COMMUNICABLE DISEASES OF THE

SKIN AND EYE

CONJUNCTIVITISCONJUNCTIVITIS

• ALSO KNOWN AS PINKEYE, IS AN INFLAMMATION OF THE CONJUNCTIVA. THE

CONJUNCTIVA IS THE THIN CLEAR TISSUE THAT LIES OVER THE WHITE PART OF
THE EYE AND LINES THE INSIDE OF THE EYELID.
• CHILDREN GET IT A LOT. IT CAN BE HIGHLY CONTAGIOUS BUT IT’S RARELY
SERIOUS. IT'S VERY UNLIKELY TO DAMAGE YOUR VISION, ESPECIALLY IF YOU
FIND IT AND TREAT IT QUICKLY. WHEN YOU TAKE CARE TO PREVENT ITS
SPREAD AND DO ALL THE THINGS YOUR DOCTOR RECOMMENDS, PINKEYE
CLEARS UP WITH NO LONG-TERM PROBLEMS.
CAUSES CONJUNCTIVITIS

• VIRUSES, INCLUDING THE KIND THAT CAUSES THE COMMON COLD

• BACTERIA (S. AUREUS, HAEMOPHILUS INFLUENZA, S. PNEUMONIAE AND
PSEUDOMONAS AERUGINOSA)
• IRRITANTS SUCH AS SHAMPOOS, DIRT, SMOKE, AND POOL CHLORINE
• A REACTION TO EYEDROPS
• AN ALLERGIC REACTION TO THINGS LIKE POLLEN, DUST, OR SMOKE. OR IT
COULD BE DUE TO A SPECIAL TYPE OF ALLERGY THAT AFFECTS SOME PEOPLE
WHO WEAR CONTACT LENSES.
• FUNGI, (STI SYPHILIS, GONORRHEA, CHLAMYDIA, HERPES SIMPLEX, ETC)
AMOEBAS (ACATHAMOEBA) AND PARASITES (HELMINTH)
TREATMENT CONJUNCTIVITIS

• BACTERIAL CONJUNCTIVITIS IS USUALLY TREATED

WITH ANTIBIOTIC EYE DROPS OINTMENTS.
BACTERIAL CONJUNCTIVITIS MAY IMPROVE AFTER THREE OR
FOUR DAYS OF TREATMENT, BUT PATIENTS NEED TO TAKE THE
ENTIRE COURSE OF ANTIBIOTICS TO PREVENT
RECURRENCE. (SULFACETAMIDE SODIUM, MOXIFLOXACIN,
GATIFLOXACIN, ERYTHROMYCIN, ETC)
• VIRAL CONJUNCTIVITIS. NO DROPS OR OINTMENTS CAN
TREAT VIRAL CONJUNCTIVITIS.
IMPETIGO CONJUNCTIVITIS

• YOUNG KIDS OFTEN GET THIS BACTERIAL INFECTION ON THEIR

FACE AND HANDS IN THE SUMMER. THE SORES START OUT
RED AND WET, THEN FORM A HONEY-COLORED CRUST. IT'S
EASILY SPREAD BY TOUCH, EITHER FROM THE SORES DIRECTLY
OR ITEMS THEY'VE TOUCHED, LIKE CLOTHING AND TOYS.
ANTIBIOTIC CREAM, LOOSELY COVERING SORES, AND LOTS
OF CLEANING CAN STOP THE SPREAD. TO HELP PREVENT IT,
WASH ANY BROKEN SKIN -- SCRAPES, CUTS, AND INSECT
BITES -- RIGHT AWAY.
 CAUSES CONJUNCTIVITIS

• IMPETIGO OCCURS WHEN THE SKIN BECOMES INFECTED WITH

BACTERIA, USUALLY EITHER STAPHYLOCOCCUS AUREUS OR
STREPTOCOCCUS PYOGENES. THE BACTERIA CAN INFECT THE
SKIN IN TWO MAIN WAYS: THROUGH A BREAK IN OTHERWISE
HEALTHY SKIN – SUCH AS A CUT, INSECT BITE OR OTHER INJURY
– THIS IS KNOWN AS PRIMARY IMPETIGO.
• BACTERIA CAUSING IMPETIGO INCLUDE (S. AUREUS AND S.
PYOGENES)
TREATMENT CONJUNCTIVITIS

