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Fall 2014 - CM Dermatology > Viral Derm > Flashcards

Viral Derm Flashcards

1
Q

ERYTHEMA INFECTIOSUM

  1. Definition
  2. Etiology
A
  1. childhood exanthem, 5ths disease

2. parvovirus B19 (highly contagious, droplet spread)

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2
Q

ERYTHEMA INFECTIOSUM

  1. Predisposing conditions
  2. Clinical features
A
  1. exposure, late winter/early spring, community outbreaks
  2. incubated 4-14 days; prodrome (fever, malaise, HA, coryza) followed by burning, hot “slapped cheek” then generalized reticular rash 1-6 weeks; adult women may have arthralgia or be asymptomatic
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3
Q

ERYTHEMA INFECTIOSUM

  1. Diagnosis
  2. Differential diagnosis
A
  1. appearance, serology

2. rubella, rubeola, scarlet fever, roseola, drug reaction, rheumatoid arthritis

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4
Q

ERYTHEMA INFECTIOSUM

  1. Treatment
  2. Complications
A
  1. supportive (lasts a few days-weeks), NOT contagious once rash appears
  2. recurrence; triggers - sun, exercise, bathing, stress; miscarriage, hydrops fatalis in pregnancy
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5
Q

HAND, FOOT & MOUTH DISEASE

  1. Definition
  2. Etiology
A
  1. short-lived contagious viral infection

2. Coxsackie A16 virus or enterovirus 71

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6
Q

HAND, FOOT & MOUTH DISEASE

  1. Predisposing conditions
  2. Clinical features
A
  1. late summer/early fall, kids under 5, household contacts, passed by direct contact w/ nasal or oral secretions
  2. 4-6 day incubation then small vesicles form in mouth; rhomboid/square yellow vesicles appear on hands, feet, buttvesicles –> bullae –> erosions, 7-10 days w/o complications
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7
Q

HAND, FOOT & MOUTH DISEASE

  1. Diagnosis
  2. Differential diagnosis
A
  1. serology, clinical presentation

2. herpangina, aphthous stomatitis, herpes simplex

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8
Q

HAND, FOOT & MOUTH DISEASE

  1. Treatment
  2. Complications
A
  1. symptomatic; recurrence rare; isolate kids 3-7 days to prevent spread
  2. rare; miscarriage; fetal growth retardation in pregnancy
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9
Q

HERPES SIMPLEX

  1. Definition
  2. Etiology
A
  1. acute, self-limiting viral infection involving skin and mucus membranes
  2. herpes simplex virus 1 and 2
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10
Q

HERPES SIMPLEX

  1. Predisposing conditions
  2. Clinical features
A
  1. direct contact; droplet infection; open skin
  2. primary infection: acute development of grouped macules to painful vesicles that erode to crusts; prodrome possible; lesions resolve 2-6 weeks; lies dormant in DRG; many asymptomaticsecondary infect: reactivation of virus; travels through peripheral nerves; predisposed by menses, fatigue, trauma, stress; fewer localized vesicles; prodrome rare
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11
Q

HERPES SIMPLEX

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation, PCR, Tzanck smear/culture, serum assay
  2. herpes zoster, herpes gladiatorum
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12
Q

HERPES SIMPLEX

  1. Treatment
  2. Complications
A
  1. symptomatic, topical/PO antivirals, L-lysine
  2. disseminated herpes simplex, herpetic whitlow (herpes on fingers that can cause circulation problems), erythema multiforme, Bell’s palsy
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13
Q

VARICELLA

  1. Definition
  2. Etiology
A
  1. highly contagious viral infection resulting in lifelong immunity; chickenpox
  2. varicella zoster virus (herpesvirus 3)
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14
Q

VARICELLA

  1. Predisposing conditions
  2. Clinical features
A
  1. exposure, immunosuppression
  2. 10-23 day incubation; contagiousness HI 2 days before symptoms until all crust; prodrome 1-2 days; crops of pruritic macules that become teardrop vesicles; surrounding erythema; crust over 6-8 hours; drop off within 1 week”dew drop on a rose petal”
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15
Q

VARICELLA

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation, PCR, culture, Tzanck smear, serology
  2. bullous impetigo, disseminated HSV, folliculitis, impetigo, measles
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16
Q

VARICELLA

  1. Treatment
  2. Complications
  3. Prevention
A
  1. symptomatic in uncomplicated cases; antiviral agents if indicated
  2. hemorrhagic varicella, 2ary infection, encephalitis, pneumonia, myocarditis, hepatitis, acute hemorrhagic nephritis; can spread in utero during pregnancy; 30% mortality to newborwns
  3. childhood immunization
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17
Q

HERPES ZOSTER

  1. Definition
  2. Etiology
A
  1. acute, unilateral, localized infection usually involving a single dermatome
  2. reactivation of varicella zoster
18
Q

HERPES ZOSTER

  1. Predisposing conditions
  2. Clinical features
A
  1. immunosuppression, localized trauma, increased age (70+), lymphoma/malignancy, radiation/chemo, steroids, stress
  2. 3-5 days localized painful symptoms; red macule rapidly becomes papular then vesicular; surrounding erythema; vesicles group over 2-3 weeks become pustular then scab; scabs fall off and leave white scar; constitutional symptoms may precede eruption
19
Q

HERPES ZOSTER

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical presentation, PCR, Tzanck smear, serology, culture
  2. HSV, contact dermatitis
20
Q

HERPES ZOSTER

  1. Treatment
  2. Complications
  3. Prevention
A
  1. PO antiviral, gabapentin, rest, topical analgesics; steroids?; sympathetic blocks
  2. post-herpetic neuralgia, disseminated herpes zoster, Ramsey-Hunt’s syndrome, herpes zoster ophthalmicus (pt should see eye doc right away), Bell’s palsy, cerebellitis
  3. vaccine > 60yrs
21
Q

