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Skin is composed of an outermost, avascular layer of epidermis with an inner layer of dermis made up of elastic tissue, collagen, and reticular fibers. Subcutaneous tissue includes fat cells, connective tissue, and muscle. Blood vessels pass through subcutaneous tissues to reach the dermis (Figure 45–1).

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Bacterial skin and skin structure infections (SSIs) can be subdivided into two groups: superficial and deep (Figure 45–1). Superficial infections tend to evolve from local spread of organisms, but can also represent circulating toxin-mediated disease. Common superficial infections include impetigo, folliculitis, carbuncles, furuncles, paronychia, cellulitis, and erysipelas (Table 45–1). Deeper infections include abscess and pyomyositis and instead tend to arise by the hematogenous spread of organisms from a distant site. This chapter will review cellulitis, cutaneous abscess, and pyomyositis (Table 45–2).

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Table 45–1. Common Superficial Skin and Skin Structure Infections
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Table 45–2. Etiology of Skin and Skin Structure Infections

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