Skin infections most often caused by bacteria, fungi or viruses very commonly affect people. While some skin infections may be related to other health problems, some infections are stand alone. Let us understand about some common bacterial, fungal and viral skin infections, their symptoms and treatments.

  1. Common Bacterial Skin Infections

    Bacterial skin infections are very common and can be easily caused by infection of a wound or skin eruption. The 3 commonly occurring bacterial skin infections are discussed below: -

    Cellulitis – A common bacterial skin infection

    Cellulitis refers to a common bacterial skin infection caused mostly by staphylococcus and streptococcus strains of bacteria. It occurs mainly post trauma or after some injury with skin cut or bee sting or via any animal sting. Cellulitis appears like a reddish swelling and is tender to touch. The area which is affected by the swelling has a raised temperature.

    The legs, thighs and feet are mostly affected. This bacterial skin infection can also disseminate and spread via lymph nodes or blood stream to other body areas.

    Cellulitis includes the following signs and symptoms: -

    • History of trauma or any injury
    • Pain, tenderness of the injured area
    • Fever with chills and rigor
    • Inflammation of skin which is mostly glossy, tense and shiny in appearance
    • Fatigue and dizziness
    • Vertigo
    • Inability to walk
    • Sweating
    • Warm skin
    • Abscess formation or purulent discharge from the affected area.

    Some conditions that may increase a person’s risk of suffering from such a bacterial skin infection includes

    Treatment of Cellulitis

    Fasciotomy – In this an incision is given in the affected area causing a decrease in the pressure of the limbs. The incision is followed by 10-21 days prescription of oral antibiotics or intravenous antibiotics.

    Treatment for specific symptoms like analgesics for pain relief and fever anti pyretic medication.

    Necrotizing Fasciitis – A common bacterial skin infection

    Necrotizing Fasciitis is also known as the flesh eating bacterial skin infection. It is commonly seen due to bacterial infection of staphylococcus and streptococcus. Some other bacteria involved in this infection include E.coli, Clostridium, Klebsiella etc.

    This type of bacterial skin infection leads to necrosis and death of the affected tissue and is sudden in onset and severely progressive in nature. It requires immediate attention and can lead to fatal conditions or may produce conditions that lead to amputation of the limbs if left untreated.

    Signs And Symptoms Of Necrotizing Fasciitis

    • History of trauma or any bacterial infection in wild or in the closed environment.
    • Intense pain
    • Inflammation of the affected area
    • Fever mostly high grade is recorded
    • Tachycardia or increased heart rate is noted
    • Abnormal respiratory sounds can be heard known as crepitus
    • Skin color progressively changes to violet and blister formation occurs
    • The temperature of the affected area is mostly raised.

    Risk Factors Include

    • Weak immune system
    • Diabetes
    • Malignant and chronic systemic disease

    Treatment of Necrotizing Fasciitis

    • Debridement of skin – Surgical removal of the damaged skin is done to prevent bacteria from progressively involving the other normal tissue and skin.
    • Antibiotics are given.
    • Amputation or removal of the damaged limb may be considered in case of irreversible damage.
    • Skin grafting is done once the debridement completes.

    Staphylococcal Scalded Skin Syndrome – A common bacterial skin infection

    Also known as SSSS pemphigus neonatorum or Ritter von Ritterschein disease and is named after the scientist who discovered it. This bacterial skin infection develops because of the toxins produced by staphylococcal infections. Toxins are harmful substances that can enter the cells and cause breakdown of proteins, resulting in skin lesions. There occurs exfoliation of skin along with reddishness and blisters on the skin.

    Staphylococcal Scalded Skin Syndrome or (SSSS) Includes The Followings Sign And Symptoms:

    • Fluid filled blisters
    • Easy rupturing of blisters
    • Pain
    • Erythematous rash
    • Burned skin appearance
    • Desquamation of skin i.e. destruction of skin cells.
    • Weakness
    • Chills
    • Fatigue
    • Malaise can occur. It refers to a general feeling of having poor health.
    • Joint pain or muscle pain
    • Epidermal accumulation of exotoxins.

    Possible Complications That Can Develop Along With This Are As Follows:

    • Sepsis
    • Pneumonia
    • Weakening of immune system
    • Chronic kidney diseases.

