Derm Lecture 3

Question 1

what is molluscum contagiosum?

Answer 1

a common pediatric virus caused by poxvirus, MCV-1 to -4

Question 2

what is molluscum contagiosum caused by? occurs in who?

Answer 2

poxvirus, MCV-1 to -4

occurs in kids

Question 3

molluscum contagiosum epidemiology

Answer 3

Primarily affects young children, sexually active adults and immunosuppressed

Question 4

molluscum contagiosum clinical features

Answer 4

Non-pruritic flesh colored dome shaped papules 3-6 mm and have central depression

Curd like material can be expressed

Question 5

where does molluscum contagiosum occur on the body?

Answer 5

Present anywhere, but classically over the face, trunk and extremities, and groin

Question 6

how is molluscum contagiosum transmitted? where does virus replicate?

Answer 6

Transmitted by direct skin to skin contact (most easily in pools), gym equipment, and spread by autoinoculation

Virus replicates in epithelial cells

Question 7

molluscum contagiosum dx

Answer 7

clinical exam/hx, punch biopsy

Question 8

molluscum contagiosum tx

Answer 8

usually not necessary b/c self-limited & resolves in few months to few years (body develops antibodies)

• Avoid autoinoculation or transmission to close contacts
• Common goal of diff txt methods is the destruction of the lesions

Txts are not FDA approved:

• Topical Cantharadin (topical irritant)
• Cryotherapy (liq nitrogen)

Question 9

molluscum contagiosum ddx

Answer 9

Warts (cauliflower appearance)

Milia (small collection of dead skin cells under the skin)

Question 10

Veruca Vulgaris (common wart) epidemiology

Answer 10

Most common ages 5-20 y/o

(develop antibodies to this strain and then don’t develop as much, which is why seen at young age & not older people)

Question 11

verruca vulgaris clinical features

Answer 11

Size is pinpoint to >1cm, papules with a rough grayish surface (“cauliflower type”; up close see finger like projections or papillae that stand up)

Question 12

verruca vulgaris location on the body

Answer 12

• Hands & palms and periungul, nail folds, bottoms of feet
• Risk with frequent exposure to water

Question 13

what is verruca vulgaris?

Answer 13

the common wart

Question 14

what causes verruca vulgaris?

Answer 14

HPV

Question 15

verruca vulgaris dx

Answer 15

clinical exam, punch biopsy (common to use for flat wart b/c can be hard to discern)

Question 16

is no tx for verruca vulgaris an option?

Answer 16

Yes, no txt is an option b/c 65% of warts regress spontaneously w/in 2 yrs, but pts risk warts that may enlarge or spread to other areas

Question 17

who is tx for verruca vulgaris recommended for?

Answer 17

-Txt recommended for pts w/extensive spreading, or symptomatic warts or warts that been present >2 yrs

Question 18

what are the txs for verruca vulgaris?

Answer 18

• Cryotherapy
• Salicyclic acid/Cantharidin (topical vesicans)
• Occlusive dressing (promotes inflammation and then body attacks wart/virus)
• Intralesional injection of Bleomycin (LAST RESORT - for someone w/HIV or immunosuppressed – injectable chemo med that causes cell death

Question 19

what is verruca plana?

Answer 19

flat wart

Question 20

verruca plana epidemiology

Answer 20

children and young adults

Question 21

verruca plana clinical features and location

Answer 21

2-4mm flat topped flesh colored papules

Location:
- Grouped together on face, neck, wrists, hands

Question 22

what causes verruca plana?

Answer 22

HPV

Question 23

dx of verruca plana?

Answer 23

clinical exam, punch biopsy (common to use for flat wart b/c can be hard to discern)

Question 24

tx for verruca plana?

Answer 24

same as verruca vulgaris

• cryotherapy
• salicyclic acid/cantaridin
• occlusive dressing
• intralesional injection of Bleomycin (LAST RESORT for someone w/HIV or immunosuppressed)***