Skin and soft-tissue infections: Difference between revisions
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'''''Please click on the specific skin and soft-tissue infections below for further information.''''' | '''''Please click on the specific skin and soft-tissue infections below for further information.''''' | ||
{| style="border: 2px solid #4479BA;" align="center" | {| style="border: 2px solid #4479BA; width: 1200px" align="center" | ||
! style="width: 150px; background: #4479BA;" colspan=2 |{{fontcolor|#FFF|Anatomic Layers of the Skin}} | ! style="width: 150px; background: #4479BA;" colspan=2 |{{fontcolor|#FFF|Anatomic Layers of the Skin}} | ||
! style="width: 150px; background: #4479BA;"|{{fontcolor|#FFF|Condition}} | ! style="width: 150px; background: #4479BA;"|{{fontcolor|#FFF|Condition}} | ||
! style="width: 500px; background: #4479BA;"|{{fontcolor|#FFF|Definition<sup>†</sup>}} | ! style="width: 500px; background: #4479BA;"|{{fontcolor|#FFF|Definition<sup>†</sup>}} | ||
! style="width: | ! style="width: 100px; background: #4479BA;"|{{fontcolor|#FFF|Image}} | ||
|- | |- | ||
| style="padding: 0 0px; background: #F8F8FF;" | [[File:Epidermis.png|x100%|link=Epidermis]] | | style="padding: 0 0px; background: #F8F8FF;" | [[File:Epidermis.png|x100%|link=Epidermis]] | ||
| style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" | [[Epidermis]] | | style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" | [[Epidermis]] | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Impetigo]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Impetigo]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Superficial pyogenic infection of the skin which usually begins as [[vesicle]]s with a very thin, fragile roof consisting only of [[stratum corneum]]. | | style="padding: 0 5px; background: #F5F5F5;" | Superficial pyogenic infection of the skin which usually begins as [[vesicle]]s with a very thin, fragile roof consisting only of [[stratum corneum]]. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Impetigo elbow.jpg|100px|link=Impetigo]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Impetigo elbow.jpg| | |||
|- | |- | ||
| style="padding: 0 0px; background: #F8F8FF;" rowspan=5 | [[File:Dermis.png|x100%|link=Dermis]] | | style="padding: 0 0px; background: #F8F8FF;" rowspan=5 | [[File:Dermis.png|x100%|link=Dermis]] | ||
| style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" rowspan=5 | [[Dermis]] | | style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" rowspan=5 | [[Dermis]] | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Erysipelas]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Erysipelas]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Infection of the upper [[dermis]] including the superficial [[lymphatics]] which typically presents as an indurated, "peau d’orange" lesion with a raised border that is demarcated from uninvolved skin. | | style="padding: 0 5px; background: #F5F5F5;" | Infection of the upper [[dermis]] including the superficial [[lymphatics]] which typically presents as an indurated, "peau d’orange" lesion with a raised border that is demarcated from uninvolved skin. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Facial erysipelas.jpg|100px|link=Erysipelas]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File: | |||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Folliculitis]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Folliculitis]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Inflammation and/or infection of the [[hair follicle]] in which [[suppuration]] presents in the [[epidermis]]. | | style="padding: 0 5px; background: #F5F5F5;" | Inflammation and/or infection of the [[hair follicle]] in which [[suppuration]] presents in the [[epidermis]]. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Folliculitis.jpg|100px|link=Folliculitis]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Folliculitis.jpg| | |||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Furuncle|Furuncle<BR>(Boil)]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Furuncle|Furuncle<BR>(Boil)]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Infection of the [[hair follicle]] in which [[suppuration]] extends through the [[dermis]] into the [[subcutaneous tissue]]. Each lesion consists of a deep-seated inflammatory [[nodule]] and an overlying [[pustule]] through which hair emerges. | | style="padding: 0 5px; background: #F5F5F5;" | Infection of the [[hair follicle]] in which [[suppuration]] extends through the [[dermis]] into the [[subcutaneous tissue]]. Each lesion consists of a deep-seated inflammatory [[nodule]] and an overlying [[pustule]] through which hair emerges. