Skin and soft-tissue infections

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Please click on the specific skin and soft-tissue infections below for further information.

Anatomic Layers of the Skin		Condition	Definition^†
	Epidermis	Impetigo	Superficial pyogenic infection of the skin which usually begins as vesicles with a very thin, fragile roof consisting only of stratum corneum.
	Dermis	Erysipelas	Infection of the upper dermis including the superficial lymphatics which typically presents as an indurated, "peau d’orange" lesion with a raised border that is demarcated from uninvolved skin.
		Folliculitis	Inflammation and/or infection of the hair follicle in which suppuration presents in the epidermis.
		Furuncle (Boil)	Infection of the hair follicle in which suppuration extends through the dermis into the subcutaneous tissue. Each lesion consists of a deep-seated inflammatory nodule and an overlying pustule through which hair emerges.
		Carbuncle	Infection of several adjacent hair follicles, producing a coalescent inflammatory mass with pus draining from multiple follicular orifices.
		Cellulitis	Acute spreading infection of the deeper dermis and the subcutaneous tissue which lacks sharp demarcation from uninvolved skin.
	Subcutaneous Tissue	Cellulitis
	Subcutaneous Tissue	Necrotizing Fasciitis	Rapidly progressive infection of deep fascia associated with bullae and necrosis of underlying skin.
	Muscle	Myonecrosis (Gas Gangrene)	Rapidly progressive toxemic infection of injured muscle, producing marked edema, crepitus, and brown bullae, characterized by extensive gaseous dissection of muscle and fascial planes on radiography.
^†Adapted from Clin Infect Dis. 2005;41(10):1373-406.,^[1] Rook's Textbook of Dermatology,^[2] and Infectious Diseases of the Skin.^[3]

A cutaneous abscess could occur at multiple locations.

Patients who require hospitalization for ICU admission, operating room surgical intervention, or death have one of the following six risk factors upon presentation^[4]:

abnormal cross-sectional imaging result
systemic inflammatory response syndrome
previous infection at the same location
infection involving the hand

diabetes
age >65 years

References[edit | edit source]

↑ Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ; et al. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249.
↑ Rook, Arthur (2010). Rook's textbook of dermatology. Chichester, West Sussex, UK Hoboken, NJ: Wiley-Blackwell. ISBN 1405161698.
↑ Elston, Dirk (2011). Infectious diseases of the skin. London: Manson. ISBN 1840761776.
↑ Mower WR, Kadera SP, Rodriguez AD, Vanderkraan V, Krishna PK, Chiu E; et al. (2018). "Identification of Clinical Characteristics Associated With High-Level Care Among Patients With Skin and Soft Tissue Infections". Ann Emerg Med. doi:10.1016/j.annemergmed.2018.09.020. PMID 30420232.

[pmid16231249-1] Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ; et al. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249.

[Rook's_Textbook_of_Dermatology-2] Rook, Arthur (2010). Rook's textbook of dermatology. Chichester, West Sussex, UK Hoboken, NJ: Wiley-Blackwell. ISBN 1405161698.

[3] Elston, Dirk (2011). Infectious diseases of the skin. London: Manson. ISBN 1840761776.

[pmid30420232-4] Mower WR, Kadera SP, Rodriguez AD, Vanderkraan V, Krishna PK, Chiu E; et al. (2018). "Identification of Clinical Characteristics Associated With High-Level Care Among Patients With Skin and Soft Tissue Infections". Ann Emerg Med. doi:10.1016/j.annemergmed.2018.09.020. PMID 30420232.

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