Viral Disorders of skin Flashcards
Other names for Erythema Infectiosum?
-5ths disease -Slapped-cheek disease
Viral cause of Erythema Infectiosum?
Parvovirus B19
Predisposing conditions for Erythema infectiosum?
-Exposure -Late winter/early spring -Community outbreak
Treatment for Erythema infectiosum?
Supportive (NOT contagious once rash appears)
How long does Erythema infectiosum usually last?
A few days to several weeks
Clinical features of Erythema infectiosum? (In order of appearance)
-Incubation period of 4-14 days -Prodrome -burning, hot “slapped-cheek” -generalized reticular rash -may be asymptomatic
Complications with Erythema infectiosum?
-Recurrance (triggers: sun, exercise, bathing, stress) -Miscarriage -Hydrops fatalis in pregnancy
Definition of Hand, Foot, & Mouth Disease?
short-lived, contagious viral infection
Viral cause of Hand, Foot, & Mouth Disease?
-Coxsackie A 16 Virus -Enterovirus 71
Predisposing conditions of Hand, Foot, & Mouth Disease?
-Late summer/early fall -Children <5 -Household Contacts
Clinical features of Hand, Foot, & Mouth Disease? (in order of appearance)
-4-6 day incubation period -small vesicles form in mouth -square, yellow vesicles appear on hands, feet, and buttocks -vesicles –> bullae –> erosions
How long does Hand, Foot, & Mouth disease usually last?
7-10 days without complications
Treatment for Hand, Foot, & Mouth disease?
Symptomatic
Complications with Hand, Foot, & Mouth disease?
-Rare -Miscarriage -Fetal growth retardation
Definition of Herpes Simplex Virus?
Acute viral infection involving skin and mucous membranes
Viral cause of Herpes Simplex?
Herpes Simplex Virus 1 & 2
Predisposing conditions for Herpes Simplex?
-Direct contact -Droplet infection -Open skin
Clinical features for primary infection of Herpes simplex?
-Acute development of grouped macules –> painful vesicles –> eroding to crusts -possible prodrome -lymphadenopathy -lies dormant in dorsal root ganglia -many are asymptomatic
Clinical features for secondary infection of Herpes simplex?
-Reactivation of virus -Travels thru peripheral nerves -Predisposed via menses, fatigue, stress, trauma, sunlight -Fewer vesicles; localized -Rarely associated w/ constitutional symptoms
Where is Herpes simplex - primary infection - mostly manifested?
Facial/oral
Where is Herpes simplex - secondary infection - mostly manifested?
Genitalia
Treatment for Herpes simplex?
-Symptomatic -Topical/PO antivirals
Complications with Herpes simplex?
-Disseminated herpes simplex -herpetic whitlow -erythema multiforme
How to diagnose Herpes simplex?
-Clinical presentation -PCR -Tzanck smear -Serum assay
Definition of Varicella?
highly contagious viral infection resulting in lifelong immunity
Viral cause of Varicella?
Varicella zoster virus (Herpes virus 3)
Predisposing conditions to Varicella?
- Exposure
- Immunosuppression
Clinical features of Varicella?
- 10-23 day incubation period
- HIGH contagiousness level
- Prodrome for 1-2 days
- Crops of pruritic macules –> teardrop vesicles –> crust over w/in 6-8 hours
- Surrounding erythema
Treatment for Varicella?
- symptomatic in uncomplicated cases
- antiviral agents if indicated
Distinguishing phrase for Varicella?
‘Dew drop on a rose petal’
Complications of Varicella?
- Hemorrhagic varicella
- Secondary infection
- Encephalitis
- Pneumonia
- Myocarditis
- Hepatitis
- Can spread in utero during pregancy
- 30% mortality to newborns
Definition of Herpes Zoster (Shingles)?
acute, unilateral, localized infection usually involving a single dermatome
Viral cause of Herpes zoster?
Reactivation of varicella zoster virus
Predisposing conditions for Herpes Zoster?
- Immunosuppression
- Localized trauma
- increased age (>70)
- lymphoma/malignancy
- radiation/chemotherapy
- steroids
- stress
Clinical features of Herpes Zoster?
- 3-5 days of localized symptoms (PAINFUL)
- Red macule –> papular –> vesicular
- Surrounded by erythema
- Vesicles group over 2-3 weeks, become pustular, scab over
- Scabs fall off, leave white scar
- Fever, chills, etc. may precede eruption
Treatment for Herpes Zoster?
- PO Antiviral
- Gabapentin (nerve pain modulator)
- rest
- topical analgesics
- steroids
- sympathetic blocks
Complications with Herpes Zoster?