MOLLUSCUM CONTAGIOSUM

  1. Definition
  2. Etiology
A
  1. self-limiting mucocutaneous viral infection

2. poxvirus

22
Q

MOLLUSCUM CONTAGIOSUM

  1. Predisposing conditions
  2. Clinical features
A
  1. swimming pools, children, communal bathing, atopic dermatitis, close contact, autoinoculation, HIV
  2. asymptomatic skin-colored papule; dome-shaped with central punctum (umbilicus); can occur anywhere
23
Q

MOLLUSCUM CONTAGIOSUM

  1. Diagnosis
  2. Differential diagnosis
A
  1. clinical features, biopsy, microscopic eval of central core
  2. keratoacanthoma, basal cell carcinoma, flat/genital warts, herpes
24
Q

MOLLUSCUM CONTAGIOSUM

  1. Treatment
  2. Complications
A
  1. supportive; topical tretinoin (RetinA); Aldara, Cantharidin, liquid N2; surgical/destructive treatment in genital region
  2. rare, scarring, can induce dermatitis
25
Q

MEASLES (Rubeola)

  1. Definition
  2. Etiology
A
  1. highly contagious childhood viral infection

2. paramyxovirus group

26
Q

MEASLES (Rubeola)

  1. Predisposing conditions
  2. Clinical features
A
  1. densely populated and socioeconomically depressed areas; winter/spring
  2. 10-15 day incubation then prodrome of 3 Cs (cough, coryza, conjunctivitis); “Koplik spots” (blue white) on buccal mucosa during prodrome then disappear at peak of rash; red macules, papules begin 4th day on face/neck/behind ears; spread to trunk and limbs 3-4 days; lesions coalesce then clear in 3 days and leave behind brown stain
27
Q

MEASLES (Rubeola)

  1. Diagnosis
  2. Differential diagnosis
A
  1. antibody titers, clinical presentation

2. viral exanthem, scarlet fever, drug eruption, rubella, mono

28
Q

MEASLES (Rubeola)

  1. Treatment
  2. Complications
  3. Prevention
A
  1. symptomatic, antibiotics if 2ary infection develops
  2. 2ary bacterial infection, post-infectious encephalitis, myocarditis, viral pneumonitis, OM, GI problems, glomerulonephritis
  3. live-attenuated vaccine
29
Q

RUBELLA (German measles, 3 day measles)

  1. Definition
  2. Etiology
A
  1. common viral infection affecting skin, lymph nodes and joints
  2. togavirus
30
Q

RUBELLA (German measles, 3 day measles)

  1. Predisposing conditions
  2. Clinical features
A
  1. lack of proper immunizations, springtime
  2. incubation 14-21 days followed by prodrome (malaise, fever, HA etc); very small pink macules with prodrome begin on face/scalp and spread downward; become papular then desquamate; papules fade in 3 days; red petechiae occur on soft palate (Forchheimer spots)
31
Q

RUBELLA (German measles, 3 day measles)

  1. Diagnosis
  2. Differential diagnosis
A
  1. antibody titers, clinical presentation

2. viral exanthem, measles, scarlet fever, drug eruption

32
Q

RUBELLA (German measles, 3 day measles)

  1. Treatment
  2. Complications
  3. Prevention
A
  1. symptomatic
  2. threat to unborn child (miscarriage, stillbirth

)3. MMR immunization

33
Q

ROSEOLA INFANTUM

  1. Definition
  2. Etiology
A
  1. childhood exanthem AKA exanthem subitum, 6th disease

2. HHV-6 or HHV-7

34
Q

ROSEOLA INFANTUM

  1. Predisposing conditions
  2. Clinical features
A
  1. exposure, 6-24 months old, otherwise healthy
  2. no URI sxs, incubation 5-15 days, high fever each night x3 days followed by pink maculopapular rash on trunk and neck 3-4 days later; febrile seizures common
35
Q

ROSEOLA INFANTUM

  1. Diagnosis
  2. Differential diagnosis
  3. Treatment
A
  1. clinical presentation, cultures, serology
  2. rubella, rubeola, erythema infectiosum, scarlet fever
  3. supportive
36
Q

WARTS

  1. Definition
  2. Etiology
A
  1. common viral infection of skin and mucus membranes

2. human papilloma virus

37
Q

WARTS

  1. Predisposing conditions
  2. Clinical features
A
  1. localized trauma, immunosuppression, communal bathing
  2. Common: skin colored, pink, thrombosed capillaries; papules smooth then rough; hands or other body areas
    Plane/Flat: skin colored, pink; smooth plaque; face, hands, limbs
    Plantar: skin colored, thrombosed capillaries; raised, rough; feet
    Mosaic: skin colored, thrombosed capillaries; rough plaque; soles, heels, palmar, periungual (along skin of nails)
38
Q

WARTS

  1. Diagnosis
  2. Differential diagnosis
A
  1. appearance, clinical presentation, disruption of skin lines
  2. seborrheic dermatitis, squamous cell carcinoma, melanoma
39
Q

WARTS

  1. Treatment
  2. Complications
  3. Prevention
A
  1. spontaneous involution; physical (duct tape, liquid N2, excision); chemical (tretinoin, cantharidin); immunotherapy (imiquimod); phototherapy; chemotherapy (5-FU, bleomycin)
  2. recurrence, spread to contacts/self, extension to treatment periphery
  3. keep surfaces clean/dry, aqua socks/flip flips in common areas
40
Q

a

Fall 2014 - CM Dermatology (11 decks)

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