• TOPICAL MUPIROCIN OINTMENT, AVAILABLE ONLY BY

PRESCRIPTION, IS HIGHLY SUCCESSFUL IN TREATING
MILD FORMS OF THE INFECTION. DON'T TRY OVER-THE-
COUNTER ANTIBACTERIAL OINTMENTS; THEY ARE TOO
WEAK TO KILL STREP AND STAPH INFECTIONS, AND
APPLYING THE OINTMENT CARELESSLY MAY ACTUALLY
SPREAD THE IMPETIGO.
RINGWORM CONJUNCTIVITIS

• RINGWORM IS A CONTAGIOUS FUNGAL INFECTION

CAUSED BY MOLD-LIKE PARASITES THAT LIVE ON
THE CELLS IN THE OUTER LAYER OF YOUR SKIN. IT
CAN BE SPREAD IN THE FOLLOWING WAYS: HUMAN
TO HUMAN. RINGWORM OFTEN SPREADS BY
DIRECT, SKIN-TO-SKIN CONTACT WITH AN INFECTED
PERSON.
CAUSES CONJUNCTIVITIS

• SOME TYPES OF RINGWORM INFECTION INCLUDE

TINEA CORPORIS, TINEA CAPITIS, TINEA PEDIS
("ATHLETE'S FOOT"), AND TINEA CRURIS ("JOCK
ITCH"). RINGWORM CAUSES A SCALY, CRUSTED
RASH THAT MAY APPEAR AS ROUND, RED PATCHES
ON THE SKIN.
TREATMENT CONJUNCTIVITIS

• APPLY A TOPICAL ANTIFUNGAL. (CLOTRIMAZOLE:

LOTRIMIN, MYCELEX; TERBINAFINE, MICONAZOLE,
KETOCONAZOLE, TOLNAFTATE)
• LET IT BREATHE. WASH BEDDING DAILY.
• CHANGE WET UNDERWEAR AND SOCKS.
• USE AN ANTIFUNGAL SHAMPOO.
• TAKE A PRESCRIPTION ANTIFUNGAL.
 MOLLUSCUMCONJUNCTIVITIS
CONTAGIOSUM
• SOMETIMES CALLED WATER WARTS, IS A VIRAL INFECTION OF
THE SKIN THAT RESULTS IN SMALL, RAISED, PINK LESIONS WITH A
DIMPLE IN THE CENTER. THEY MAY OCCASIONALLY BE ITCHY
OR SORE. THEY MAY OCCUR SINGLY OR IN GROUPS. ANY
AREA OF THE SKIN MAY BE AFFECTED, WITH ABDOMEN, LEGS,
ARMS, NECK, GENITAL AREA, AND FACE BEING MOST
COMMON. ONSET OF THE LESIONS IS AROUND 7 WEEKS AFTER
INFECTION. IT USUALLY GOES AWAY WITHIN A YEAR
WITHOUT SCARRING.
CAUSES CONJUNCTIVITIS

• MOLLUSCUM CONTAGIOSUM IS CAUSED BY A VIRUS

(THE MOLLUSCUM CONTAGIOSUM VIRUS) THAT IS
PART OF THE POX VIRUS FAMILY. THE VIRUS
IS CONTAGIOUS THROUGH DIRECT CONTACT AND IS
MORE COMMON IN CHILDREN. HOWEVER, THE VIRUS
ALSO CAN BE SPREAD BY SEXUAL CONTACT AND
CAN OCCUR IN PEOPLE WITH
COMPROMISED IMMUNE SYSTEMS.
TREATMENT CONJUNCTIVITIS

