Cellulitis

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Summary of Cellulitis

Cellulitis is a bacterial infection involving the deep layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a couple of days. Common risk factors include recent surgery, trauma, or insect bite.

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Cellulitis

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Chapter 8 Skin & Soft Tissue Inﬂammation & Infections SIGNS & SYMPTOMS ▪ Papules, pustules, painful nodules (cysts) on face, neck, chest, back ▪ Closed comedones ▪ Erythema DIAGNOSIS ▪ In case of comedonal acne, use azelaic acid, salicylic acid as anti-inﬂammatory, antibacterial, antiproliferative agent Mild to moderate ▪ Benzoyl peroxide, retinoid ▪ Add topical antibiotic (clindamycin) for synergistic effect with benzoyl peroxide Severe ▪ Oral isotretinoin decreases sebum production, bacterial proliferation, inﬂammation ▪ Avoid using tetracycline due to sun sensitivity OTHER DIAGNOSTICS ▪ Clinical presentation TREATMENT OTHER INTERVENTIONS MEDICATIONS ▪ Target sebum production, inﬂammation, bacterial/follicular proliferation Mild ▪ Benzoyl peroxide treats Propionibacterium acnes ▪ Add topical retinoids to prevent follicular proliferation ▪ Clean skin with gentle agents ▪ Comedones extraction ▪ Pigmentation ▫ Topical retinoid, azelaic acid, chemical peels ▫ Photodynamic treatment with lasers (removes superﬁcial layers of skin) ▫ Dermabrasion (treatment of scars; may irritate skin) CELLULITIS osms.it/cellulitis PATHOLOGY & CAUSES ▪ Non-necrotizing inﬂammation of dermis, subcutaneous tissue, typically caused by streptococci (S. aureus, S. pyogenes); usually unilateral ▪ Skin breach: trauma; dry, ﬁssuring skin; ulcers → bacteria invade skin, subcutaneous tissue ▪ Common locations: face, legs; may affect arms ▪ Other locations: causes vary ▫ Orbital cellulitis: originates from trauma, sinuses, hematogenous spread ▫ Abdominal wall cellulitis: morbid obesity causes bacteria to enter skin sores ▫ Buccal cellulitis: spread from tooth infection ▫ Perianal cellulitis: affects all demographics TYPES ▪ Purulent ▫ Furuncles (inﬂamed follicles), carbuncles (accumulation of furuncles), abscesses, cysts ▪ Non-purulent ▫ Superﬁcial cellulitis, erysipelas OSMOSIS.ORG 45

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Cellulitis

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Questions

USMLE® Step 1 style questions USMLE

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USMLE® Step 2 style questions USMLE

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A 53-year-old woman, with a history of type II diabetes mellitus, comes to the emergency department with a two-day history of febrile illness and a progressive, red, painful rash on the left lower extremity. The affected area is warm and tender to the touch. There is no crepitus. The right leg appears to be unaffected. Which of the following is the most likely causative agent of this skin disease?

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