Geriatric Skin Conditions

This presentation is going to go over some basic geriatric skin conditions. This is a typical picture of what an impetigo would look like, even though this is in a small child, it still has that crusty appearance that we’ll see whenever impetigo or strep infections are present. More worrisome I think in our market would be staph infections. We often see mrsa, which is methicillin-resistant staph aureus may have a more of an appearance like you see here. This is actually erythema with cellulitis surrounding a blister, so this is a typical picture for what would be developing into something that was a little more invasive.

Pseudomonas and anaerobes are common. Pseudomonas is best treated with Ciprofloxacin, Cipro, systemically. Topically you can use triple antibiotic solution or Gentamicin. Anaerobes, the best treatment is just to make the anaerobe have to survive in an aerobic environment by taking an abscess and and opening that up. The antibiotic would be metronidazole and the dose is listed here, but once again the most important portion of this is to release those pus pockets and expose that area to the air.

Viral infections are commonly seen in a nursing home as well. Herpes infections are very prevalent. There are various different types of herpes that we’ll talk about, being herpes labialis as opposed to herpes zoster or genital herpes or any of the other forms that we might see. You can treat these with antivirals, Acyclovir being one, famciclovir being another. Keep them covered and you can use topicals silver to prevent secondary bacterial infection.

You may see warts and molluscums as well. The treatment for those is to do cryotherapy on them. This is herpes labialis which is commonly seen. People have outbreaks of this whenever they get stressed. This is ophthalmic herpes and this is actually an emergency and requires an ophthalmic evaluation, so when you do see this you want to make sure that those people get to the appropriate follow up. Again, this is genital herpes and this is genital herpes as well.