Epidemiology of HPV - age - prevalence

- any age, most common 12-16yo - 16% general population - common in pts. on immunosuppressive drugs, lymphoma

- major cause of cervical cancer - men are asymptomatic carriers - gardasil for prevention

Viral Derm Flashcards by Ann C

HPV/Verrucae confined to where?

epithelium

- They hijack the keratin for their own purposes and reproduce

How well did you know this?

Not at all

Perfectly

transmission of HPV

auto-inoculation, contact, contagious

How well did you know this?

Not at all

Perfectly

incubation period of HPV

incubation period 2-18 months

How well did you know this?

Not at all

Perfectly

Epidemiology of HPV

age
prevalence

any age, most common 12-16yo
16% general population
common in pts. on immunosuppressive drugs, lymphoma

How well did you know this?

Not at all

Perfectly

differential diagnoses forHPV

corns, calluses, skin tags, carcinoma, syphilis

How well did you know this?

Not at all

Perfectly

verruca vulgaris

flesh colored warts, with papillate, hyperkeratotic surface

How well did you know this?

Not at all

Perfectly

Verruca vulgaris (plantar)

plantar warts, common in communal showers

-painful

How well did you know this?

Not at all

Perfectly

verruca plana

flat warts are pink, light brown or tan

-forehead, mouth, etc

How well did you know this?

Not at all

Perfectly

HPV impact

major cause of cervical cancer
men are asymptomatic carriers
gardasil for prevention

How well did you know this?

Not at all

Perfectly

HPV: Condyloma Acuminata

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

How well did you know this?

Not at all

Perfectly

Condyloma acuminata presentation

usually asymptomatic/ painless

-plantar warts can be painful

How well did you know this?

Not at all

Perfectly

risk factors for condyloma acuminata

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

How well did you know this?

Not at all

Perfectly

Diagnosis for condyloma acuminata

warts dx usually clinical
aceto-whitening
colposcopy, anoscopy
pap smear

How well did you know this?

Not at all

Perfectly

treatment for condyloma acuminata

cryosurgery, electrosurgical excision (LEEP)

How well did you know this?

Not at all

Perfectly

Provider administered treatments for HPV warts/ condyloma acuminata

cryocautery (liquid nitrogen freeze)
electro-dissection and curettage (scarring concern)
laser

How well did you know this?

Not at all

Perfectly

patient administered treatments for condyloma acuminata

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

How well did you know this?

Not at all

Perfectly

Filiform warts

put picture here

How well did you know this?

Not at all

Perfectly

Pearly penile papules (PPP)

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

Molluscum contagiosum

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

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

molluscum contagiosum

contraction?

direct skin contact, fomites, autoinoculation

Molluscum contagiosum dx and tx

usually clinical dx by visual inspection

conservative treatment preferred
may need cryotherapy, curettage

Herpes! HSV-1 and HSV-2

-epidemiology

common!

HSV 1 in childhood
HSV2 after sexual activity

Pathogenesis of HSV-1

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

pathogenesis of HSV-2

primarily spread through contact with genital secretions/tissues

HSV-1 associated with which location of lesions

oral lesions

HSV-2 associated with which location of lesions

genital lesions

primary infection of Herpes

established in root ganglion

most common blister lesions are caused by what

herpes

secondary phase of herpes

recurrent disease at same site

HSV concepts

latency/recurrence, viral shedding, incurable - a lot of asymptomatic viral shedding - start to shed 4-5 days prior to outbreak

Classic clinical features of HSV

- 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

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

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

Recurrent infections of HSV

shorter, milder - male more likely to infect female than vice versa - 7-% during asymptomatic viral shedding

Herpes diagnosis

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

Herpes differential

- chancroid - aphthous ulcer - herpangina - syphilis - impetigo

Herpes tx

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

ophthalmic herpes

refer to ophthalmologist!

Herpetic whitlow

around fingernail-see picture

Varicella

- chickenpox - highly contagious, vaccine for children - causes VESICULAR eruption usually on torso - progresses to crusted

Herpes Zoster

- Shingles | - Increases with age

Clinical presentation of Herpes Zoster

- 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)

Zoster Diagnosis

inspection, Tzank smear, rising Ab titer

Zoster Therapy

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