Vesicular Dermatoses Flashcards
1
Q
Herpes Simplex 1
transmitted how?
A
- viral transmission
- contaminated saliva
- infected body secretions
2
Q
Herpes Simplex 1
Pathophys
A
- direct contact at mucosal or skin sites
- viral entry into upper dermis until it reaches sensory & autonomic nerve endings
3
Q
Herpes Simplex 1
clinical presentation of primary infection
2 components
A
- most commonly asx
- can cause tonsil pharyngitis or gingivostomatitis
4
Q
Herpes Simplex 1
clinical presentation of recurrent infection
2 components
A
- prodromal sx w/in 24 hrs of viral reactivation
- development of grouped vesicles on erythematous base
5
Q
Herpes Simplex 1
dx
A
PCR (most sensitive & specific)
6
Q
Herpes Simplex 1
tx
A
valacyclovir 2g BID x1d
7
Q
Herpes Simplex 2
affects what % of the population?
A
approx 25%
8
Q
Herpes Simplex 2
pathophys
A
- sexually transmitted via direct contact
- viral entry into upper dermis until it reaches sensory and autonomic nerve endings
9
Q
Herpes Simplex 2
clinical presentation
4 components
A
- prodrome sx
- painful genital ulcers
- vesicles which evolve to pustules
- (+/-) inguinal LAD
10
Q
Herpes Simplex 2
describe the vesicles
3 components
A
- multiple, shallow, tender, grouped
- 2-4mm in size
- erythemtous base
11
Q
Herpes Simplex 2
how do the vesicles progress?
A
- vesicles
- vesicle pustules, erosions, or alterations
12
Q
Herpes Simplex 2
dx
A
- PCR (most sens/spec)
- Tzanck smear (classic, but not specific)
13
Q
Herpes Simplex 2
what will you see on Tzanck smear?
A
multi-nucleated giant cells
14
Q
Herpes Simplex 2
tx options
A
- acyclovir
- valacyclovir
- famciclovir
15
Q
Herpes Zoster
reactivation of what?
A
latent varicella zoster virus infection
16
Q
Herpes Zoster
where does the virus lie dormant?
A
- dorsal root ganglia
- terminal ganglia
17
Q
Herpes Zoster
clinical presentation of prodrome
4
A
- fever
- malaise
- sensory changes
- rash
18
Q
Herpes Zoster
clinical presentation of rash
5 components
A
- unilateral
- vesicular dermatomal eruption
- painful, grouped vesicles
- erythematous base
- does not cross midline
19
Q
Herpes Zoster
clinical manifestation
2- PPP for boards
A
- thoracic and lumbar roots most commonly affected
20
Q
Herpes Zoster
dx
A
usually clinical
PCR as needed
21
Q
Herpes Zoster
Tx
A
- valacyclovir, acyclovir, famiciclovir w/in 72 hrs of sx onset
22
Q
Herpes Zoster
education to provide to pts on infectiousness
A
no longer infectious once lesions crust over
23
Q
Herpes Zoster
prophylaxis for immunocompromised pts
A
VZV immune globulin
24
Q
Herpes Zoster
prevention
A
- Shingrix vax
25
# Herpes Zoster
when to refer to opthalmology?
zoster on face/eyes
26
# Herpes Zoster
what does Shingrix vax reduce the risk of?
postherpetic neuralgia
27
# Atopic Dermatitis
1. rash due to what?
2. susceptible to what?
3. leading to what?
1. defective skin barrier
2. drying
3. pruritis, inflammation
28
# Atopic Dermatitis
atopic triad?
