Tuesday - Westra - Inflammatory blistering diseases

Question 1

What anti-viral do you give to someone with herpes simplex?

Answer 1

Zovirax, acyclovir

Question 2

Herpes simplex 1 vs 2

Answer 2

1 - get during childhood via non sexual contact. 90% cause facial lesions call herpes labialis.

2 - Lifelong, recurrant. VIRAL CULTURE PREFERRED DIAGNOSIS

Question 3

Herpes Varicella

Answer 3

Chicken pox, zoster virus.
Prodrome: fever, chills, malaise.
HALLMARK: dew drop on rose pedal
spread by respiratory droplets
2-3 week incubation period

Question 4

Major complications with chicken pox

Answer 4

encephalitis, pneumonia, hepatitis, reye’s syndrome

Question 5

Key hallmarks of shingles

Answer 5

Only one dermatome, unilateral.
prodrome: pain along nerve root up to 5 days prior to rash
Dissemination: then it isn’t due to ummunosuppression

Question 6

Hutchenson’s sign

Answer 6

When shingles appears on the tip of the nose, you are more likely to have eye complicaiton.

Question 7

How to immunize against shingles?

Answer 7

Zostavax

Question 8

Non - bullous impetigo

Answer 8

caused by Strep pyogenes, staph aureus, most common type of impetigo.

small vesicle ruptures, and rapidly becomes an erosion with honey colored crusts

Question 9

Bullous pemphigoid. Age? What is treatment?

Answer 9

IgG at bottom of basement membrane, destruction of hemidesmosomes. erythematous bubbles. 60-80 years.

prednisone, oral.

Question 10

Dermatitis herpetiformis. Age?

Answer 10

autoimmune. associated with celiac. most patients are between 20 and 40.

Question 11

Pemphigous vulgaris

Answer 11

destruction of desmosomes (autoimmune). rare. Nikolsky sign (top layers of skin slip away from lower layers when slightly rubbed, may create blister). 40-60 years.

Question 12

porphyria cutanea tarda

Answer 12

Deficiency in heme - synthesizing enzyme.
Blisters on skin in sun-exposed areas.
hyperpigmentation