Fred A Lopez MD Serge Lartchenko MD

Section of Infectious Diseases, Department of Internal Medicine, Louisiana State University Health Sciences Center, Box E7-17, 2020 Gravier Street, New Orleans, LA 70112, USA

Primary skin infections (ie, pyodermas) typically are initiated by some breach in the epidermis, resulting in infection by organisms, such as Streptococcus pyogenes and Staphylococcus aureus, that colonize the skin. Host-associated factors, such as immunosuppression, vasculopathy, neuropathy, or decreased lymphatic drainage, may predispose to skin infection. The clinical syndromes associated with skin infections are often characteristic and are defined most simplistically by anatomic distribution (Fig. 1). Although often mild and self-limited, skin infections can be more aggressive and involve deeper structures, including fascia and muscle. This article discusses skin and soft tissue infections, including impetigo, hair follicle-associated infections (ie, folliculitis, furuncles, and carbuncles), erysipelas, cellulitis, necrotizing fasciitis, pyomyositis, septic bursitis, and tenosynovitis.

Impetigo

Impetigo is a superficial skin infection that typically presents with multiple vesicular lesions on an erythematous base that eventually crust over. The microbiology of these infections consists primarily of S aureus and S pyogenes, either alone or in combination. Recent trends have shown an increasing incidence of S aureus-associated impetigo. Although usually seen in children aged 2 to 5 years, these infections can occur in individuals of any age. Impetigo is more common in humid and warm climates, but also can occur in cooler climates during the fall and summer months. It usually occurs on exposed parts of the body, including the face, extremities, and scalp. Predisposing factors include skin abrasions; minor trauma; burns; poor

This article is based in part on: Valeriano-Marcet J, Carter JD, Vasey FB. Soft tissue disease. Rheum Dis Clin North Am 2003;29:77-88; with permission.

* Corresponding author.

E-mail address: [email protected] (F.A. Lopez).

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