tinea

pedis,leg

ulcer,rhinitisetal.

Inducingfactors：pool

immunity

such

as

diabetes，chronic

liver

diseases

and

malnutrition

et

al.etiologyusuallyonanyofthelegsandtoes,face,arms,andfingersSkinlesion：

①skinlesionenlargesrapidlyandhasasharplydemarcated,raisededge.

②red,swollen,warm,andpainful.

③vesicles、blisters、and

petechiaewithpossibleskin

necrosis

System：fevers,

shaking,

chills,

fatigue,

headaches,vomitingClinicalmanifestationerysipelaserysipelaserysi