Facial cellulitisFacial cellulitis

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PreseptalPreseptal cellulitiscellulitis

� Infection of the eyelids anterior to theorbital septum

� Erythema, tenderness and edema of theeyelidseyelids

� No restricted or painful ocular motility,decreased vision, and proptosis

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PreseptalPreseptal cellulitiscellulitis

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PreseptalPreseptal cellulitiscellulitis

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PreseptalPreseptal cellulitiscellulitis� Types:◦ Posttraumatic: S. aureus, S. pyogenes◦ Nontraumatic: S. pneumoniae, H. influ type b(

2-3% meningitis)T� Treatment:◦ Posttraumatic: clindamycin◦ Nontraumatic:� LP in systemic toxicity and extremely young

children� Clindamycin+ ceftriaxone

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ImpetigoImpetigo� Superficial bacterial infection that that progress

from papules to vesicles, pustules, and crusts� Nonbullous :◦ Rapidly progress from vesicle to pustule◦ Few to 10 mm size◦ margin of erythema,g y ,◦ honey colored crust,◦ sometimes adenopathy and spread to exposed area

� Bullous:◦ Small vesicle that progress to flaccid painless bulla> 1

cm◦ Erythematous moist base after rupture

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NonNon bullous impetigobullous impetigo

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Multiple non bullous impetigoMultiple non bullous impetigo

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BullousBullous impetigoimpetigo

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Bullous impetigoBullous impetigo

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Treatment of impetigoTreatment of impetigo

� Topical mupirocin (10-14 d):◦ localized nonbullous

� Oral cephalexine, clindamycin, co-trimoxazol :trimoxazol :◦ Streptococcal ( bullous)◦ Widespread◦ Perioral (licked off)◦ Deep (cellulitis, abscess, or lymphadenitis)

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EcthymaEcthyma

� An ulcer with elevated margins( till 4 cm)� A vesicle or pustule that erodes the

dermis� The ulcer obscured by dry adherent crust� The ulcer obscured by dry, adherent crust� Autoinoculation� Mostly on the legs� GABHS� Penicillin+ warm compresses

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EcthymaEcthyma

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FolliculitisFolliculitis� Superficial infection of the hair follicles with

purulent material� Small, dome-shaped pustules with an

erythematous base� Scalp, buttocks, and extremities� Poor hygiene, maceration, and shaving of the legsPoor hygiene, maceration, and shaving of the legs� Most often S. aureus� Treatment:◦ mild cases: topical mupirocin, tetracyclin, or

clindamycin BID◦ more severe cases:

� culture� Oral dicloxacillin, or cephalexin.

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FolliculitisFolliculitis

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FolliculitisFolliculitis

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