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The first 25 slides, exactly as they appear. The full deck has 188 content slides.
Dermatology
Mycobacterial Infections
Built from Dermatology, 5th Edition

What’s inside
4 sections · 188 slides
Overview
- What are mycobacteria
- Why mycobacterial disease is rising
- Mycobacteria that cause cutaneous disease
- How mycobacteria are grouped (Runyon system)
Hansen Disease (Leprosy)
A chronic infection of the skin and peripheral nerves caused by Mycobacterium leprae
- Key features of Hansen disease
- A disease known since antiquity
- Naming the disease
- How common is Hansen disease
- New leprosy cases worldwide, 2021
- Hansen disease in the United States
- How Hansen disease spreads
- Hansen disease as a zoonosis
- The organism and where it lives in the body
- Why some people get sick and others do not
- More susceptibility genes
- The clinical-immunologic spectrum of Hansen disease
- Clinical-immunologic spectrum of Hansen disease
- The tuberculoid (strong-immunity) immune response
- The lepromatous (weak-immunity) immune response
- Clues from the antibody phenolic glycolipid-1 (PGL-1)
- Classifying Hansen disease
- Classification of Hansen disease across the spectrum - LL
- Classification of Hansen disease across the spectrum - BL
- Classification of Hansen disease across the spectrum - BB
- Classification of Hansen disease across the spectrum - BT
- Classification of Hansen disease across the spectrum - TT
- Classification of Hansen disease across the spectrum - I
- The WHO operational classification
- Cutaneous findings in paucibacillary and multibacillary leprosy
- Examining the peripheral nerves
- Nerve enlargement in lepromatous Hansen disease
- The lepromatous form - clinical picture
- Lepromatous Hansen disease - clinical appearance
- Lepromatous Hansen disease - forearm nodules
- Lepromatous Hansen disease - leonine facies
- Late sequelae of lepromatous disease
- Sequelae of Hansen disease
- Histoid and Lucio leprosy - two distinct variants
- Borderline leprosy - features in between
- Mid-borderline (BB) leprosy
- Borderline tuberculoid leprosy
- The tuberculoid form - clinical picture
- Tuberculoid Hansen disease - clinical appearance
- Tuberculoid leprosy - plaque with central hypopigmentation
- Reactions - a complication of treatment
- Leprosy reactions - reversal reaction, ENL, and Lucio phenomenon
- Type 1 (reversal) reactions
- Type 2 reactions (erythema nodosum leprosum)
- Lucio phenomenon
- The two major types of leprosy reactions compared - Type 1 - reversal reaction
- The two major types of leprosy reactions compared - Type 2 - erythema nodosum leprosum
- Leprosy reactions - clinical spectrum
- Type 1 upgrading reaction - facial involvement
- Erythema nodosum leprosum
- Erythema nodosum leprosum - three cases
- Lucio phenomenon - retiform purpura and ulcers
- Three histopathologic patterns
- Lepromatous pattern on biopsy
- Tuberculoid pattern on biopsy
- Borderline and indeterminate patterns
- Confirming the diagnosis - slit-skin smear and biopsy
- PCR testing for Hansen disease
- PCR testing requirements for M. leprae and M. lepromatosis
- Submitting specimens for expert review
- US specimen submission protocol for Hansen disease
- US pathology consultation request form
- Blood tests and the lepromin (Mitsuda) test
- A trap for other diagnostic tests
- Preventing disability
- Clinical differential diagnosis of Hansen disease
- WHO multidrug therapy (MDT) for Hansen disease
- WHO 2018 treatment guidelines for Hansen disease
- WHO 2018 treatment guidelines for Hansen disease (continued)
- WHO 2018 treatment guidelines for Hansen disease (continued)
- WHO 2018 treatment guidelines for Hansen disease (continued)
- Treatment in the United States
- How well does treatment work
- Alternative and future drugs
- Treating leprosy reactions
- Outlook and prevention
Cutaneous Tuberculosis
Skin disease caused by Mycobacterium tuberculosis, from direct inoculation to disseminated infection
- Key features of cutaneous tuberculosis
- A disease traced through history
- How common is cutaneous tuberculosis
- Tuberculosis incidence rates worldwide, 2021
- The organism itself
- From infection to disease
- How a tuberculous granuloma forms
- Stages of granuloma formation in tuberculosis