    Treatment of Staphylococcal Scalded Skin Syndrome or SSSS

    • This common bacterial skin infection is often treated symptomatically. Conservative management includes rehydration with oral rehydration solution (ORS).
    • Antipyretics can be given that is paracetamol, ibuprofen the etc.
    • Antibiotics for destruction of S.aureus are given these include oxacillin or vancomycin
    • Clindamycin is given to provide security and protection from its exotoxins.
  2. Common Fungal Skin Infections

    Fungal infections too are one of the most commonly occurring skin manifestations. The top infecting agents being, Candida Albicans, Trichophyton, Epidermophyton etc. Fungal skin infection usually occur due to moisture in the environment or weakness in the body’s immune system. A mild temp and moisture provide the best environment for the fungus to grow and hence these infections are seen most commonly in the axilla, infra mammary folds, vagina or groin regions in the body.

    Athlete’s Foot - A common fungal skin infection

    It is also known as Tenia Pedis and is a common fungal infection of the foot. It grows best in warm and moist environment and is commonly seen in people who wear tight shoes. It grows on toes, toe nails or inter digital nail webs. This infection is most often caused by Trichophyton Rubrum.

    Types of Athlete’s Foot

    Athlete’s foot can be of the following 3 types: -

    • Inter Digital- It is the most common type and occurs between two smallest toes hence causing itching, burning sensation and it can spread to the entire foot.
    • Moccasin- It is usually associated with minor irritation, dryness or scaly skin formation and the infection involves the entire foot and sole.
    • Vesicular- It the least common type and begins with a sudden outbreak of blisters all over the foot and usually involves nails, sole etc.

    Common Signs and Symptoms of Athlete’s Foot Include the Following:

    • Peeling
    • Crackling
    • Redness
    • Blister formation
    • Ulceration
    • Scaling of skin
    • Itching in inter digital web spaces
    • Burning sensation can be felt in some cases
    • Softening or breaking down of skin

    Treatment of Athlete’s Foot

    • Topical anti-fungal creams are given for application at the site of lesion.
    • In severe cases, oral medication is given like oral clindamycin.

    Tinea Cruris - A common fungal skin infection

    It is also known as the jock itch or dermatophytosis and is one of the commonest fungal skin infections. It is a pruritic fungal infection and mainly affects the groin region and its adjacent structures. It is caused by fungi like Trichophyton Rubrum, Trichophyton Mentagrophytes, and Trichophyton Verrucosum and Epidermophyton Floccosum. It occurs more commonly in men than in women, adolescents and in people suffering from diabetes mellitus or obesity are also highly susceptible. It is mildly contagious and is mainly caused due to sharing of towels, bed sheets as they contain the contiguous particles which hence get transmitted and cause severe skin lesions and infection.
    It can be easily diagnosed by physical examination by the doctor and a sample of smear can be sent to a lab for checking fungi.

    These include the following signs and symptoms: -

    • Irritation
    • Itching
    • Rubbing of skin that causes chafing or burning sensation in groin
    • Redness of skin
    • Peeling and cracking of skin
    • Rashes with well-defined margins, raised and red in color can occur.

    Treatment of Tinea Cruris

    • The affected area is properly washed and dried
    • Antifungal ointments, sprays or powder are applied at site of lesions
    • Avoid the use of dirty clothes and used clothes.
    • The person should maintain proper hygiene and change clothes time to time.

    Ringworm Infection - - A common fungal skin infection

    It is also called as Tinea Corporis and is also one of the most commonly occurring fungal skin infection. It affects about ninety percent of the population and is seen equally in both males and females. It can occur anywhere in the body and usually spreads through direct or indirect contact. Direct contact can occur through any infected person or animal and indirect factors include moisture in environment, wet clothing etc.

    Diagnosis of this fungal skin infection is mostly made by observing the rash and history of any animal infection. The skin scrapings can be taken and sent to the laboratories for fungal detection.

    Various Signs and Symptoms Of Ringworm Fungal Skin Infection Include The Following:

    • Rashes are the first major sign and are usually red, raised and scaly in nature.
    • There might be multiple patches and that too overlapping.
    • Allergic manifestations
    • Itching, which can also cause bleeding if scratched.

    Treatment:

    • Antifungal therapy is started using various drugs that are Lamisil, Lotrimin or Micatin etc.
    • Maintenance of proper hygiene and bathing daily and washing your body thoroughly and drying all parts after washing is recommended.
  3. Common Viral Skin Infections:

    Viral skin infections have recently seen a rise in its incidence and they are most commonly seen in immune-compromised patients. They may occur due to some allergic manifestations and problems.

