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SS: Dermatology > Viral Infections: Chickenpox, Herpes Zoster, HIV, Molluscum Contageosum, Viral Warts, Herpes Simplex > Flashcards

Viral Infections: Chickenpox, Herpes Zoster, HIV, Molluscum Contageosum, Viral Warts, Herpes Simplex Flashcards

1
Q

Common Viral Infections

A

Chickenpox, Herpes Zoster, HIV, Molluscum Contageosum, Viral warts, Herpes Simplex

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2
Q

Chickenpox

A
  • Contagious 1-2 days before the rash appears until blisters have scabbed over
  • Can take 10-21 days after contact to develop chickenpox
  • Children should stay away from school
  • Immunocompromised individuals and pregnant women should stay away
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3
Q

Causes of Chickenpox

A

Varicella Zoster Virus, Herpes type 3, airborne or contact with fluid

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4
Q

Features of Chicken Pox

A
  • Itchy red papules to vesicles
  • Stomach, back, face, blister in mouth
  • Fever, headache, D&V
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5
Q

Treating Chicken Pox

A
  • Blisters clear up naturally in 1-3 weeks, but can leave scars
  • IV Aciclovir
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6
Q

Complications of Chicken Pox

A
  • Secondary bacterial infection caused by scratching
  • Dehydration from D&V
  • Viral Pneumonia
  • Disseminated varicella infection
  • Reye’s, Guillain-Barre, encephalitis
  • Thrombocytopenia & purpura
  • Viral pneumonia, premature labour
  • Shingles
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7
Q

Herpes Zoster aka Shingles

A

Localised, painful rash caused by reactivation of VZV. Anyone who has previously had chickenpox can get shingles. VZV remains dormant in dorsal rot ganglia for years. When reactivated, migrates to sensory nerves to skin

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8
Q

Risk factors for Herpes Zoster

A

Adults, elderly, poor immunity

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9
Q

Triggers of Herpes Zoster

A
  • Nerve Pressure
  • Radiotherapy at level of nerve root
  • Spinal Surgery
  • Infection
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10
Q

Features of Herpes Zoster

A
  • Severe pain in one sensory nerve distribution
  • Fever, headache, lymphadenopathy
  • After 1-3 days, blistering rash appears in same area of skin
  • Red papules to blistering or pustules that crust over
  • Chest, neck, forehead and lumbar/sacral regions commonly affected
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11
Q

Treatment for Herpes Zoster

A

Antiviral: Aciclovir
Recovery is 2-4 weeks
Rest and pain relief, vaseline

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12
Q

Complications of Herpes Zoster

A
  • Several dermatomes involved
  • Deep blisters with prolonged healing and scarring
  • Muscle weakness e.g. facial nerve palsy- Ramsay Hunt Syndrome
  • Infection of organs
  • Pregnancy- fetus can be infected
  • Post-herpetic neuralgia: persistent pain in the same area more than 1 month after onset
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13
Q

Herpes Simplex

A

‘Cold Sores’ or ‘Fever blisters’

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14
Q

Causes of Herpes Simplex

A
  • Type 1: Oral and facial infections
  • Type 2: genital and rectal infections
    Spread by direct or indirect contact. Remains dormant in dorsal root nerves until reactivated
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15
Q

Features of Type 1 Herpes Simplex

A

-Type 1 presents as gingivostomatitis in children 1-5: fever, restlessness, excessive dribbling and bad breath, swollen gums, eating is painful, white vesicles to yellow ulcers inside mouth, lymphadenopathy

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16
Q

Features of Type 2 Herpes Simplex

A
  • Genital Herpes after onset of sexual activity
  • Painful vesicles, ulcers, redness, swelling for 2-3 weeks
  • In females: vulva and vagina. Often painful to urinate. Cervical infection may lead to severe ulcers
  • Type 2 recurrence more common
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17
Q

Treatments for HSV

A

Antiviral drugs

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18
Q

Complications of HSV

A

Eye infection, throat infection, eczema herpeticum, erythema multiforme ( symmetrical plaques on hands, forearms, feet and lower legs), disseminated/widespread infection

