Nrnp 6531 Care of Adults Across
Lifespan
Impetigo - reddened macules progressing to water-filled vesicles. Strep infx usually
the cause. Staph Aureus may cause small vesicle impetigo as well
Impetigo treatment - good hygiene, system therapy to cover for MRSA
Folliculitis - Lesions appear as yellowish pustules, the encircling thin band of erythema
around hair follicles
Folliculitis Treatment - Improved hygiene, mupirocin or bacitracin, systemic therapy to
include anti-psuedomonal medication such as cipro
Foruncle - a tender fluctuant lesion, with surrounding erythema
Foruncle Treatment - Drainage. Abx not generally needed (with exception of
immunocompromised pts)
Carbuncle - a collection of furuncles, generally on the back of the neck in men older
than 40yrs old.
carbuncle treatment - drainage or debridement, systemic abx with MRSA coverage is
often required
Cellulitis - Spreading infection of the epidermis and subcutaneous tissues that
generally begins following a break in the skin. Strep and Staph Aureaus
Cellulitis Treatment - Pts with uncomplicated disease - systemic tx with coverage for
MRSA. Bactrim, doxycycline
Very ill will be hospital for IV abx.
Tinea Capitis - fungal infection of the scalp
tinea corporis - fungal infection of the body
Tinea cruris - fungal infection of the groin; jock itch
tinea pedis - athlete's foot
, Tinea Mannuum - Fungal infection of hands
Tinea faciei - fungal infection of the face
Tinea unguium (onychomycosis) - fungal infection of the nails Treatment for Fungal
infections - Characteristic: annular erythema with scaling. Prevention: wearing loose
undergarments, cotton socks, tight control of BS in DM pts, drying well between folds of
skin.
Management: oral antifungal, topical agents
Candida Infection - Often associated with abnormalities of the epithelium or host
immunologic system. Common sites Oral mucosa (thrush), Vaginal / Perineal
(vulvovaginitis)
Candida Treatment - Topical antifungal, thrush - nystatin oral suspension X10-14
days.
Pediculosis and Mite Infestations - head lice, scabies, crab lice, body lice
Prevention: All close contacts of ind'l infected. All clothing, bed linens and towels should
be washed and dried on a hot cycle or dry cleaned. Education on hygiene is important
Acne Vulgaris - Very common follicular d/o. Mild:
non-inflammatory, comedones
Moderate: inflammatory, papules and pustules
Severe: nodular cysts
Acne vulgaris treatment - Avoid excessive scrubbing. No picking or popping. Avoid
makeup or moisturizers with oil. Smoking cessation if applicable.
Mild/ Moderate: Benzoyl peroxide 1X a day. Tretinoin, adapalene, tazarotene Moderate:
Topical with antibiotics. (tetracycline, minocycline, doxycycline). Oral contraceptives with
low dose estrogen ( No progesterone). Diuretic spironolactone (antiadrenergic).
Severe: Try different combos. May consider retin-A Takes
4-8 weeks to start to see improvement.
Psoriasis - life long papulo-squamous d/o transmitted genetically, characterized by
chronic recurrent bouts of erythematous papules and scaling plaques. 1-3 percent of
population.
At increased risk for sclerotic vascular disease and metabolic syndrome.
Psoriasis treatment - behavioral. Meds - topical, phototherapy, systemic treatments,
and immuno-biologics. Refer to dermatology. Refer to Rheumatology if suspected
psoriatic arthritis.
Lifespan
Impetigo - reddened macules progressing to water-filled vesicles. Strep infx usually
the cause. Staph Aureus may cause small vesicle impetigo as well
Impetigo treatment - good hygiene, system therapy to cover for MRSA
Folliculitis - Lesions appear as yellowish pustules, the encircling thin band of erythema
around hair follicles
Folliculitis Treatment - Improved hygiene, mupirocin or bacitracin, systemic therapy to
include anti-psuedomonal medication such as cipro
Foruncle - a tender fluctuant lesion, with surrounding erythema
Foruncle Treatment - Drainage. Abx not generally needed (with exception of
immunocompromised pts)
Carbuncle - a collection of furuncles, generally on the back of the neck in men older
than 40yrs old.
carbuncle treatment - drainage or debridement, systemic abx with MRSA coverage is
often required
Cellulitis - Spreading infection of the epidermis and subcutaneous tissues that
generally begins following a break in the skin. Strep and Staph Aureaus
Cellulitis Treatment - Pts with uncomplicated disease - systemic tx with coverage for
MRSA. Bactrim, doxycycline
Very ill will be hospital for IV abx.
Tinea Capitis - fungal infection of the scalp
tinea corporis - fungal infection of the body
Tinea cruris - fungal infection of the groin; jock itch
tinea pedis - athlete's foot
, Tinea Mannuum - Fungal infection of hands
Tinea faciei - fungal infection of the face
Tinea unguium (onychomycosis) - fungal infection of the nails Treatment for Fungal
infections - Characteristic: annular erythema with scaling. Prevention: wearing loose
undergarments, cotton socks, tight control of BS in DM pts, drying well between folds of
skin.
Management: oral antifungal, topical agents
Candida Infection - Often associated with abnormalities of the epithelium or host
immunologic system. Common sites Oral mucosa (thrush), Vaginal / Perineal
(vulvovaginitis)
Candida Treatment - Topical antifungal, thrush - nystatin oral suspension X10-14
days.
Pediculosis and Mite Infestations - head lice, scabies, crab lice, body lice
Prevention: All close contacts of ind'l infected. All clothing, bed linens and towels should
be washed and dried on a hot cycle or dry cleaned. Education on hygiene is important
Acne Vulgaris - Very common follicular d/o. Mild:
non-inflammatory, comedones
Moderate: inflammatory, papules and pustules
Severe: nodular cysts
Acne vulgaris treatment - Avoid excessive scrubbing. No picking or popping. Avoid
makeup or moisturizers with oil. Smoking cessation if applicable.
Mild/ Moderate: Benzoyl peroxide 1X a day. Tretinoin, adapalene, tazarotene Moderate:
Topical with antibiotics. (tetracycline, minocycline, doxycycline). Oral contraceptives with
low dose estrogen ( No progesterone). Diuretic spironolactone (antiadrenergic).
Severe: Try different combos. May consider retin-A Takes
4-8 weeks to start to see improvement.
Psoriasis - life long papulo-squamous d/o transmitted genetically, characterized by
chronic recurrent bouts of erythematous papules and scaling plaques. 1-3 percent of
population.
At increased risk for sclerotic vascular disease and metabolic syndrome.
Psoriasis treatment - behavioral. Meds - topical, phototherapy, systemic treatments,
and immuno-biologics. Refer to dermatology. Refer to Rheumatology if suspected
psoriatic arthritis.