    Some of the common viral skin infections include: -

    Molluscum Contagiosum - A common viral skin infection

    It is a common skin infection and occurs due to infection with Molluscum Contagiosum fungi and hence produces lesions. These lesions are often multiple and occur in clusters or bumps on the skin and are mostly painless in nature. These lesions have a special feature that is they have a white spot in between the lesion and are generally pinkish or flesh colored. These infections occur in areas like neck, arms, chest region, abdomen, legs, gluteal region (buttocks) and sometimes it can affect palms and the sole of the body. It spreads by direct contact with infected person or using any toiletries of the infected person.

    The viral skin infection can turn risky if there is suppression of the immune system or person has a weak immune system. Children and people living in the tropical regions are most susceptible.

    Signs and symptoms:

    Various signs and symptoms include: -

    • Pinkish flesh colored multiple lesions are seen these are shiny, smooth, firm and shaped like a dorm with a white spot in the centre.
    • Pain
    • Itching
    • Swelling

    Treatment

    The most commonly used treatments are as follows: -

    • Cryotherapy can be done this includes usage of liquid nitrogen to freeze each lesion.
    • Scraping of the bump that is curettage can be done to remove the lesion
    • Laser therapy can be used for destruction of the lesion.
    • Topical treatment can be done with the use of medication like trichloroacetic acid or podophyllotoxin etc. But these therapies requires proper sessions and completion of treatment.
    • Anti-retroviral drugs can be used in people who are suffering from HIV infection.

    Herpes zoster - A common viral skin infection

    Herpes zoster also known as shingles is a common viral infection that occurs in people who have earlier suffered or have been infected from chicken pox virus. The virus causing it is Varicella Zoster virus (VZV). It occurs only when the body’s immunity falls below the desired level. This leads to reactivation of earlier suppressed action of the virus thus causing herpes zoster. It is associated with a painful rash along with blister formation. It can affect any part of the body including the face, lips, eyes, lower limbs, genitals etc. It occurs most commonly in the people in the age group of 50-80 years.

    Various signs and symptoms include: -

    • Headache
    • Fever
    • Malaise
    • Burning sensation
    • Itching
    • Oversensitivity
    • Stinging and pricking needle like pain.

    Blisters usually affect a particular dermatome (nerve track) and are multiple, clustered and remain to one side of the body and don’t cross to the other side. Later the rash becomes vesicular and goes through a stage of macule, papule and finally forms a scab and is shed from the body.

    Blisters are filled with purulent discharge.

    Treatment

    • Analgesics for nerve pain sensation is given like morphine, gabapentin etc.
    • Calamine lotion can be applied all over the rash.
    • Antiviral drug therapy can be started which include acyclovir, valacyclovir or famciclovir etc.
    • In immune compromised patients acyclovir is given intravenously.
    • Corticosteroids are also given some cases but no proper effects are seen.

    Chicken Pox - A common viral skin infection

    Chicken pox also known as varicella is caused by Varicella Zoster virus. It is a highly infectious disease and is accompanied by the vesicular rashes. Man acts as the host to the virus and the infection can occur in any age group but is most commonly seen in children below 10 years. Once infected, the person becomes life time immune against this disease. It has an incubation period of 14-16 days and is spreads mainly through secretion that is oropharyngeal secretions or direct contact with the infected person. Overcrowding also promotes the spread of chicken pox very rapidly.

    Signs and symptoms of chicken pox can be classified into two stages: -

    Pre-eruptive stage

    • Sudden in onset
    • Mild to moderate fever
    • Backache
    • Malaise
    • It occurs for 3-4 days.

    Eruptive stage: -

    • Centripetal distribution- In this the rash first appears on the abdomen and are abundant there and slowly spread to peripheral areas.
    • Rapid evaluation- Rashes go through the stages of macule, papule, pustule etc.
    • Pleomorphic- This refers to the phenomenon that all the stages of rashes are present simultaneously in the body at the same time.
    • Fever- It is mild in intensity and increases when new rashes appear.

    Treatment

    • Good hygiene includes daily bathing & soaks.
    • Secondary bacterial infection of the skin can be avoided by meticulous skin care particularly with the cutting of fingernails.
    • Pruritus can be decreased with topical dressings or the administration of antipruritic drugs.
    • Tepid water baths and wet compresses are better than drying lotions for the relief of itching.
    • Acyclovir (800 mg by mouth five times daily), Valacyclovir (three times daily), or Famciclovir (250 mg three times daily) for 5-7 days is recommended for adolescents and adults with chicken pox.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 7, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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