1. eczema
2. allergic rhinitis
3. asthma
29
# Atopic Dermatitis
triggers
| 4
1. heat
2. perspiration
3. allergens
4. contact irritants
30
# Atopic Dermatitis
pathophys
disruption of skin barrier due to filaggrin gene mutation and disordered immune response
31
# Atopic Dermatitis
dx
clinical
32
# Atopic Dermatitis
hallmark components of presentation
| 2
pruritis
xerosis
33
# Atopic Dermatitis
clinical maifestations of rash
1. erythematous
2. scaly
3. ill-defined papules or plaques
34
# Atopic Dermatitis
describe nummular clinical presentation
* sharply-defined discoid or circular coin-shaped lesions
* on hands, feet, extensor surfaces
35
# Atopic Dermatitis
tx
| mild/mod disease
1. topical corticosteroids w/ emollient
2. antihistamines for itching
36
# Atopic Dermatitis
tx
| moderate/severe disease
dupliumab
37
# Contact Dermatitis
pathophys of irritant rxn
nonummunologic rxn, immediate
38
# Contact Dermatitis
pathophys of allerng rxn
typer 4 hypersensitivity rxn
develops over time
39
# Contact Dermatitis
causes of irritant rxn
| 3
1. chemicals
2. alcohol
3. creams/lotions
40
# Contact Dermatitis
common causes of allergen rxn
| 5
1. nickel/metals
2. poison ivy
3. chemicals
4. detergent
5. cleaners
41
# Contact Dermatitis
dx
clinical
42
# Contact Dermatitis
what testing may be helpful to reduce potential allergens
patch testing
43
# Contact Dermatitis
clinical presentations
* erythematous papules or vesicles
* linear or geometric distribution
* associated w/ local pruritis, stinging, burning
44
# Contact Dermatitis
tx
avoid the irritant
topical corticosteroids + general measures
45
# Contact Dermatitis
general measures for tx
* cool compress
* oatmeal bath
* skin emollients
46
# Contact Dermatitis
tx for severe/extensive disease
1- day prednisone taper
47
# Dyshidrotic Eczema/Pompholyx
most commonly affects who?
young adults
48
# Dyshidrotic Eczema/Pompholyx
triggers
| 4
1. sweating
2. emotional stress
3. warm/humid weather
4. metals
49
# Dyshidrotic Eczema/Pompholyx
clinical manifestation
1. sudden onset of pruritic "tapioca like" small, tense vesicles
2. on hands, palms, or fingers
50
# Dyshidrotic Eczema/Pompholyx
how does rash progress?
* desiccation
* desquamation
* papules
* scaling
* lichenification
51
# Dyshidrotic Eczema/Pompholyx
dx
clinical
52
# Dyshidrotic Eczema/Pompholyx
tx
| mild, severe
* mild/moderate: topical corticosteroid ointment
* severe: PO corticosteroids, potent topical corticosteroid
53
# Dyshidrotic Eczema/Pompholyx
general measures
| 4
* lukewarm water
* fragrence free & sensitive skin produces
* gloves during household chores
* use emollients
54
# Impetigo
commonly found in who?
children
55
# Impetigo
risk factors
| 5
1. poor personal hygiene
2. poverty
3. crowding
4. warm/humid weather
5. skin trauma
56
# Impetigo
3 classifications
1. Non-bullous
2. Bullous
3. Ecthyma
57
# Impetigo
describe non-bullous presentation
| 5 components
* most common type
* typically caused by *S. aureus*
* papules, vesicles, pustules w/ weeping
* progress to: honey color, golden crust
* primarily on face & arms
58
# Impetigo
describe bullous clinical presentation
| 3 components
* commonly caused by *S. aureus*
* vesicles form large bulla rapidly which rupture
* ruptured bulla develop a thin, varnish-like curst
59
# Impetigo
ecthyma clinical presentation
| 3 components
* ulcerative pyoderma
* group a strep
* rare
60
# Impetigo
dx
clinical
61
# Impetigo
tx
| mild vs severe
1. mupirocin (TID, 10d)
2. extensive: cephalexin, dicloxacillin
62
# Impetigo
complications
| 2
1. cellulitis
2. acute glomerulonephritis
