Benign Skin Lesions and Viral Infections of Skin Flashcards
warts HPV
-caused by virus (HPV)
-many genotypes
-some may be oncogenic 16-18-31-33
-common in children- sports with mats and bare feet -> foamites
-most people’s immune system can recognize and fight virus
-those can cant…
-condyloma accuminatum
-plantar (foot) and acral (Hand) mostly caused by HPV type 1, 2, and 4
-genital mostly types 6 and 7
-virus needs entry point-> break in barrier
genital warts
-dry
-keratotic
-irregular
-friable
warts- cancer
-we dont like to ignore them -> some can turn into SCC
-types 16, 18, 31, and 33 may be precursor to cancers anal, cervical, and mouth cancers**
-cervical cancer 4th mc cancer in women types 16 and 18
-some may be oncogenic 16-18-31-33
sun damage
-mostly when a kid
-cumulative
warts treatment
-many ways to treat -> acids, lasers, ED&C (electrodessication curettage)
-treatment varies based on size and location
-can spontaneously resolve- immune system
-remain for years
-genital warts = men treat- women refer
-irritate the skin to start inflammatory cascade
-irritate- with acids, lazers, glue, banana peels (organic matter -> acid -> irritant ), garlic, liquid nitrogen, cantharidin (outer layer of beetle), surgery
-high dose oral cimetidine besides being an H2 blocker is known to stimulate T cells -> useful for wide spread warts
-salicylic acid- internal female warts
warts: black dot in center***
-thrombosed capillaries
-pathognomonic for warts
-not all have them
management of genital warts
-imiquimode cream- immune response modifier
-podophylin- not in pregnancy
-condylox gel or solution- not in pregnancy
-LN2
-veregen ointment (gree tea extract)- not in pregnancy, lactating women or children
-men we treat
-women we refer to GYN
onicolysis
-nails come off nailbed
-fungus can get under
prevention of genital warts
-dont have sex
-have safe sex
-vaccines:
-gardasil HPV types 6 and 11 - covers 90%
-also covers 16 and 18 31 33 35 52 58
molluscum contagiosum
-benign member of POX VIRUS- NOT A WART*
-lesions that appear anywhere on body
-white, pink or flesh colored
-umbilicated- central umbilication
-abdomen and buttocks - can spread everywhere
-itchy, RED sore and swollen
-looks like little seed in the center
-highly contagious **
-pediatric ninja
molluscum treatment
-cryotherapy - hurts
-cantharone
-podophyllin
-acids
-retin A
-imiquimod
zoster
-reactivation of chickenpox virus
-virus lives in the dorsal nerve root and becomes activated
-stress?
-illness
-immunocompromised
-infection follows lines of Langer
-rarely crosses midline**
-vesicles that develop on tip or side of nose - Hutchinson’s sign
-tiny vesicles that can be filled with fluid- virus is in the fluid
-tingling, painful
Ramsey Hunt Syndrome
-zoster on the face
-facial palsy
-ear, tympanic membrane with or without tinnitus
- vertigo and deafness
zoster dx
-immuno compromised
-most of time its clinical dx but bx if unsure
-tzank smear- not diagnostic -> cant differentiate between herpes
-culture, and PCR testing more specific for Zoster -> PCR preferred
zoster tx
-famcyclovir 500mg po q8 hrs x 7 days
-acyclovir 800mg po q 4 hrs x 7-10 days
-valacyclovir 1000mg po q3x a day x 7 days
-pain meds prn
-vaccine- shingrix
-treat quickly
PHN- post herpetic neuralgia
-worst consequence of shingles
-can go on for years
-painful
-NSAID
HSV 1 and 2
-dormant in dorsal nerve root ganglia (like shingles)
-double stranded DNA viruses that cause primary, latent and recurrent infections*
-can occur anywhere on the body
-pay attention to tingling sensation
-painful vesicles with crusting
-virus is in the fluid -> spread on urself
-oral and topical antivirals effective if given within first 72 hrs
HSV 1
-most people have been exposed
-skin to skin contact
-viral shedding when there are no active sores -> why so many people have been exposed
-kissing, sharing utensils
-can be anywhere
whitlow
-lesion on finger
-caused by herpes
HSV 2
-20% sexually active adults carry
-female
-have other sexually transmitted diseases
-weakened immune system
HSV triggers
-stress
-illness
-fever
-sun exposure
-menstruation
-surgery
-prophylaxes with antiviral before laser treatment
HSV medication
-topical anti virals- acyclovir ointment, docosanol cream, pencyclovir cream
-oral and antivirals- acyclovir, famcyclovir, valcyclovir
