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INTRODUCTION

Skin and soft tissue infections are some of the most common infectious diagnoses and result in hundreds of thousands of medical office and emergency room visits each year. These infections often occur following a break in normal skin integrity from either trauma or skin disease (e.g., atopic dermatitis). The vast majority of these infections are caused by Staphylococcus aureus and Streptococcus pyogenes (Table 77–1). Hematogenous seeding of organisms into the skin can occur but is uncommon. Normal histology of the skin can be seen in Figure 77–1.

FIGURE 77–1

Layers of the skin and subcutaneous tissue. Note sebaceous glands (purple coils) and hair follicles with protruding hair. (Reproduced with permission from Mescher AL. Chapter 18. Skin. In: Mescher AL. eds. Junqueira’s Basic Histology: Text & Atlas, 13e. New York, NY: McGraw-Hill; 2013.)

Table 77–1Skin and Soft Tissue Infections: Appearance of Lesions, Skin Layers Involved, Common Pathogens, and Treatment Modalities

IMPETIGO

Definition

Impetigo is an infection of the epidermal layer of skin.

Pathophysiology

There are two modes of acquisition of impetigo, primary infection that occurs in otherwise normal skin or secondary impetigo, which occurs following a break in normal skin integrity. ...

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