By Mary Jo Goolsby, Laurie Grubbs
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Example text
Superficial cellulitis, erysipelas, is associated with streptococcal infections. Signs and Symptoms. The patient often describes a skin injury preceding the onset of redness, swelling, and pain at the site. The affected area is tender, swollen, reddened, and warm. There is regional lymphadenopathy. When streptococcal infection is involved, bullae may form on the surface. Diagnostic Studies. Typically none are indicated unless the condition is severe; if so, CBC and cultures may be warranted. HIDRADENITIS SUPPURATIVA (PLATE 16) Hidradenitis suppurativa involves occlusions of hair follicles.
The site is commonly the axillae or groin. The cause or trigger of the occlusion is unknown. Signs and Symptoms. The patient complains of pain at the site of swelling and redness. The lesions range from papules to nodules and are red, warm, and tender. There are usually multiple lesions present. The lesions often become infected, drain, and/or may form abscesses. Lymphadenopathy is absent. Without treatment, the lesions can become chronic, with prolonged drainage, and/or scarring. Diagnostic Studies.
Family History The family history should include the occurrence of such skin diseases as eczema, psoriasis, and skin cancer, as well as other disorders commonly associated with skin problems, such as cardiovascular, respiratory, hepatic, immunologic, and endocrine disorders. Habits Investigate habits related to skin, hair, and nail care. Identify any chemicals used in grooming, as well as potential exposures encountered through work and recreational activities. Identify occupational, daily living, and recreational activities that could be responsible for lesions resulting from friction, infestations, environmental extremes (heat/cold/sun), and other variables.