The skin is the largest organ in the body and functions as a protective barrier from infection. Sometimes the skin itself becomes infected. These can be caused by a wide variety of germs, and symptoms can vary from mild to severe. Mild infections may be treatable with over-the-counter medications and home remedies, whereas more severe infections may require medical attention

Types of Skin Infections
There are four types of skin infections

Brief Description of Various Skin Infections

Risk Factors for Developing Skin Infections
• Loss of integrity of skin barrier – atopic eczema, Breaks in skin (trauma, leg ulcers, surgical wounds)
• Impaired host immunity – AIDS, immunosuppression, diabetes
• Altered normal skin flora (normally prevent colonisation by pathogenic organisms)
• Excessive sweating, wearing moist or inappropriately warm clothing – increases risk of fungal infection

Diagnosis of Skin Infections
Physical examination – Most common skin infections are diagnosed by characteristic appearance of the rash or sore and associated symptoms

Skin swabs – Occasionally skin swabs or scrapings for bacterial or fungal culture and sensitivity may be done to establish the causative organism of impetigo, boils, blister for appropriate treatment

UV light examination – Examination of skin using a black light to view skin in the affected area. The fungus will fluoresce (glow) under black light and the areas of the skin where fungus is located will glow

Microscopy/KOH examination – In superficial fungal skin infections such as tinea, a small area of infected skin is scraped off and placed in potassium hydroxide (KOH). The KOH destroys normal cells leaving the fungal cells untouched, so they’re easily visible under a microscope. In suspected scabies skin scraping examined under microscopy may demonstrate the itch mite or eggs of Sarcoptes scabei

Blood test – Serological blood tests to demonstrate IgM antibodies to viral antigens

Blood Culture – If symptoms are severe a blood culture may be performed to rule out bacteremia or septicemia in the case of extensive cellulitis or boils

Skin biopsy – Although a diagnosis may be suspected based on clinical history and examination, a skin biopsy may be done to confirm diagnosis of leprosy and to demonstrate cytopathic changes in viral infections such as warts.

Skin testing – A lepromin test is done to determine type of leprosy and immune status of the patient. A suspension of the lepra bacilli is injected intradermally. Persons with tuberculoid leprosy (usually having good immunity)will develop redness and induration at the injection site within 48-72 hours

Treatment of Skin Infections
Treatment depends on the cause and severity of infection.

Viral infections – Some infections improve spontaneously within days or weeks. Most viral skin infections are caused by herpes viruses. Acyclovir cream is effective in genital herpes and cold sores, while shingles requires oral Acyclovir.

Bacterial infections – Mild infections often respond to topical antibiotics applied directly to the skin or a course of oral antibiotics. If the infection is extensive, or the strain of bacteria is resistant to treatment, intravenous antibiotics may have to be administered in the hospital setting.

Fungal nail infections – can be treated with antifungal creams painted onto the infected nails. Fingernails usually need six months of treatment to resolve while toenails take longer (9 to 12 months). Oral antifungal agents are usually more effective, but still may take a few months to go away

Fungal skin infections – such as athlete’s foot, ringworm, sweat rash, jock itch are managed with
topical antifungals applied directly to the skin. It is important to continue treatment for at least one to two weeks after the symptoms have cleared up to prevent recurrences. Some of the products
contain a corticosteroid such as hydrocortisone to reduce the inflammation and itch accompanying the infection.

Lice infestation is treated with pesticides such as pyrethrin, permethrin

Scabies is treated with topical 5% permethrin, 25% benzyl benzoate, 10% sulphur,

Miscellaneous measures – Application of cold compresses over the area several times a day or antihistamines taken orally may reduce itching and inflammation associated with skin infections

Prevention of Skin Infections
• Frequent hand washing and good hygienic practices
• Avoid sharing of towels, undergarments, soaps or other topical preparations (deodorants, lotions)
• Avoid touching eyes, nose or mouth with hands
• Taking bath at least twice a day in hot summer months due to excess sweating
• Towel entire body dry after a bath; moist areas and sweating promote fungal infections
• Wearing thick clothes in warm weather can increase risk of fungal infection
• Avoid contact with infected person