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Irritating skin problems affecting the axilla – 10 cases

The 10 patients in this quiz are complaining of an irritating skin problem affecting the axilla(e).

For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.

Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.

When you finish the quiz, you can download a certificate.

Case 1

Bullous impetigo

Bullous impetigo is a common contagious superficial skin infection mainly affecting children. It is due to Staphylococcus aureus, phage II, type 71. The bacterial toxins cause a split in the superficial epidermis.
The rash affects the face, trunk, flexures or extremities. It starts as small vesicles that rapidly enlarge into flaccid bullae; surrounding skin appears normal. These may rupture; leaving shiny erosions that soon dry up. The affected child usually has no systemic symptoms.
Treatment includes cleansing, removal of crusts and application of wet dressings. Localised impetigo may be treated with topical antiseptic (e.g., hydrogen peroxide cream or povidone iodine) or topical antibiotic (e.g., fusidic acid cream or mupirocin ointment). Extensive or recurrent infection may require oral flucloxacillin or erythromycin.

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