Beruflich Dokumente
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Chapter 21
Objectives
Know the general structure of the skin
Normal microbiota of the skin
Some major microbial diseases (Bacteria,
Viral & fungal)
Differentiate staphylococci from
streptococci, and name skin infections
caused by them
Know some arthropods infestation of the
skin
Mucous Membranes
Line body cavities
Gastrointestinal, respiratory, urinary, and
genital tracts
Often folded to maximize surface area, ~400
m2
Epithelial cells attached to extracellular matrix
Cells secrete mucus
Acidic
May contain lysozyme (tears)
Some cells have cilia
Ciliary escalator
Life threatening
Toxin (with superantigenic properties) enter the bloodstream
Characterized by high fever, low blood pressure, malaise and
confusion, can progress to coma and multi-organ failure
Figure 21.4
Erysipelas
Reddish patches with raised margins (more
superficial-not very deep)
Impetigo
In older children
Sometime occurs together with S. aureus
Infections by Pseudomonads
Pseudomonads
Pseudomonas aeruginosa
Opportunistic infection
Major problem in cystic fibrosis patients (accumulation of thick
and sticky mucus)
Deep burn patients
Adhesin for colonization
Exotoxins (proteases and hemolysins) for tissue damage,
bloodstream invasion and dissemination
Biofilms, against complement, phagocytosis, and antibiotics
Endotoxin
Relative resistance to antibiotics
Pseudomonas dermatitis
Self limiting rash associated with swimming pools, saunas, and hot
tubs
Otitis externa (swimmers ears)
Treatment: Quinolones and antipseudomonal -lactam antibiotics
Names:
Acne
Characteristics of organism:
Gm (+) rods, aerotolerant anaerobes
Breakdown sebum inflammatory
reaction
http://en.wikipedia.org/wiki/Acne_vulgaris
Mild Acne
Topical applications: salicylic acid and vitamin A derivative
(tretinoin, tazarotene)
Smallpox
During the Middle Ages, ~80% of the
population of Europe contracted this
disease
Caused by an orthopoxvirus
Two basic forms: variola major (> 20% mortality and
variola minor (< 1% mortality)
Transmitted by the respiratory route
First infect internal organs before they move into
bloodstream and eventually infect the skin
Eradicated by vaccination
Treatment: Acyclovir
Cold Sores
(Fever Blisters)
Treatment:
Acyclovir (encephalitis)
No vaccine available
Measles (Rubeola)
Measles virus
Viral characteristics; ________________
Highly contagious (extremely dangerous disease
in infants & very old people)
Characterized by macular rash
Symptoms similar to smallpox & chickenpox,
resembling those of common cold
Frequently complicated by middle ear infection &
pneumonia
Prevented by vaccination
Type of vaccine?
Figure 21.15
Cutaneous Mycoses
Dermatomycoses
Tineas or ringworm
Athletes foot
Metabolize keratin
keratinase
Trichophyton
hair, skin, & nails
Epidermophyton
skin & nails
Microsporum
hair & skin
Treatment
Oral griseofulvin
Topical miconazole
Candidiasis
Caused by
Candidiasis
Can result from suppression of
competing bacteria due to
antibiotics use
Occurs in skin
On mucous membranes of
genitourinary tract and mouth
Thrush is an infection of mucous
membranes of mouth
Topical treatment:
Antifungal agents
Miconazole or nystatin.
Scabies
Also known as the itch
Characterized by intense itching, a generalized rash and can lead to secondary infection
http://en.wikipedia.org/wiki/File:Sarcoptes_scabei_2.jpg
Figure 21.18
Pediculosis
Pediculosis
Contagious
Feed on blood
Lay eggs (nits) on hair
Cause itching
Treated with topical insecticides