- post-herpetic neuralgia
- disseminated herpes zoster
- Ramsey-Hunt’s syndrome
- Herpes zoster ophthalmicus (can lead to blindness)
- Bell’s palsy
- cerebellitis
Prevention for Herpes Zoster?
Vaccine (must be >60 years)
Prevention for Varicella?
Childhood immunization (>12 mo.)
Definition of Molluscum Contagiosum?
self-limiting mucocutaneous viral infection
Viral cause of Molluscum Contagiosum?
Poxvirus
Predisposing conditions to Molluscum Contagiosum?
- Swimming pools
- children
- communal bathing
- atopic dermatitis
- close contact
- autoinoculation
Clinical features of Molluscum Contagiosum?
- Asymptomatic skin-colored papule
- dome-shaped w/ central punctum
Treatment for Molluscum Contagiosum?
- Supportive
- topical tretinoin
- Aldara (immune modulator)
- Cantharidin (erodes area)
- liquid N2
- surgical/destructive tx
Complications of Molluscum Contagiosum?
Rare, but occasional scarring
Definition of Measles (Rubeola)?
highly contagious childhood viral infection; spreads from neck down
Viral cause of Measles?
Paramyxovirus group
Predisposing conditions of Measles?
- densely populated/socioeconomically depressed areas
- winter/spring
Clinical features of Measles?
- 10-15 day incubation period
- Prodrome of 3 C’s
- cough, coryza, conjunctivitis
- “Koplik spots” - blue/white on buccal mucosa during prodrome
- red macules/papules on 4th day - face/neck/ears
- become papules, spread to trunk & limbs w/in 3-4 days
- lesions coalesce, clear in 3 days
- leaves brown stain behind
Treatment for Measles?
- Symptomatic
- Antibiotics if secondary infection develops
Complications for Measles?
- secondary bacterial infection
- post-infectious encephalitis
- myocarditis
- viral pneumonitis
- OM
- GI problems
- glomerulonephritis
Prevention of Measles?
Live-attenuated vaccine
Definition of Rubella?
common viral infection affecting skin, lymph nodes, and joints
Viral cause of Rubella?
Togavirus
Predisposing conditions for Rubella?
- alck of proper immunizations
- springtime
Clinical features of Rubella?
- Incubation period 14-21 days
- Prodrome follows
- Small, pink macules coincide with prodrome
- begins on face/scalp, spreads down
- Macules become papular, then desquamate
- Papules fade w/in 3 days
- Red petechiae may occur on soft palate
Treatment for Rubella?
Symptomatic
Complications of Rubella?
Threat to unborn child
Prevention of Rubella?
MMR vaccination
Other terms for Rubella?
- German measles
- “3 Day Measles”
Other terms for Roseola Infantum?
- Childhood exanthem
- Exanthem subitum
- 6th Disease
Viral cause of Roseola Infantum?
-Human Herpes Virus (HHV) 6 or 7
Predisposing conditions to Roseola Infantum?
- exposure
- 6-24 month-olds, otherwise healthy
Clinical features of Roseola Infantum?
- incubation of 5-15 days
- high fever each night, no day fever
- followed by pink maculopapular rash 3-4 days later
- usually trunk & neck
- otherwise asymptomatic
- febrile seizures common
Treatment of Roseola Infantum?
Symptomatic
Definition of Warts?
Common viral infections of skin and mucous membranes
Viral cause of warts?
Human papilloma virus (HPV)
Predisposing conditions of warts?
- Localized trauma
- immunosuppression
- communal bathing
4 different types of warts?
- Common
- Plane (flat)
- Plantar
- Mosaic
Characteristics of Common Wart?
- Skin-colored/pink
- Thrombosed capillaries (patches of black streaks)
- Papules, smooth –> rough
- Hands, anywhere
Characteristics of Plane (Flat) warts?
- Skin-colored, pink
- Smooth plaque surface (shiny)
- Face, hands, limbs
Characteristics of Plantar warts?
- Skin-colored
- thrombosed capillaries
- raised, rough, thick
- feet - can be painful
Characteristics of Mosaic warts?
- skin-colored
- thrombosed capillaries
- rough plaque
- soles, heels, palmar, periungual (skinfolds underneath nails)
Treatment of warts?
- spontaneous involution
- physical (N2, duct tape)
- chemical
- immunotherapy
- phototherapy
- chemotherapy
Complications of warts?
- recurrence
- spread to contacts/self-innoculation
- extension to tx periphery
Prevention of warts?
- keep surfaces clean/dry
- aqua socks/flip flops/slippers in common areas
