Viral, fungal and parasitic skin infections

Question 1

What are the characteristic signs of Herpes Simplex Virus?

Answer 1

Primary and recurrent vesicular eruptions

Question 2

Where are HSV eruptions most commonly found?

Answer 2

Orolabial and Genital regions

Question 3

How do these hsv strains spread?

Answer 3

HSV-1: contact with contaminated secretions
HSV2: sexual contact

Question 4

When do symptoms of HSV start?

Answer 4

3-7 days after exposure

Question 5

What are HSV symptoms preceded by?

Answer 5

Malaise, general unwellness w/ lethargy
Anorexia,
Lymphadenopathy, swollen lymph nodes

Question 6

Describe the vesicles in HSV

Answer 6

Painful vesicles with erythematous base, ulceration and crusting

Question 7

What medical emergency cutaneous sign can be caused by HSV?

Answer 7

Eczema Herpeticum
can spread to the brain and cause fatal encephalitis

Question 8

What are the systemic manifestations of HSV, and its prevalence?

Answer 8

Aseptic meningitis (up to 10%)

Question 9

Orolabial vs genital symptoms

Answer 9

orolabial, often asymptomatic, painless
genital, painful and may lead to urinary retention

Question 10

Describe the vesicles in eczema herpeticum

Answer 10

Monomorphic, punched out erosions

Question 11

What is herpetic whitlow?

Answer 11

Infection of digits - causing pain and swelling
common in children and mistaken for dactylitis

Question 12

What manifestation of HSV is more common in childbirth?

Answer 12

Neonatal HSV infection
vesicles localised in scalp/trunk

Question 13

What are the complications of Neonatal HSV

Answer 13

Encephalitis, 50% mortality w/o treatment
survivors may have serious neuro deficits

Question 14

Treatment for neonatal HSV

Answer 14

IV antivirals

Question 15

Who can severe, chronic HSV affect?

Answer 15

Immunocompromised patients (HIV, transplants)

Question 16

How to diagnose HSV

Answer 16

Swab for PCR

Question 17

What is the treatment for HSV?

Answer 17

Oral acyclovir

Question 18

What are the four types of fungal infections?

Answer 18

Superficial, Deep, Disseminated, Opportunistic

Question 19

What is a superficial fungal infection most commonly found in adolescence?

Answer 19

Pityriasis Versicolor
caused by malessezia

Question 20

What are the cutaneous signs of pityriasis versicolor?

Answer 20

Hypo or hyperpigmented erythematous macular eruption
flares with high temp/humidity

Question 21

Dermatophytes

Answer 21

Fungi that feed on keratin

Question 22

What is the most common fungal agent?

Answer 22

Trichophyton Rubrum
causes Tinea pedis - athletes foot

Question 23

What is the main sign of trichophyton tonsurans?

Answer 23

Kerion - inflammatory fungal infection causing abscess of scalp
frq also infected with staph A.

Question 24

What is an Id reaction?

Answer 24

AKA dermatophyte infection
Inflammatory reactions distal to associated fungal infection

Question 25

What are the signs of an Id reaction?

Answer 25

Urticaria (hives), Dermatitis (eczema like)

Question 26

What is another superficial fungal infection commonly affecting intertriginous (skin folds) areas?

Answer 26

Candidiasis caused by candida albicans

Question 27

What is candidiasis predisposed by

Answer 27

occlusion, moisture, warm temp, DM

Question 28

What are the cutaneous signs of candidiasis?

Answer 28

Erythema oedema, thin discharge in intetriginous areas

Question 29

What is an example of an opportunistic fungal infection?

Answer 29

Mucormycosis

Question 30

What is the presentation of mucormycosis?

Answer 30

Oedema, Pain, Eschar lesion (dry dead tissue, black crust)

Question 31

What is mucormycosis associated with?

Answer 31

Diabetes Mellitus, Neutropaenia, HIV (aka immunocompromised), burns, malnutrition

Question 32

What is the treatment for mucormycosis?

Answer 32

Aggressive debridement, Antifungal Therapy

Question 33

What is a contagious infestation cause by the Sarcoptes species?

Answer 33

Scabies

Question 34

How does Scabies spread?

Answer 34

Female sarcoptes mite lays eggs in upper epidermis and dies

Question 35

What are the cutaneous signs of Scabies?

Answer 35

Red pruritic papules in interdigital areas, Norwegian scabies (hyperkeratosis) affects digits, axilla, genitals

Question 36

What is the treatment for scabies?

Answer 36

Oral ivermectin (antiparasitic)