What are the types of skin infections?

From the Guidelines

Skin infections can be categorized into uncomplicated and complicated types, with uncomplicated infections including superficial conditions like cellulitis, abscesses, impetigo, and furuncles, and complicated infections involving deeper tissues and potentially life-threatening conditions like necrotizing fasciitis, as classified by the US Food and Drug Administration and supported by the 2018 WSES/SIS-E consensus conference 1.

Types of Skin Infections

• Bacterial infections: impetigo, cellulitis, folliculitis, typically treated with antibiotics like cephalexin or clindamycin
• Viral skin infections: herpes simplex, shingles, warts, with treatments ranging from acyclovir for herpes to topical treatments for warts
• Fungal infections: ringworm, athlete's foot, candidiasis, responding to antifungal medications like clotrimazole cream or oral fluconazole
• Parasitic infections: scabies and lice, treated with permethrin cream or malathion lotion

Classification of Skin and Soft-Tissue Infections

The classification of skin and soft-tissue infections (SSTIs) is crucial for their management, and according to the 2018 WSES/SIS-E consensus conference, SSTIs can be classified based on their severity, anatomical location, and the presence of necrosis or purulent discharge 1.

Management of Skin Infections

Proper diagnosis is essential for the effective management of skin infections, and treatments differ significantly between infection types. Good hygiene practices, including regular handwashing and avoiding sharing personal items, help prevent many skin infections. If symptoms worsen, spread, or are accompanied by fever, prompt medical attention is necessary as some infections can become serious if left untreated, as emphasized by the Infectious Diseases Society of America guidelines 1.

Recent Guidelines

Recent guidelines, such as those from the 2018 WSES/SIS-E consensus conference 1, highlight the importance of a multidisciplinary approach to managing skin and soft-tissue infections, involving general and emergency surgeons, intensivists, and infectious disease specialists.

From the FDA Drug Label

Complicated skin and skin structure infections, including diabetic foot infections, without concomitant osteomyelitis, caused by Staphylococcus aureus (methicillin-susceptible and -resistant strains), Streptococcus pyogenes, or Streptococcus agalactiae. Uncomplicated skin and skin structure infections caused by Staphylococcus aureus (methicillin-susceptible only) or Streptococcus pyogenes. Skin and Skin Structure Infections: Due to S. aureus (including beta-lactamase-producing strains), S. pyogenes, and other strains of streptococci.

The types of skin infections that can be treated with these medications are:

• Complicated skin and skin structure infections caused by:
  • Staphylococcus aureus (methicillin-susceptible and -resistant strains)
  • Streptococcus pyogenes
  • Streptococcus agalactiae
• Uncomplicated skin and skin structure infections caused by:
  • Staphylococcus aureus (methicillin-susceptible only)
  • Streptococcus pyogenes
• Skin and Skin Structure Infections due to:
  • S. aureus (including beta-lactamase-producing strains)
  • S. pyogenes
  • Other strains of streptococci 2 3

From the Research

Types of Skin Infections

• Bacterial skin infections:
  • Impetigo 4, 5
  • Cellulitis 6, 4, 5
  • Erysipelas 4, 5
  • Folliculitis 4, 5
  • Furuncles and carbuncles 4, 5
  • Staphylococcal scalded skin syndrome 4
  • Blistering distal dactylitis 4
  • Pseudomonal infections such as external otitis and malignant external otitis, ecthyma gangrenosum, pseudomonal folliculitis, toe web infection, and erysipeloid 4
• Fungal skin infections:
  • Tinea pedis 7, 5
  • Tinea cruris 7
  • Tinea capitis 7, 5
  • Tinea unguium 7
  • Tinea versicolor 7
  • Candidiasis 7
  • Sporotrichosis 5
• Viral skin infections:
  • Herpes simplex virus 7, 6, 5
  • Herpes zoster 7, 5
  • Condyloma acuminata 7
  • Molluscum contagiosum 7, 5
  • Warts 5