Infectious Diseases of the Skin

Skin problems generally fall into either of the following categories: Most skin problems are minor and are not accompanied by fever. Diagnosis of skin problems in returned travelers is based on the following:. It is important to recognize that skin conditions in returned travelers may not have a travel-related cause.

Insect bites , the most common cause of papular lesions, may be associated with secondary infection or hypersensitivity reactions. Bed bug and flea bites may produce grouped papules see Box for more information about bed bugs. Flea bites tend to have hemorrhagic centers. Scabies infestation usually manifests as a generalized or regional pruritic, papular rash. Scabies burrows may present as papules or pustules in a short linear pattern on the skin, frequently in the web spaces of the fingers. Onchocerciasis may occur in long-stay travelers living in rural sub-Saharan Africa and, rarely, Latin America.

It usually manifests as a generalized pruritic, papular dermatitis. Bacterial skin infections may occur more frequently after bites and other wounds in the tropics, particularly when good hygiene cannot be maintained.

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Organisms responsible are commonly Staphylococcus aureus or Streptococcus pyogenes. Drug-resistant organisms are frequently acquired in the tropics. The presentations can include pyoderma or impetigo, abscess formation, erysipelas, cellulitis, lymphangitis, or ulceration. Furunculosis, or recurrent pyoderma, may be the result of colonization of the skin and nasal mucosa with S. Boils may continue to occur weeks or months after a traveler returns and, if associated with S. In addition to pyoderma, cellulitis or erysipelas may complicate excoriated insect bites or any trauma to the skin.

Cellulitis and erysipelas manifest as areas of skin erythema, edema, and warmth in the absence of an underlying suppurative focus. Unlike cellulitis, erysipelas lesions are raised, there is a clear line of demarcation at the edge of the lesion, and the lesions are more likely to be associated with fever. Cellulitis, on the other hand, is more likely to be associated with lymphangitis.

Another common bacterial skin infection, especially in children in the tropics, is impetigo due to S. Local care and a topical antibiotic such as mupirocin may be used, although a systemic antibiotic may be required. Emerging antibiotic resistance among staphylococci and streptococci complicates antimicrobial options.

Myiasis presents as a painful lesion similar to a boil. It is caused by infestation with the larval stage of the African tumbu fly Cordylobia anthropophaga or the Latin American bot fly Dermatobia hominis. At the center of the lesion is a small punctum that allows the larva to breathe. Extraction of the fly larva can be difficult, especially of the bot fly; extraction may be facilitated by first asphyxiating the larva, usually with an occlusive dressing or covering such as a bottle cap filled with petroleum jelly for several hours and then squeezing the larva out.

Tungiasis is caused by a sand flea Tunga penetrans. The female burrows into the skin, usually the foot, and produces a nodular, pale, subcutaneous lesion with a central dark spot. The painful or pruritic lesion expands as the female produces eggs in her uterus. Loa loa filariasis occurs rarely in long-term travelers living in rural sub-Saharan Africa. The traveler may present with transient, migratory, subcutaneous, painful, or pruritic swellings produced by the adult nematode migration Calabar swelling. Rarely, the worm can be visualized crossing the conjunctiva of the eye or eyelid.

Loiasis can be diagnosed by finding microfilariae in blood collected during daytime; however, since microfilaremia may be absent, filarial serologic tests may be helpful. Gnathostomiasis is a nematode infection found primarily in Southeast Asia and less commonly in Africa and Latin America. Infection results from eating undercooked or raw freshwater fish.

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Infected travelers may experience transient, migratory, subcutaneous, pruritic, or painful swellings that may occur weeks or even years after exposure. The symptoms are due to migration of the worm through the body, and the central nervous system may be involved. Eosinophilia is common, and a definitive diagnosis is often difficult. Dermatologic conditions of the ill returned traveler: Int J Infect Dis. Macular lesions are common and often nonspecific and may be due to drug reactions or viral exanthems.

Superficial mycoses, such as tinea versicolor and tinea corporis, may also present as macular lesions. Tinea versicolor , due to Malassezia furfur previously Pityrosporum ovale , is characterized by asymptomatic hypopigmented or hyperpigmented oval, slightly scaly patches measuring 1—3 cm that are found on the upper chest, neck, and back. Treatment with topical or systemic azoles ketoconazole, fluconazole , terbinafine, or selenium sulfide present in some shampoos is recommended.

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Tinea corporis ringworm may be caused by a number of different superficial fungi. Candidiasis of the skin is a fungal infection that causes a red, itchy rash. Learn about candidiasis of the skin causes, diagnosis, and treatment. We explain the basics of impetigo, a highly contagious bacterial infection of the skin. Necrotizing fasciitis is a type of soft tissue infection. It can destroy the tissue in your skin and muscles as well as subcutaneous tissue, which is….

Skin Infections

Cellulitis is a common bacterial skin infection. Cellulitis may first appear as a red, swollen area that feels hot and tender to the touch. Athlete's foot, or tinea pedis, is a contagious fungal infection that affects the skin on the feet. This condition is contagious and can spread to the…. Infected eczema is common in people who have frequent eczema outbreaks.

However, not all people with eczema will experience infections. Many people have experienced an occasional skin rash or unexplained mark. Some conditions that cause skin rashes are very contagious. There are many different skin disorders. Some skin disorders, like contact dermatitis, are temporary and relatively minor, while others, like….

Tattoo infections aren't likely if you take care of the area after you get inked. Here's how to identify and treat an…. What are the types of skin infections? Pictures of types of skin infections. What are the symptoms of a skin infection? What are causes and risk factors for a skin infection? How is a skin infection diagnosed? How is a skin infection treated? Outlook for a skin infection. Candidiasis of the Skin Cutaneous Candidiasis.

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Symptoms, Causes, and Treatment. Necrotizing Fasciitis Soft Tissue Inflammation.



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