Skin Infections
Overview
Skin infections can be caused by various microbes which include bacteria, fungus, parasites or viruses
and there can be different manifestations of each. There are lots of bacteria and fungus which are normal residents of our skin termed as ‘GOOD MICROBES’ which protect our skin from invasion by ‘BAD MICROBES’. However, several factors like the immune status of the patient, environmental exposure to bad microbes, hygienic status, humidity, internal disorders predispose a patient to these infections.
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Bacterial Infection
Superficial bacterial infections
• Superficial folliculitis/boils: they present as painful pus-filled lesions in different parts of the body and are commonly localized to hair follicles. they are common in hairy areas and in females post waxing.
• Impetigo: they present as multiple bullae (fluid-filled lesions) or raw crusted areas on the face and are very common in children especially in hot humid weather. They can also be associated with swelling of the regional glands.
Deep bacterial infections
• Deep folliculitis: also called furuncles or carbuncles are deep, painful infections of hair follicles which usually spread to the surrounding skin and ooze out bloody or pus discharge from the centre. Sometimes may be associated with fever.
• Cellulitis/erysipelas: they present as diffuse red raised painful plaques commonly on lower legs associated with fever and body aches. There is usually no oozing but these lesions are very painful to touch.
Treatment of bacterial infections
General measures include hot fomentation, a good cleaning of the area, and leg elevation in case of cellulitis. Topical or oral antibiotics are needed depending on the type and severity of the infection. Sometimes a pus c/s is needed in recurrent/resistant cases.
Mycobacterial Infections
Tuberculosis can infect the skin very common especially in India and since these infections are usually asymptomatic they are ignored for a long time. They can present in the following ways :
• Well-defined annular red raised plaques with nodular borders and scarred depigmented centre usually on face and buttocks.
•Bluish red painless swelling which later breaks out leading to oozing and sinus formation usually located near lymph nodes on the neck, axilla, or groins.
•Raised warty lesion with an erythematous base usually on trauma prone sites on extremities.
• Skin tuberculosis is always confirmed by biopsy and few other blood tests and an X-ray chest is done to rule out the involvement of internal organs.
• Treatment of tuberculosis involves 6 months of standard anti-tubercular drugs which should be taken according to the prescribed schedule. Any messing with the ATTT leads to the development of resistant tuberculosis which is very difficult to manage.
Mycobacterial Infections
Tuberculosis can infect the skin very common especially in India and since these infections are usually asymptomatic they are ignored for a long time. They can present in the following ways