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† | Image

|
|
|

| 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
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]

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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
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.
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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)