PANCE Blueprint Dermatology (5%)

• Caused by Staphylococcus and Streptococcus in adults
• H. influenzae or strep pneumonia in children

DX: culture taken of all purulent wounds and follow up in 48 hours

Treat mild cellulitis (MSSA) with Cephalexin or Dicloxacillin 

• Cat bite with augmentin or doxycycline if PCN allergic
• Puncture wound with Cipro (cover pseudomonas)

Treat methicillin-resistant Staphylococcus aureus infection (MRSA) with

• Trimethoprim-sulfamethoxazole (TMP-SMZ) 1 DS tab PO BID
• Clindamycin 300–450 mg PO
• Doxycycline 100 mg PO BID
• Intravenous Vancomycin or Linezolid

Cellulitis with erythematous tender swelling of the left lower extremity

• Symptoms may include redness and pain at the affected site, fevers, and chills

DX: culture and sensitivity

TX:

• Mild disease can be treated with Penicillin G (erythromycin/clindamycin for PCN allergy)
• Moderate: Bactrim and penicillin/cephalexin
• severe IMP or MER IV and linezolid BID or Vanco IV/Dapto IV

Erysipelas. This patient has large, confluent erythematous plaques. A bulla is present near the angle of her jaw.

• The main symptom is red sores that form around the nose and mouth. The sores rupture, ooze for a few days, then form a yellow-brown crust
• “honey-colored” and weeping
• Most commonly caused by S. aureus

Treatment is topical mupirocin, dicloxacillin, cephalexin for more severe illness

• Complications: poststreptococcal glomerulonephritis

Impetigo with crusted patches around the mouth.