Nrnp 6531 Care of Adults Across Lifespan
Impetigo - reddened macules progressing to water-filled vesicles. Strep infx usually the cause. Staph Aureus
... [Show More] may cause small vesicle impetigo as well
Impetigo treatment - good hygiene, system therapy to cover for MRSA
Folliculitis - Lesions appear as yellowish pustules, the encircling thin band of erythema around hair follicles
Folliculitis Treatment - Improved hygiene, mupirocin or bacitracin, systemic therapy to include anti-psuedomonal medication such as cipro
Foruncle - a tender fluctuant lesion, with surrounding erythema
Foruncle Treatment - Drainage. Abx not generally needed (with exception of immunocompromised pts)
Carbuncle - a collection of furuncles, generally on the back of the neck in men older than 40yrs old.
carbuncle treatment - drainage or debridement, systemic abx with MRSA coverage is often required
Cellulitis - Spreading infection of the epidermis and subcutaneous tissues that generally begins following a break in the skin. Strep and Staph Aureaus
Cellulitis Treatment - Pts with uncomplicated disease - systemic tx with coverage for MRSA. Bactrim, doxycycline
Very ill will be hospital for IV abx.
Tinea Capitis - fungal infection of the scalp
tinea corporis - fungal infection of the body
Tinea cruris - fungal infection of the groin; jock itch
tinea pedis - athlete's foot
Tinea Mannuum - Fungal infection of hands
Tinea faciei - fungal infection of the face
Tinea unguium (onychomycosis) - fungal infection of the nails
Treatment for Fungal infections - Characteristic: annular erythema with scaling.
Prevention: wearing loose undergarments, cotton socks, tight control of BS in DM pts, drying well between folds of skin.
Management: oral antifungal, topical agents
Candida Infection - Often associated with abnormalities of the epithelium or host immunologic system. Common sites Oral mucosa (thrush), Vaginal / Perineal (vulvovaginitis)
Candida Treatment - Topical antifungal, thrush - nystatin oral suspension X10-14 days.
Pediculosis and Mite Infestations - head lice, scabies, crab lice, body lice
Prevention: All close contacts of ind'l infected. All clothing, bed linens and towels should be washed and dried on a hot cycle or dry cleaned. Education on hygiene is important
Acne Vulgaris - Very common follicular d/o.
Mild: non-inflammatory, comedones
Moderate: inflammatory, papules and pustules
Severe: nodular cysts
Acne vulgaris treatment - Avoid excessive scrubbing. No picking or popping. Avoid makeup or moisturizers with oil. Smoking cessation if applicable.
Mild/ Moderate: Benzoyl peroxide 1X a day. Tretinoin, adapalene, tazarotene
Moderate: Topical with antibiotics. (tetracycline, minocycline, doxycycline). Oral contraceptives with low dose estrogen ( No progesterone). Diuretic spironolactone (anti-adrenergic).
Severe: Try different combos. May consider retin-A
Takes 4-8 weeks to start to see improvement. [Show Less]