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19
Q

Acute HIV Infection Syndrome

A

Occurs in those infected with HIV during the first few weeks following exposure

20
Q

Symptoms of HIV Infection Syndrome

A

Fever & lymphadenopathy, sore muscles/joints, malaise, loss of appetite, GI symptoms, erythematous maculopapular rash, mucocutaneous ulceration, symmetrical rash on face, palms and soles

21
Q

Pruritic Papular Eruption of HIV

A

Most common rash seen in HIV
Form of prurigo
Itchy, red bumps, symmetrical, diffuse, extremities and trunk affected, no mucosal, palmar or webbing involvement

22
Q

Treatment of Pruritic Papular Eruption

A

Topical Steroids, emollients, antihistamines then phototherapy

23
Q

Viral skin conditions associated with HIV

A

HSV, VZV, Molluscum Contagiosum, Human papillomavirus, oral hairy leukoplasia due to EBV

24
Q

Fungal skin conditions associated with HIV

A

Tinea, Candidiasis, Cryptococcosis, pityrosporum, pityriasis versicolor, Pneumocystosis

25
Q

Bacterial skin conditions associated with HIV

A

Cellulitis, ecthyma impetigo, folliculitis (strep), syphillis, atypical mycobacteria

26
Q

Infestations of the skin associated with HIV

A

Leishmaniasis

Scabies

27
Q

Inflammatory skin conditions associated with HIV

A

Seborrhoeic dermatitis, psoriasis, eczema, Pruritic papular eruption, granuloma annulare

28
Q

Malignant skin conditions associated with HIV

A

Kaposi’s Syndrome, B & T cell lymphoma, Melanoma, SCC, BCC

29
Q

Viral warts

A

common non-cancerous growths

30
Q

Risk factors for viral warts

A

School aged children, Eczema, immunosuppressed individuals

31
Q

Causes of viral warts

A
  • Human Papilloma Virus (HPV)
  • Infection occurs in superficial epidermis, causing keratinocyte proliferation and hyperkeratosis
  • Spread by skin-to-skin contact or auto-inoculation-
  • Up to 12 months incubation period
32
Q

Features of Viral Warts

A

Hard surface with black dot in the middle of each scale - thrombosed capillary blood vessel

33
Q

Features of Common Warts

A

Papules with hyperkeratotic, rough surface, back of fingers or toes, around nails and knees, butcher’s warts- cauliflower like

34
Q

Features of Plantar warts (Veruccas)

A

Tender, inward growing ‘mymecia’ with clusters of mosaic warts

35
Q

Features of Plane Warts

A

flat, hands, face and shins. Spread by shaving/scratch

36
Q

Features of Filiform Warts

A

Long thread/stalk. Common on face

37
Q

Mucosal Wart

A

Lips and inside cheeks

38
Q

Treatments of Warts

A
  • Topical: salicylic acid, removes dead surface cells
  • Cryotherapy: freezing wart, success after 3-4 months
  • Electrosurgery: curettage and cautery for large warts
39
Q

Molluscum Contagiosum

A

Small, firm, raised papules on the skin with a characteristic small dimple in the middle. The spots are not painful, but can be itchy. Common in armpits, knee and groin

40
Q

Risk factors for Molluscum Contagiosum

A

Children under 10, warmer climates, wet conditions, overcrowded environments, atopic eczema, immunocompromised

41
Q

Causes of Molluscum

A

Molluscum Contagion Virus part of the Poxvirus

Spreads: skin-to-skin, Indirect e.g. towels, auto-inoculation i.e. shaving or scratching, sexual transmission

42
Q

Features of Molluscum

A

Clusters of small, round papules 1-6mm, few to hundreds
White, pink or brown
Often shiny with umbilicated pit
Papules contain white, cheesy material
Arise in warm, moist places e.g. flexures

43
Q

How to reduce spread of molluscum

A 
Washing hands
Avoid scratching/shaving
Cover visible lesions with clothes/plasters
Do not share towels
Adults practise safe sex
44
Q

Treating Molluscum

A 
Picking out white core
Cryotherapy
Laser ablation 
Antiseptic e.g. hydrogen peroxide
Wart paint e.g. salicylic acid
45
Q

Complications of Molluscum

A

Secondary bacterial infection (impetigo)
Secondary eczema
Conjunctivitis if eyelid becomes infected
Large and numerous mollusca in immunocompromised

SS: Dermatology (12 decks)

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