• CRYOTHERAPY – WHICH INCLUDES THE DOCTOR FREEZES EACH BUMP WITH

LIQUID NITROGEN.
• CURETTAGE - THE DOCTOR PIERCES THE BUMP AND SCRAPES IT OFF THE SKIN
WITH A SMALL TOOL.
• LASER THERAPY - THE DOCTOR USES A LASER TO DESTROY EACH BUMP.
• TOPICAL THERAPY - THE DOCTOR APPLIES CREAMS CONTAINING ACIDS OR
CHEMICALS TO THE BUMPS TO INDUCE PEELING OF THE TOP LAYERS OF THE
SKIN.
• YOUR DOCTOR MIGHT ALSO PRESCRIBE MEDICATIONS SUCH AS:
TRICHLOROACETIC ACID, TOPICAL PODOPHYLLOTOXIN CREAM (CONDYLOX),
CANTHARIDIN (CANTHARONE), WHICH IS OBTAINED FROM THE BLISTER BEETLE
AND APPLIED BY YOUR DOCTOR AND IMIQUIMOD (ALDARA)
METHICILLIN-RESISTANT
CONJUNCTIVITIS
STAPHYLOCOCCUS AUREUS
• IS RESPONSIBLE FOR SEVERAL DIFFICULT-TO-TREAT INFECTIONS IN
HUMANS. MRSA IS ANY STRAIN OF S. AUREUS THAT HAS DEVELOPED,
THROUGH HORIZONTAL GENE TRANSFER AND NATURAL
SELECTION, MULTIPLE DRUG RESISTANCE TO BETA-LACTAM ANTIBIOTICS.
Β-LACTAM ANTIBIOTICS ARE A BROAD SPECTRUM GROUP WHICH
INCLUDES SOME PENAMS – PENICILLIN DERIVATIVES SUCH
AS METHICILLIN AND OXACILLIN, AND CEPHEMS SUCH AS
THE CEPHALOSPORINS. STRAINS UNABLE TO RESIST THESE ANTIBIOTICS
ARE CLASSIFIED AS METHICILLIN-SUSCEPTIBLE S. AUREUS, OR MSSA.
CAUSES CONJUNCTIVITIS

• STAPH CAN BE A PROBLEM IF IT MANAGES TO GET INTO THE BODY, OFTEN

THROUGH A CUT. ONCE THERE, IT CAN CAUSE AN INFECTION. STAPH IS ONE
OF THE MOST COMMON CAUSES OF SKIN INFECTIONS IN THE U.S. USUALLY,
THESE ARE MINOR AND DON'T NEED SPECIAL TREATMENT. LESS OFTEN, STAPH
CAN CAUSE SERIOUS PROBLEMS LIKE INFECTED WOUNDS OR PNEUMONIA.
• STAPH CAN USUALLY BE TREATED WITH ANTIBIOTICS. BUT OVER THE
DECADES, SOME STRAINS OF STAPH -- LIKE MRSA -- HAVE BECOME
RESISTANT TO ANTIBIOTICS THAT ONCE DESTROYED IT. MRSA WAS FIRST
DISCOVERED IN 1961. IT'S NOW RESISTANT TO
METHICILLIN, AMOXICILLIN, PENICILLIN, OXACILLIN, AND MANY OTHER
COMMON ANTIBIOTICS.
TREATMENT CONJUNCTIVITIS

• MEDICATION OPTIONS FOR MRSA SKIN AND SOFT TISSUE

INFECTIONS MAY INCLUDE:
• CLINDAMYCIN
• TETRACYCLINE DRUGS - DOXYCYCLINE AND MINOCYCLINE
• TRIMETHOPRIM AND SULFAMETHOXAZOLE
• RIFAMPIN
• LINEZOLID
 CHICKENPOXCONJUNCTIVITIS
AND SHINGLES
• IS A SKIN RASH THAT FORMS SMALL, ITCHY BLISTERS, WHICH
EVENTUALLY SCAB OVER. IT USUALLY STARTS ON THE CHEST, BACK,
AND FACE THEN SPREADS TO THE REST OF THE BODY. OTHER
SYMPTOMS MAY INCLUDE FEVER, TIREDNESS,
AND HEADACHES. SYMPTOMS USUALLY LAST FIVE TO SEVEN
DAYS. COMPLICATIONS MAY OCCASIONALLY
INCLUDE PNEUMONIA, INFLAMMATION OF THE BRAIN, AND
BACTERIAL SKIN INFECTIONS. THE DISEASE IS OFTEN MORE SEVERE IN
ADULTS THAN IN CHILDREN. SYMPTOMS BEGIN 10 TO 21 DAYS
AFTER EXPOSURE TO THE VIRUS.
CAUSES CONJUNCTIVITIS

• ALSO KNOWN AS VARICELLA, IS A

HIGHLY CONTAGIOUS DISEASE CAUSED BY THE
INITIAL INFECTION WITH VARICELLA ZOSTER VIRUS (VZV).
• CHICKENPOX IS AN AIRBORNE DISEASE WHICH
SPREADS EASILY THROUGH THE COUGHS AND SNEEZES
OF AN INFECTED PERSON. IT MAY BE SPREAD FROM
ONE TO TWO DAYS BEFORE THE RASH APPEARS UNTIL
ALL LESIONS HAVE CRUSTED OVER. IT MAY ALSO
SPREAD THROUGH CONTACT WITH THE BLISTERS.
TREATMENT CONJUNCTIVITIS

