Skin Infection

Aka: Skin Infection, Pyoderma, Fungal Dermatoses, Parasite infestation, Parasitic Infections of the Skin, Skin and Soft Tissue Infection, SSTI, Skin and Subcutaneous Tissue Infection and Infestation

1. See Also
   1. Cutaneous Conditions in Febrile Patients
2. Pathophysiology: Predisposing factors
   1. Decreased tissue perfusion oxygenation
   2. Peripheral fluid stasis and edema
   3. Increased Skin Trauma risk
   4. Suppressed immune function
3. Types: Bacterial Skin Infections (Pyoderma)
   1. Impetigo
   2. Folliculitis
   3. Furunculosis (Furuncle or Skin Boil), Carbuncle or Skin Abscess
   4. Ecthyma
   5. Erysipelas
   6. Cellulitis
   7. Acute Paronychia
   8. Felon
   9. Necrotizing Fasciitis
   10. Staphylococcal Scalded Skin Infection
   11. Nodular Lymphangitis
   12. Preseptal Cellulitis and Periorbital Cellulitis
   13. Intertrigo
4. Types: Complicated Bacterial Skin Infections
   1. Methicillin Resistant Staphylococcus Aureus (MRSA)
   2. Deep space infection including deep abscess
   3. Decubitus Ulcer
   4. Necrotizing Fasciitis
   5. Fournier's Gangrene
   6. Perirectal Abscess
   7. Diabetic Foot Infection
   8. Dog Bite Infection
   9. Cat Bite
   10. Cat Scratch Disease
   11. Human Bite
5. Types: Fungal Skin Infection
   1. Cutaneous Candidiasis
   2. Onychomycosis
   3. Chronic Paronychia
   4. Tinea Barbae
   5. Tinea Capitis
   6. Tinea Corporis (Ringworm)
   7. Tinea Cruris (Jock Itch)
   8. Tinea Faciale
   9. Tinea Pedis (Athlete's Foot)
   10. Tinea Versicolor
   11. Intertrigo
6. Types: Parasitic Skin Infection
   1. Scabies
   2. Lice
   3. Bed Bugs
7. Types: Viral Skin Infections
   1. See Also Viral Exanthem
   2. Herpetic Whitlow
   3. Genital Herpes
   4. Herpes Zoster
   5. Chicken Pox
8. Risk Factors
   1. Immunodeficiency
      1. Asplenia
      2. Diabetes Mellitus (5 fold increased SSTI risk)
      3. HIV Infection
      4. Chemotherapy
      5. DMARDs (Rheumatoid Arthritis)
   2. Chronic Disease
      1. Comorbidity (e.g. cardiopulmonary, hepatorenal, debility)
      2. Dialysis (ESRD)
      3. Longterm intravascular access (MRSA risk)
      4. Lymphedema
      5. Obesity
      6. Peripheral Neuropathy
      7. Peripheral artery disease
      8. Trauma or surgery
      9. Eczema and other Pruritic Conditions
   3. Demographics
      1. Children and older adults (MRSA risk)
      2. Healthcare Worker
      3. Prolonged hospitalization (MRSA risk)
      4. Longterm care (MRSA risk)
      5. Military (close quarters)
      6. Athlete
   4. Lifestyle
      1. Alcohol Abuse
      2. Nutritional deficiency
      3. IV Drug Abuse
      4. Water exposure (swimming in lakes, hot tubs)
9. Classification
   1. Class 1
      1. Simple infection without systemic symptoms or signs of spread
      2. No uncontrolled comorbidities impacting treatment
      3. Outpatient antibiotic management planned
   2. Class 2
      1. Infection with systemic symptoms or signs of spread (e.g. fever, sweats, Tachycardia) or
      2. Uncontrolled comorbidities impacting treatment or
      3. Parenteral antibiotics required
   3. Class 3
      1. Infection with systemic symptoms or signs of spread (e.g. fever, sweats, Tachycardia) or
      2. Uncontrolled comorbidities impacting treatment
      3. Inpatient parenteral antibiotics required
   4. Class 4
      1. Infection with life-threatening systemic symptoms or signs of spread (e.g. severe Sepsis)
      2. Inpatient management with parenteral antibiotics (may require ICU care)
      3. Surgical Consultation may be warranted
10. References
    1. Ramakrishnan (2015) Am Fam Physician 92(6): 474-83 [PubMed]
    2. Ki (2008) Can J Infect Dis Med Microbiol 19(2): 173-84 [PubMed]
    3. Stevens (2014) Clin Infect Dis 59(2): e10-52 [PubMed]