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Derm > Viral Derm > Flashcards

Viral Derm Flashcards

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Dermatology Board Prep flashcards
1
Q

HPV/Verrucae confined to where?

A
  • epithelium

- They hijack the keratin for their own purposes and reproduce

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2
Q

transmission of HPV

A

auto-inoculation, contact, contagious

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3
Q

incubation period of HPV

A

incubation period 2-18 months

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4
Q

Epidemiology of HPV

  • age
  • prevalence
A
  • any age, most common 12-16yo
  • 16% general population
  • common in pts. on immunosuppressive drugs, lymphoma
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5
Q

differential diagnoses forHPV

A

corns, calluses, skin tags, carcinoma, syphilis

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6
Q

verruca vulgaris

A

flesh colored warts, with papillate, hyperkeratotic surface

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7
Q

Verruca vulgaris (plantar)

A

plantar warts, common in communal showers

-painful

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8
Q

verruca plana

A

flat warts are pink, light brown or tan

-forehead, mouth, etc

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9
Q

HPV impact

A
  • major cause of cervical cancer
  • men are asymptomatic carriers
  • gardasil for prevention
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10
Q

HPV: Condyloma Acuminata

A
  • veneral warts
  • most common viral STD in the world
  • incubation avg 3 mos
  • most infections are transient and clear within 2 yrs
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11
Q

Condyloma acuminata presentation

A

usually asymptomatic/ painless

-plantar warts can be painful

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12
Q

risk factors for condyloma acuminata

A

sexual activity, # partners, types of sex, HIV status

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13
Q

Diagnosis for condyloma acuminata

A
  • warts dx usually clinical
  • aceto-whitening
  • colposcopy, anoscopy
  • pap smear
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14
Q

treatment for condyloma acuminata

A

cryosurgery, electrosurgical excision (LEEP)

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15
Q

Provider administered treatments for HPV warts/ condyloma acuminata

A
  • cryocautery (liquid nitrogen freeze)
  • electro-dissection and curettage (scarring concern)
  • laser
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16
Q

patient administered treatments for condyloma acuminata

A

-podophyllin, trichloroacetic acid (compound W), home remedies

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17
Q

Filiform warts

A

put picture here

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18
Q

Pearly penile papules (PPP)

A

NOT a wart,
don’t treat,
leave them alone –it’s a normal variant

19
Q

Molluscum contagiosum

A

Discrete, flesh colored, 2-5mm dome shaped, UMBILICATED papules

  • very common pox virus
  • incubation-2 wk to 2mos
  • self limiting 6-9mos
20
Q

molluscum contagiosum

contraction?

A

direct skin contact, fomites, autoinoculation

21
Q

Molluscum contagiosum dx and tx

A

usually clinical dx by visual inspection

  • conservative treatment preferred
  • may need cryotherapy, curettage
22
Q

Herpes! HSV-1 and HSV-2

-epidemiology

A

common!

  • HSV 1 in childhood
  • HSV2 after sexual activity
23
Q

Pathogenesis of HSV-1

A

(DNA virus)
-usually spread through close contact of oral secretions and genital herpes is usually spread through oral-genital contact

24
Q

pathogenesis of HSV-2

A

primarily spread through contact with genital secretions/tissues

25
Q

HSV-1 associated with which location of lesions

A

oral lesions

26
Q

HSV-2 associated with which location of lesions

A

genital lesions

27
Q

primary infection of Herpes

A

established in root ganglion

28
Q

most common blister lesions are caused by what

A

herpes

29
Q

secondary phase of herpes

A

recurrent disease at same site

30
Q

HSV concepts

A

latency/recurrence, viral shedding, incurable

  • a lot of asymptomatic viral shedding
  • start to shed 4-5 days prior to outbreak
31
Q

Classic clinical features of HSV

A
  • highly variable
  • prodrome, malasia
  • eruption of superficial, pain, sometimes itchy, clustered vesicles (*blister)
  • turn to pustules than ulcerate and scab
  • may have lymphadenopathy
  • primary outbreak most painful
  • secondary outbreak shorter
  • contagious
32
Q

Clinical features of HSV (not classical features, but realistic features)

A

-90% of pts. test HSV-2+, have no symptoms!

33
Q

Recurrent infections of HSV

A

shorter, milder

  • male more likely to infect female than vice versa
  • 7-% during asymptomatic viral shedding
34
Q

Herpes diagnosis

A
  • H&P
  • Tzanck smear (but nobody does it anymore)
  • viral culture
  • serology to distinguish 1&2 Abs
35
Q

Herpes differential

A
  • chancroid
  • aphthous ulcer
  • herpangina
  • syphilis
  • impetigo
36
Q

Herpes tx

A
  • acyclovir/antivirals in acute phase
    - decreases viral excretion, new lesion formation and vesicles, &promotes healing
  • possible prophylactic antivirals for recurrent disease
37
Q

ophthalmic herpes

A

refer to ophthalmologist!

38
Q

Herpetic whitlow

A

around fingernail-see picture

39
Q

Varicella

A
  • chickenpox
  • highly contagious, vaccine for children
  • causes VESICULAR eruption usually on torso
  • progresses to crusted
40
Q

Herpes Zoster

A
  • Shingles

- Increases with age

41
Q

Clinical presentation of Herpes Zoster

A
  • dew drops on a rose petal
  • promdrome itch tingling then severe sharp pain
  • radicular pain in a dermatomal distribution
  • unilateral involvement (virtually never crosses the midline)
42
Q

Zoster Diagnosis

A

inspection, Tzank smear, rising Ab titer

43
Q

Zoster Therapy

A
  • antivirals
  • dry the lesion
  • prevent secondary pain syndrome complications
  • vaccine >50yo

Derm (8 decks)

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