- Host genetics and immune defense
- Two routes into the skin
- Tuberculous chancre
- Tuberculosis verrucosa cutis
- Scrofuloderma
- Scrofuloderma with bone involvement
- Tuberculous mastitis
- Orificial tuberculosis
- Tuberculous ulcer of the tongue
- Lupus vulgaris - overview
- Lupus vulgaris - clinical spectrum
- Lupus vulgaris - patterns and sites
- Miliary tuberculosis and tuberculous gumma
- What early cutaneous TB looks like under the microscope
- Clinical presentations of cutaneous tuberculosis compared - Tuberculous chancre
- Clinical presentations of cutaneous tuberculosis compared - TB verrucosa cutis
- Clinical presentations of cutaneous tuberculosis compared - Scrofuloderma
- Clinical presentations of cutaneous tuberculosis compared - Scrofuloderma (continued)
- Clinical presentations of cutaneous tuberculosis compared - Orificial tuberculosis
- Clinical presentations of cutaneous tuberculosis compared - Lupus vulgaris
- Clinical presentations of cutaneous tuberculosis compared - Acute miliary TB
- Clinical presentations of cutaneous tuberculosis compared - Tuberculous gumma
- What are tuberculids
- Papulonecrotic tuberculid
- Lichen scrofulosorum
- Erythema induratum (nodular vasculitis)
- Erythema induratum - under the microscope
- BCG vaccination and its complications
- BCG vaccination site complication (BCGitis)
- Complication of BCG immunotherapy injection
- Testing for TB infection - skin test vs blood test
- IFN-gamma release assays versus tuberculin skin testing - Tuberculin skin test
- IFN-gamma release assays versus tuberculin skin testing - IFN-gamma release assays
- Test pitfalls and molecular diagnosis
- Treating cutaneous tuberculosis
- Targets of the antituberculous agents
- Classes, activity, and cross-resistance of antituberculous agents
- Classes, activity, and cross-resistance of antituberculous agents (continued)
- Multidrug-resistant and extensively drug-resistant tuberculosis
- Drug regimens for culture-positive pulmonary tuberculosis - Intensive phase - drugs
- Drug regimens for culture-positive pulmonary tuberculosis - Intensive phase - interval & doses
- Drug regimens for culture-positive pulmonary tuberculosis - Continuation phase - drugs
- Drug regimens for culture-positive pulmonary tuberculosis - Continuation phase - interval & doses
- Drug regimens for culture-positive pulmonary tuberculosis - Total doses
- Drug regimens for culture-positive pulmonary tuberculosis - Comments
- New drugs for resistant tuberculosis
- Vaccines - present and future
Non-tuberculous Mycobacterioses
Skin infections from environmental mycobacteria other than M. leprae and M. tuberculosis
- Key features of non-tuberculous mycobacterioses
- Discovery and where these organisms live
- Who is most at risk of severe infection
- A hazard of modern cosmetic and medical procedures
- Classifying and treating NTM species
- Mycobacterium ulcerans (Buruli ulcer) - overview
- Where Buruli ulcer occurs
- How Buruli ulcer causes such severe, painless damage
- Buruli ulcer - clinical course
- Grading severity and diagnosis
- Buruli ulcer - undermined indurated border
- Treating Buruli ulcer
- Mycobacterium marinum - fish tank and swimming pool granuloma
- How M. marinum infection happens
- Clinical patterns of M. marinum infection
- Diagnosing and treating M. marinum
- Mycobacterium kansasii
- M. kansasii - clinical picture and diagnosis
- Rapidly growing mycobacteria - overview
- How rapid-grower infections happen
- Clinical features of rapid-grower infections
- Suppurative lymphadenitis from M. fortuitum inoculation
- Mycobacterium chelonae infection
- Diagnosing and treating rapid growers
- Mycobacterium avium complex (MAC) - overview
- Clinical features of MAC infection
- MAC - pathology, diagnosis, and treatment
- Mycobacterium haemophilum
- M. haemophilum - clinical picture, diagnosis, treatment
- Mycobacterium scrofulaceum
- M. scrofulaceum - diagnosis and treatment
- Treatment of non-tuberculous mycobacterial infections by species - Local treatment
- Treatment of non-tuberculous mycobacterial infections by species - Systemic medications (alone or combined)
- ~130,000
- Putting it all together
- References
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- Dermatology, 5th Edition (2-Volume Set)