cellulitis
how can cellulitis occur in pediatrics?
any opening in the skin can lead to an infection and to cellulitis. the germs that usually cause cellulitis are:
name the 2 hallmarks for impetigo
1. bright red skin
2. “honey-colored” crusted lesions
why do lice live in hairy environments?
easy access to blood supply & ideal egg-laying environment
most common symptom of scabies
intense pruritis
superficial fungal skin infection of the ____ , referred to as "ringworm"
scalp
define "induration"
swelling underneath the skin
what is impetigo caused by & by what pathogens?
probably from upper respiratory infection, drainage, and blowing/touching the area = introducing bacteria to the area (secondary infection) - staph/strep
how do you differentiate dandruff from lice during visual exam?
nits are stuck to the hair, and won't flake off
how does scabies present?
mites that burrow under the skin, causing tiny white pimple-looking bumps
how does tinea capitis present?
bright red with centralized clearing, raised edges, and flaky skin, very itchy
what are the minimum requirements to treat cellulitis?
oral antibiotics, IV antibiotics may be necessary
name some treatments if MRSA is reoccurring
bleach baths (not in the nares) & mupirocin ointment
are vaseline, cooking oils, vinegar, butter, alcohol, mayonnaise, and electric combs effective treatment options?
no
list the 4 main symptoms/presentation of candidiasis
bright red skin, “satellite” lesions (dots surrounding it), itchy, and painful (usually from dark, moist, and warm environment (diapers))
TX, alternatives if condition is more severe
topic antifungals or oral antifungals if more severe, usually for the scalp, all the “azoles”, terbinafine, or griseofulvin
what are possible complications of cellulitis?
-an area of pus in the skin (abscess)
-area of dead skin or tissue (necrosis)
-infection spreading to other tissue or organs
what are a few key teaching pieces that would prevent the spread an continuation of this condition (3)
1. good handwashing/hygiene
2. do not share topical ointments (different strains spread)
3. finish antibiotic course (resistance)
explain why prescription might be better than OTC shampoo medications, even though they are more expensive. do you follow directions for all the meds the same?
-OTC will treat the live bugs BUT nits are still alive & will hatch in 7-10 days, so tx. needs to be done in 7-10 days later AGAIN to kill hatched nits (2-week treatment in total)
-Prescription meds treat both (one-time tx.)
-NO, apply accordingly using the instructions
how should the skin be before applying ointment?
dry
what labs might you do to monitor hepatotoxicity during treatment?
LFTs
what type of cellulitis are most concerned about & why?
periorbital cellulitis: an infection of soft tissues around the eyes = behind the eye is a hole straight to the brain (IV antibiotics), CT imaging, blood cultures, and neurological monitoring
treatment methods for impetigo (4), which one is resistant to MRSA?
1. triple antibiotic ointment, on small discrete and localized areas but MRSA is resistant to this ointment so use below
2. Oral penicillins (amoxicillin)
3. Cephalosporins (cephalexin)
4. Bactrim
5. IV vancomycin might be necessary
list the 5 home care steps for managing lice
1. Wash all clothing/bedding in hot water/hot dryer
2. Vacuum all cloth surfaces
3. Non-washable items (stuffed animals) in a garbage bag, tie a knot, and leave outside for 2 weeks = live lice and nits will die
4. Soak hair care items in lice-killing product or boiling water
5. Do not share hats/clothes with friends at school
name the 6 management/treatments for candidiasis
1. leave them open to air as much as possible (less hospitable environment)
2. avoid baby wipes = chemicals that will dry the skin
3. use wet, washcloths to clean
4. change promptly and frequently (urine/feces can irritate the skin), 5. use a hair dryer on cool setting before applying ointments
6. diaper rash cream (zinc oxide) can provide barriers to moisture but trap moisture if the skin is not dry
name an important education piece about tinea capitis and how it develops vs. how it is treated (think time wise)
fungi are slow growing, and slow to remove/kill (takes 3-6 months)