Vesicular rashes Flashcards
Hand, foot and mouth disease:
Pathogen?
Type of rash and where?
Other symptoms
Management? School?
Coxsackie A16
Vesicular rash on mouth, palms and soles
Fever, sore throat and child miserable
Keep out of school if unwell
Return if feeling better and rash still there
Chicken Pox:
Pathogen
Incubation
When infectious?
Varicella zosyer borius (VZV, human herpes virus 3)
1 - 3 weeks
2 days before
5 days after symptoms start
Chicken Pox:
Disease pattern - what type of lesions?
Where
What type of prodrome and for how long?
Crops of papules then vesicles then pustules then crust
Starts on head, trunk and/or back then spreads to peripheries
Fever 2 days
Chicken Pox:
Management:
- What most common?
- Analgesia/antipyresis?
- What about for neonates, the immunosupressed or those at risk of complications (e.g. CVD or lung diseases)?
Conservative for most
Paracetamol preferred
NSAID’s increase the risk of servere skin and soft tissure complications
Antivaricella-zoster immunoglobulin (VZIG) plus aciclovir
Chicken Pox:
Complications
Acute
Long term
Obstetric
Secondary bacterial infection - Staph aureus or group A strep
Encephalitis
Pneumonia
DIC
Shingles
Fetal problems in first 20 wks - limb hypoplasia, microcephaly and cataracts
Give VZIG if previously unexposded woman is exposded and VZV IgG is negative and it is less than 10 days
Other cutaneuous herpes simplex:
HSV1 - how it enters?
HSV2 - what it cuases in adults
What is one feature of herpes simplex viruses?
Skin and mucosa
Genital herpes
Reactivation of latent virus
Other cutaneuous herpes simplex:
Signs and symptoms:
- Oral herpes
- Systemic
- What is eczema herpeticum?
- What is herpetic whitlows?
Painful vesicles in mouth (primary infection)
Painful vesicles on lips (secondary infection)
Fever
Irritable
Miserable
Vesicels on pre-existing eczema
Painful red pustules on fingers
Other cutaneuous herpes simplex:
Management
- Topical
- Analgesia - types (especially for children)
Topical aciclover but most don’t need treatment
Analgesia for pain or topical local anatheisia - benzydamine
Spray or mouthwash for children
Impetigo:
What is it?
Pathogen?
Where does it occur?
What makes this worth knowing about?
Superficial infection of the epidermis
Staph aureus / group A strep (less common)
Broken skin
Commonest bacterial skin infection in children
Impetigo:
Where?
Type of rash?
Another feature with lymph nodes?
Usually face
Pustules that rupture and leave yellow-brown plaques
Regional lymphadenopathy
Impetigo:
Rx:
- Topical
- What if widespread?
- When to go back to school?
Topical fusidic acid and crust should be removed in bath for proper penetration
Flucloxacillin PO if widespread
When lesions crust over
What is Bullous impetigo?
Where?
Rarer, form
Flaccid, transparent bullae which easily rupture
Usually on limbs, trunks, buttocks or face
Viral warts:
Pathogens
Where are the warts?
Management
- what if they persist?
Human papilloma virus
Warts usually occur on fingers or soles
Usually conservative
Cosmetic concern - cover with tape, salycylic acid, cyrotherapy, cautery