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Fig 2.33 Bacterial Infections I-H

n

B 2 0

S3 m > cÂŤ w

SIGNS & SYMPTOMS Increased pruritus Exudate, crusting

INVESTIGATION Nose and skin swabs for culture and sensitivities

TREATMENT Topical fusidic acid Systemic flucloxacillin

Plate 2.12 Delayed hypersensitivity investigated by patch testing. Allergens are applied, dispersed in white soft paraffin in aluminium cups, applied in sets of 10 on non-allergic tape (left lower back). They are read at 48 hours. In this patient several positives are easily visible. Interpretation of patch test reactions needs much experience to differentiate true allergy from irritant reactions. True delayed cutaneous hypersensitivity is lifelong and positive patch tests are repeatable. In practice in atopic eczema patch tests are chiefly useful for identifying and hence eliminating secondary hypersensitivities, e.g. to medicaments, nickel and preservatives.

Plate 2.13 Bacterial infection. When an area of lichenification becomes wet and sticky, as around this eye, secondary infection has probably occurred. The most usual organism is Staphylococcus aureus.

Plate 2.14 Bacterial infection. Infection deep in the pores of an eczematous area causes inflamed folliculitis as seen in this child's ankle. The organisms are streptococci or staphylococci. Such infection is favoured by the use of topic corticosteroids, occlusion and tar.

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Profile for Christopher Bridgett

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients