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Infections and the skin 

Infections and the skin

Chapter:
Infections and the skin
Author(s):

Roderick Hay

DOI:
10.1093/med/9780199204854.003.2310_update_001

Update:

Reviewed June 2013—minor updates made.

Updated on 28 Nov 2013. The previous version of this content can be found here.
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date: 30 March 2017

A huge variety of different organisms exist on healthy skin. Under certain circumstances, microbes can actively infect the skin as a primary or secondary event in cutaneous or systemic disease.

The most common causes of bacterial infection of the skin are Staphylococcus aureus or β‎-haemolytic streptococci. There are increasing reports of both hospital- and community-acquired infection by methicillin-resistant S. aureus. Superficial infection that spreads laterally in the upper dermis or along the subcutaneous fascia is known as cellulitis. Complications of cellulitis include septicaemia or involvement of nearby structures, hence it requires immediate antibiotic therapy.

Mycobacterium tuberculosis remains a common skin infection in many tropical areas, and syphilis, leprosy, and leishmaniasis are important skin infections in some parts of the world (see Section 7).

Dermatophytosis or ringworm is caused by mould fungi that can digest keratin (keratinophilic). The diagnosis can be confirmed in the laboratory by examining scrapings or clippings of skin, hair, or nails mounted in potassium hydroxide. Pityriasis versicolor is mainly caused by Malassezia globosa: it is a chronic scaly condition in which the skin becomes either hyper or hypopigmented in the affected area; macules and scales join and may become confluent over the back and chest, less commonly elsewhere.

Herpes simplex (HS) infections cause both acute as well as recurrent infections such as cold sores. Occasionally, in the immunocompromised patient these and other herpesvirus infections may disseminate, both to other parts of the skin as well as internally.

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