• ALTHOUGH THERE HAVE BEEN NO FORMAL CLINICAL STUDIES EVALUATING THE

EFFECTIVENESS OF TOPICAL APPLICATION OF CALAMINE LOTION, IT HAS AN
EXCELLENT SAFETY PROFILE.
• IT IS IMPORTANT TO MAINTAIN GOOD HYGIENE AND DAILY CLEANING
OF SKIN WITH WARM WATER TO AVOID SECONDARY BACTERIAL INFECTION.
SCRATCHING MAY ALSO INCREASE THE RISK OF SECONDARY INFECTION.
• PARACETAMOL (ACETAMINOPHEN) BUT NOT ASPIRIN MAY BE USED TO REDUCE
FEVER.
• ANTIVIRALS ARE SOMETIMES USED.
COLD SORES CONJUNCTIVITIS

• HERPES LABIALIS, COMMONLY KNOWN AS COLD SORES, IS A TYPE

OF INFECTION BY THE HERPES SIMPLEX VIRUS THAT AFFECTS
PRIMARILY THE LIP. SYMPTOMS TYPICALLY INCLUDE A BURNING PAIN
FOLLOWED BY SMALL BLISTERS OR SORES. THE FIRST ATTACK MAY
ALSO BE ACCOMPANIED BY FEVER, SORE THROAT, AND ENLARGED
LYMPH NODES. THE RASH USUALLY HEALS WITHIN 10 DAYS, BUT THE
VIRUS REMAINS DORMANT IN THE TRIGEMINAL GANGLION. THE
VIRUS MAY PERIODICALLY REACTIVATE TO CREATE ANOTHER
OUTBREAK OF SORES IN THE MOUTH OR LIP.
CAUSES CONJUNCTIVITIS

• THE INFECTION IS TYPICALLY SPREAD BETWEEN PEOPLE BY DIRECT

NON-SEXUAL CONTACT. ATTACKS CAN BE TRIGGERED
BY SUNLIGHT, FEVER, PSYCHOLOGICAL STRESS, OR A MENSTRUAL
PERIOD.
• HERPES LABIALIS INFECTION OCCURS WHEN THE HERPES SIMPLEX
VIRUS COMES INTO CONTACT WITH ORAL MUCOSAL TISSUE
OR ABRADED SKIN OF THE MOUTH. INFECTION BY THE TYPE 1 STRAIN
OF HERPES SIMPLEX VIRUS (HSV-1) IS MOST COMMON; HOWEVER,
CASES OF ORAL INFECTION BY THE TYPE 2 STRAIN ARE INCREASING.
SPECIFICALLY, TYPE 2 HAS BEEN IMPLICATED AS CAUSING 10–15%
OF ORAL INFECTIONS.
TREATMENT CONJUNCTIVITIS

• APPLY A TOPICAL ANTIFUNGAL.

• ACICLOVIR, VALACICLOVIR, DUCOSAMOL,
FAMCICLOVIR, LIP BALM)
• LET IT BREATHE. WASH BEDDING DAILY.
• CHANGE WET UNDERWEAR AND SOCKS.
• USE AN ANTIFUNGAL SHAMPOO.
• TAKE A PRESCRIPTION ANTIFUNGAL.
VIRAL KERATITIS

• IS A COMMON INFECTION OF THE CORNEA AND NOT

ALWAYS ASSOCIATED WITH CONTACT LENS USE.
• THE MOST PREVALENT VIRUSES ARE HERPES SIMPLEX,
VARICELLA ZOSTER AND ADENOVIRUS 1
CAUSES

• THE MOST COMMON CAUSES OF KERATITIS ARE

INFECTION AND INJURY.
• BACTERIAL (PSEUDOMONAS AERUGINOSA, S. AUREUS
• AN INFECTIOUS KERATITIS CAN HAPPEN AFTER AN
INJURY TO THE CORNEA.
TREATMENT

• ANTIVIRAL THERAPY, TOPICAL OR ORAL, IS AN EFFECTIVE

TREATMENT FOR EPITHELIAL HERPES INFECTION.
• GANCICLOVIR OPHTHALMIC GEL, TRIFLURIDINE,
VIDARABINE, ORAL ACYCLOVIR, A CYCLOPLEGIC AGENT.
FUNGAL KERATITIS