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Furuncle.jpg|100px|link=Furuncle]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Furuncle.jpg| | |||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Carbuncle]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Carbuncle]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Infection of several adjacent [[hair follicle]]s, producing a coalescent inflammatory mass with [[pus]] draining from multiple follicular orifices. | | style="padding: 0 5px; background: #F5F5F5;" | Infection of several adjacent [[hair follicle]]s, producing a coalescent inflammatory mass with [[pus]] draining from multiple follicular orifices. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Carbuncle on buttok.JPG|100px|link=Carbuncle]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Carbuncle on buttok.JPG| | |||
|- | |- | ||
| style="padding: | | style="padding: 50px 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" rowspan=2 | [[Cellulitis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" rowspan=2 | Acute spreading infection of the deeper [[dermis]] and the [[subcutaneous tissue]] which lacks sharp demarcation from uninvolved skin. | |||
| style="padding: | | style="padding: 0 0px; background: #F5F5F5;" rowspan=2 | [[File:Cellulitis4.jpg|100px|link=Cellulitis]] | ||
| style="padding: 0 0px; background: #F5F5F5;" rowspan=2 | [[File:Cellulitis4.jpg| | |||
|- | |- | ||
| style="padding: 0 0px; background: #F8F8FF;" rowspan=2 | [[File:Subcutaneous tissue.png|x100%|link=subcutaneous tissue]] | | style="padding: 0 0px; background: #F8F8FF;" rowspan=2 | [[File:Subcutaneous tissue.png|x100%|link=subcutaneous tissue]] | ||
| style="padding: 5px 5px; background: #F8F8FF; text-align: center; font-weight: bold;" rowspan=2 | [[Subcutaneous tissue|Subcutaneous<BR>Tissue]] | |||
| style="padding: | |||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Necrotizing fasciitis|Necrotizing<BR>Fasciitis]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Necrotizing fasciitis|Necrotizing<BR>Fasciitis]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Rapidly progressive infection of deep [[fascia]] associated with bullae and [[necrosis]] of underlying skin. | | style="padding: 0 5px; background: #F5F5F5;" | Rapidly progressive infection of deep [[fascia]] associated with bullae and [[necrosis]] of underlying skin. | ||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Necrotizing fasciitis left leg.JPEG|100px|link=Necrotizing fasciitis]] | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Necrotizing fasciitis left leg.JPEG| | |||
|- | |- | ||
| style="padding: 0 0px; background: #F8F8FF;" | [[File:Muscle layer.png|x100%|link=Muscle]] | | style="padding: 0 0px; background: #F8F8FF;" | [[File:Muscle layer.png|x100%|link=Muscle]] | ||
| style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" | [[Muscle]] | | style="padding: 0 0px; background: #F8F8FF; text-align: center; font-weight: bold;" | [[Muscle]] | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Gas gangrene|Myonecrosis<BR>(Gas Gangrene)]] | | style="padding: 0 5px; background: #F5F5F5; text-align: center; font-weight: bold; font-size: 120%;" | [[Gas gangrene|Myonecrosis<BR>(Gas Gangrene)]] | ||
| style="padding: 0 5px; background: #F5F5F5;" | Rapidly progressive toxemic infection of injured muscle, producing marked [[edema]], [[crepitus]], and brown bullae, characterized by extensive gaseous dissection of muscle and fascial planes on radiography. | |||
| style="padding: 0 0px; background: #F5F5F5;" | [[File:Gas gangrene.jpg|100px|link=Myonecrosis]] | |||
|- | |||
