PENYAKIT KULIT YANG DISEBABKAN OLEH

BAKTERI
INFEKSI BAKTERI PD KULIT DIBAGI MENJADI 4:

Infeksi primer
Infeksi sekunder
Manifestasi kulit akibat infeksi bakteri pd organ
dalam
Kondisi reaktif kulit akibat infeksi bakteri
PATOGENESIS UMUM INFEKSI BAKTERI PD KULIT :

The portal of entry

The host defenses and inflammatory response
to microbial invasion
Pathogenic properties of the organism
PIODERMA
Infeksi pada kulit, yang disebabkan oleh bakteri yg
membentuk nanah atau piogenik dan mudah menular
Etiologi :
Staphylococcus S.aureus
Streptococcus Streptococcus grup A
Kedua-duanya
FAKTOR PREDISPOSISI :

Daya tahan tubuh rendah

Higiene individu kurang
Higiene lingkungan kurang
Telah ada penyakit kulit sebelumnya
PYODERMA :
Impetigo
Folikulitis
Furunkel
Karbunkel
Ektima
IMPETIGO

Pioderma superfisialis (terbatas pada epidermis)

Etiology : Streptococcus B hemolyticus
S.aureus
Ada 2 bentuk:
a. Bulosa
b. Non-bulosa / krustosa
A. IMPETIGO BULOSA
Impetigo vesiko-bulosa, cacar monyet
Etiology : phage group II S.aureus (strain 77 & 55) exfoliatin
toxin type A and B
Clinical :
newborn and older infants
Vesicle flaccid bullae (rapid progression)
Nikolsky sign (-)
Bullae : clear yellow fluid dark yellow & turbid
Margin : sharply demarcated w/o erythematous halo
w/i a day or two bullae rupture & collapse
IMPETIGO BULOSA
IMPETIGO BULOSA
DD/ :
Lab :
Contact dermatitis
Gram stain
Insect bite
Culture
Bullous drug eruption
histoPA
IMPETIGO BULOSA

Complication :
Cellulitis
Lymphangitis
Bacteremia
Osteomyelitis
Septic arthritis
Septicemia
IMPETIGO NON BULOSA/KRUSTOSA
Impetigo kontagiosa, impetigo vulgaris, impetigo Tillbury
Fox
70% of cases of this form of pyoderma
Etiology :
Streptococcus group A pre-school aged children (<2 y.o)
S.aureus Children of all ages and adults
IMPETIGO NON BULOSA/KRUSTOSA
Clinical finding:
Pruritus; soreness; burning ; painless
Commonly on the skin of the face (around the nares) or extremities
after trauma
Transient pustule or vesicle honey-colored crusted plaque
(2cm) w/i surrounding erythema
No constitutional symptoms
Regional lymphadenopathy (90%)
IMPETIGO NON BULOSA/KRUSTOSA
IMPETIGO NON BULOSA/KRUSTOSA
Lab :
Gram stain
Culture
DD/ :
Atopic dermatitis
Allergic contact dermatitis
Varicella
Dermatophyte infection
IMPETIGO NON BULOSA/KRUSTOSA

Complication :
Untreated process may persist and new lesions over the course
and for several weeks
Resolve spontaneusly except there is some underlying cutaneous
disease
Erysipelas
Cellulitis
Bacteremia
Major serious sequela acute post-streptococcal glomerulonephritis
MANAGEMENT OF IMPETIGO
Washing (removal of dirt, crusts and debris by soaking with soap & water)
Good hygiene
Pharmacology: topical and systemic
Topical : mupirocin; fusidic acid
Systemic :
Penicillin DOC
Dicloxacillin; amoxicillin and clavulanic acid
Azythromycin
Clindamycin
Erythromycin
FOLIKULITIS

Def : a pyoderma that begins within the hair

follicles
Classified :
Depth of invasion : superficial and deep
Microbial etiology : bacterial, fungal, viral and parasite
infestation
 FOLIKULITIS SUPERFISIAL
Impetigo Bockhart; follicular impetigo
Etiology : S.aureus
Clinical finding:
Location : scalp (children); beard area, axillae,
extremities, buttocks (adults)
A small, fragile, dome-shaped pustule
infudibulum of a hair follicle
DD/ : - gram-negative folliculitis
Pityrosporum folliculitis
Herpes simplex

Deep folliculitis sycosis barbae

FURUNKEL
Boil
Deep-seated inflammatory nodule that develops around a hair follicle, usually
from a preceding, more superficial folliculitis and often evolving into an abcess
Etiology: S.aureus
Clinical finding :
Pain surrounding the lesion
Nodule (hard, tender, red folliculocentric) enlarge fluctuant abcess formation
rupture
Single/multiple
FURUNKEL
FURUNKEL

Lab: Complication
Leukocytosis
Not common
Gram stain of pus
Culture
Recurrent
furunculosis
KARBUNKEL
Larger, more serious
inflammatory lesion with a
deeper base
Extremely painful
Fever, malaise
Location : nape of the neck,
the back or thighs
Efl : red, indurated, multiple
pustules confluent
MANAGEMENT OF FURUNCLE & CARBUNCLE

Washing and hygiene

Localized local application of moist heat
Systemic systemic antibiotic
Incision and draining the lesions
EKTIMA
A cutaneous pyoderma characterized by thick crusted
erosions or ulceration
Etiology: S.aureus &/ group A Streptococcus
Clinical finding:
Poor hygiene & neglect
Location : lower extremities (children, DM, elderly)
Efl: ulcer punched-out, indurated, raised, violaceous,
granulating base
slow to heal need several weeks of antibiotic treatments
ERISIPELAS

Soft tissue infection erysipelas & cellulitis

Usually present at an antecedent lesion or site
Local pain, variable degrees of erythema, systemic
symptoms
 ERISIPELAS
Distinct type of superficial cutaneous cellulitis
with marked dermal lymphatic vessel
involvement
Etiology : group A -hemolytic Streptococcus
(>>) ; S.aureus (<<)
Clinical finding :
Face, lower extremities
Pain, superficial erythema and plaque-like edema with
sharply defined margin to normal tissue Recurrent lymphedema
SELULITIS
Extends deeper into the dermis and subcutaneous tissue
Etiology : S.aureus and group A Streptococcus (>>)
Clinical finding :
Erythema, tenderness, pain
Lack of distinctive margins between affected and normal skin
Deeper, firmer form of tender induration
Crepitus on palpation
Bulla and necrosis
Regional lymphadenopathy
SELULITIS
ERITRASMA
Common superficial bacterial infection of the skin characterized by well-
defined but irregular reddish brown patches, occuring in intertrigonous areas,
or by fissuring and white maceration in the toe clefts
Etiology : Corynebacterium minutissimum
Clinical finding:
Men > women
Asymptomatic pruritus
Location : genitocrural, web spaces of the feet, axillary, inframammary regions
Efl: well demarcated, reddish brown, superficial, finely scaly and finely wrinkled patches;
hyperkeratotic white macerated plaque
ERITRASMA
Lab : Management :
Woods lamp coral red Topical
Gram stain Benzoyl peroxide wash
DD/ BPO 5% gel
Tinea cruris Clindamycin 2% sol
Pitiriasis versikolor Systemic
Psoriasis inversa Erythromycin PO
Clarythromycin 1g SD