• AN INFECTION OF THE CORNEA THAT IS CAUSED BY A

FUNGUS.
• SOME FUNGI THAT HAVE BEEN KNOWN TO COMMONLY
CAUSE FUNGAL KERATITIS INCLUDE
• FUSARIUM SPECIES
• ASPERGILLUS SPECIES
CAUSES
• SOME FUNGI THAT HAVE BEEN KNOWN TO
COMMONLY CAUSE FUNGAL KERATITIS INCLUDE
• FUSARIUM SPP.
• ASPERGILLUS SPP.
 TREATMENT
• IT MUST BE TREATED WITH PRESCRIPTION ANTIFUNGAL MEDICINE
FOR SEVERAL MONTHS.
NATAMYCIN IS A TOPICAL (IN THE FORM OF EYE DROPS) TO TREAT
KERATITIS CAUSED BY ASPERGILLUS AND FUSARIUM.
• NATAMYCIN, AMPHOTERICIN B, KETOCONAZOLE, MICONAZOLE,
FLUCONAZOLE, ITRACONAZOLE.
• CORNEAL TRANSPLANTATION ARE REQUIRED IF PATIENTS DO NOT
TRACHOMA
• AN INFECTIOUS DISEASE CAUSED BY BACTERIUM CHLAMYDIA
TRACHOMATIS
• THE INFECTION CAUSES A ROUGHENING OF THE INNER SURFACE
OF THE EYELIDS
• THIS ROUGHENING CAN LEAD TO PAIN IN THE EYE, BREAKDOWN
OF THE OUTER SURFACE OR THE CORNEA OF THE EYES, AND
EVENTUAL BLINDNESS.
CAUSES
• TRACHOMA IS CAUSED BY CERTAIN SUBTYPES OF
CHLAMYDIA TRACHOMATIS, A BACTERIUM THAT CAN ALSO
CAUSE THE SEXUALLY TRANSMITTED INFECTION
CHLAMYDIA.
• TRACHOMA SPREADS THROUGH CONTACT WITH
DISCHARGE FROM THE EYES OR NOSE OF AN INFECTED
PERSON
TREATMENT

• ANTIBIOTICS ARE NEEDED FROM THE EARLY STAGES OF

TRACHOMA.
• IT ALONE IS ENOUGH TO ELIMINATE THE INFECTION.
• DOCTOR’S PRESCRIPTION MAY INCLUDE TETRACYLINE EYE
OINTMENT OR ORAL AZITHROMYCIN (ZITHROMAX).
ENDOPHTHALMITIS

• AN INFLAMMATION OF THE INTERIOR OF THE EYE.

• IT IS A POSSIBLE COMPLICATION OF ALL INTRAOCULAR
SURGERIES, PARTICULARLY CATARACT SURGERY, WITH
POSSIBLE LOSS OF VISION AND THE EYE.
CAUSES

• COAGULASE-NEGATIVE STAPHYLOCOCCI ARE THE MOST

COMMON CAUSES OF POST-CATARACT
ENDOPHTHALMITIS, AND THESE BACTERIA AND VIRIDANS
STREPTOCOCCI CAUSE MOST CASES OF POST-
INTRAVITREAL ANTI VEGF INFECTION ENDOPHTHALMITIS.
TREATMENT

• PARS PLANA VITRECTOMY OR VITREOUS

ASPIRATION MAY BE PERFORMED BY AN
OPHTHALMOLOGIST WITH ADMINISTRATION OF
INTRAVITREAL ANTIBIOTICS.
• VANCOMYCIN, AMIKACIN, CEFTAZIDIME
ACANTHAMOEBA KERATITIS

• A RARE DISEASE IN WHICH AMOEBAE INVADE

THE CORNEA OF THE EYE, AND AFFECTS
ROUGHLY 1.2 TO 3 MILLION PEOPLE EACH
YEAR.
CAUSES

• ACANTHOMOEBA CAN ALSO CAUSE DISSEMINATED

INFECTION BY ENTERING THE SKIN THROUGH A CUT,
WOUND, OR THROUGH NOSTRILS.
• ONCE INSIDE THE BODY, THE AMOEBAS TRAVEL THROUGH
THE BLOODSTREAM TO OTHER PARTS OF THE BODY
 TREATMENT
• THESE TOPICAL ANTIMICROBIALS ARE ADMINISTERED EVERY HOUR
IMMEDIATELY AFTER CORNEAL DEBRIDEMENT OR FOR THE FIRST
SEVERAL DAYS OF THERAPY.
• A COMBINATION OF CHLOROHEXIDINE AND POLYHEXAMETHYLENE
BIGUANIDE.