| style="padding: 0 0px; background: #F5F5F5;" colspan=5 |<sup>†</sup><SMALL>Adapted from ''Clin Infect Dis. 2005;41(10):1373-406.'',<ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249 }} </ref> ''Rook's Textbook of Dermatology'',<ref name="Rook's Textbook of Dermatology">{{cite book | last = Rook | first = Arthur | title = Rook's textbook of dermatology | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Hoboken, NJ | year = 2010 | isbn = 1405161698 }}</ref> and ''Infectious Diseases of the Skin''.<ref>{{cite book | last = Elston | first = Dirk | title = Infectious diseases of the skin | publisher = Manson | location = London | year = 2011 | isbn = 1840761776 }}</ref></SMALL> | |||
|} | |||
A [[cutaneous abscess]] could occur at multiple locations. | |||
Patients who require hospitalization for ICU admission, operating room surgical intervention, or death have one of the following six risk factors upon presentation<ref name="pmid30420232">{{cite journal| author=Mower WR, Kadera SP, Rodriguez AD, Vanderkraan V, Krishna PK, Chiu E et al.| title=Identification of Clinical Characteristics Associated With High-Level Care Among Patients With Skin and Soft Tissue Infections. | journal=Ann Emerg Med | year= 2018 | volume= | issue= | pages= | pmid=30420232 | doi=10.1016/j.annemergmed.2018.09.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30420232 }} </ref>: | |||
|} | * abnormal cross-sectional imaging result | ||
* systemic inflammatory response syndrome | |||
* previous infection at the same location | |||
* infection involving the hand | |||
* diabetes | |||
* age >65 years | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 16:46, 1 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Please click on the specific skin and soft-tissue infections below for further information.
| Anatomic Layers of the Skin | Condition | Definition† | Image | |
|---|---|---|---|---|
|
Epidermis | Impetigo | Superficial pyogenic infection of the skin which usually begins as vesicles with a very thin, fragile roof consisting only of stratum corneum. | 
|
|
Dermis | Erysipelas | Infection of the upper dermis including the superficial lymphatics which typically presents as an indurated, "peau d’orange" lesion with a raised border that is demarcated from uninvolved skin. | 
|
| Folliculitis | Inflammation and/or infection of the hair follicle in which suppuration presents in the epidermis. | 
| ||
| Furuncle (Boil) |
Infection of the hair follicle in which suppuration extends through the dermis into the subcutaneous tissue. Each lesion consists of a deep-seated inflammatory nodule and an overlying pustule through which hair emerges. | 
| ||
| Carbuncle | Infection of several adjacent hair follicles, producing a coalescent inflammatory mass with pus draining from multiple follicular orifices. | 
| ||
| Cellulitis | Acute spreading infection of the deeper dermis and the subcutaneous tissue which lacks sharp demarcation from uninvolved skin. | 
| ||
|
Subcutaneous Tissue | |||
| Necrotizing Fasciitis |
Rapidly progressive infection of deep fascia associated with bullae and necrosis of underlying skin. | 
| ||
|
Muscle | Myonecrosis (Gas Gangrene) |
Rapidly progressive toxemic infection of injured muscle, producing marked edema, crepitus, and brown bullae, characterized by extensive gaseous dissection of muscle and fascial planes on radiography. | 
|
| †Adapted from Clin Infect Dis. 2005;41(10):1373-406.,[1] Rook's Textbook of Dermatology,[2] and Infectious Diseases of the Skin.[3] | ||||
A cutaneous abscess could occur at multiple locations.
Patients who require hospitalization for ICU admission, operating room surgical intervention, or death have one of the following six risk factors upon presentation[4]:
- abnormal cross-sectional imaging result
- systemic inflammatory response syndrome
- previous infection at the same location
- infection involving the hand
- diabetes
- age >65 years
References
- ↑ Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ; et al. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249.
- ↑ Rook, Arthur (2010). Rook's textbook of dermatology. Chichester, West Sussex, UK Hoboken, NJ: Wiley-Blackwell. ISBN 1405161698.
- ↑ Elston, Dirk (2011). Infectious diseases of the skin. London: Manson. ISBN 1840761776.
- ↑ Mower WR, Kadera SP, Rodriguez AD, Vanderkraan V, Krishna PK, Chiu E; et al. (2018). "Identification of Clinical Characteristics Associated With High-Level Care Among Patients With Skin and Soft Tissue Infections". Ann Emerg Med. doi:10.1016/j.annemergmed.2018.09.020. PMID 30420232.