Tetracycline skin eruptions with

Antibiotics are used in dermatology for both infectious and noninfectious skin eruptions. Noninfectious skin eruptions, such as acne vulgaris and acne rosacea, are often treated with systemic antibiotics. The mechanism of action is not clear, although tetracycline inhibits lipases derived from resident flora in the sebaceous follicle Staphylococcus epidermidis, Propionibacterium ac-nes). These lipases cleave irritating fatty acids from triglycerides in sebum, presumably contributing to cutaneous inflammation. 

Brucellosis is caused by three different gramnegative rods Brucella suis from pigs. B. abortus from cattle, and B. melitensis from sheep and goats. Infection is from handling infected animals or ingesting contaminated unpasteurized milk or cheese. The skin manifestations can include maculopapular lesions, petechiae, a chronic ulcer at the site of inoculation, and an urticarial eruption with subsequent vesiculopustules. Treatment is oral tetracycline plus intramuscular streptomycin. Prevention of brucellosis in humans is based on elimination of animal brucellosis. Immunization of animals is done using a live attenuated Brucella vaccine. 

The incubation period ranges from I to 2 weeks, with an average of 12 days. Rickettsia Canada cannot be directly transmitted from human to human, but it is a bloodbome pathogen, and universal precautions should be practiced. Victims are infective for hce from the time in which the febrile (fever) illness is present and for 2 to 3 days after the body temperatme returns to normal. Infection remains in the louse for 2 to 6 days after biting the source, although it may occur quicker if the louse is crushed. Symptoms include headache, chills, fever, prostration, and general pains. On the 5th or 6th day, a macular eruption (unraised spots on the skin) occurs on the upper trunk and spreads to the entire body (except for the face, palms of the hands, and soles of the feet). The illness lasts for approximately 2 weeks. Without treatment, the fatahty rate is about 10 to 40%. Treatment involves antibiotic therapy with tetracyclines and chloramphenicol. 

In patients who are already prone to acne, a chemical peel can exacerbate a break out. Shortly after the peel, multiple erythematous tender papules can ajjpear this is most commonly due to the emollient creams used during the healing phase of the treatment. Treating this can be difficult since most topical acne agents irritate sensitive skin which is recovering from a peel. Patients are best treated with oral antibiotics such as tetracycline (500 mg bid) or minocycline (100 mg bid) to improve the acne. These eruptions can be expected to resolve in about a week in most cases. 

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