Viral infections of skin Flashcards by Justin Tu

Exogenous: means what?

Endogenous means what?

From without: infection at site of lesion, breaks in skin integrity: cuts, insect bites, pimples; mucous membranes
From within: viremia (spread through blood), reactivation from latency (think neurons and lymphocytes)

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Exanthem is

an eruptive disease, infectious rash

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Macular/macule is

flat, discolored patch

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Papular/papule is

raised, discolored patch

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Vesicle is

raised, fluid-filled blister

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Erythema is

redness

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Petechial/petechiae is

tiny, dark spots due to localized hemorrhage

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Pustular/pustule is

vesicle filled with pus

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Umbilicated is

pustule with dimple (umbilicus) in center

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Herpesvirus is

a large enveloped icosahedral DNA virus, primary infection (first exposure and THEN DISEASE), latency in neurons or lymphocytes , then potential recurrence with or without symptoms

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____ person that is ____ to an individual infected with ____ is at risk for acquiring what?

Naive; exposed; herpesvirus; infection

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____ and _____ contain what when?

Secretion (saliva, breastmilk) and mucous membranes (oral, genital); infectious herpesviruses when infected individual has primary infection or recurrence of latent one

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When doe most people acquire a primary infection?

Childhood, but naive adults also susceptible

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What can occur at any time and be transmitted to naive people?

Asymptomatic shedding!!!

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Primary Herpes Simplex virus: who, spread, lesion types/location, latency, treat

Who: Childhood
Spread: close contact with active lesions or asymp shedding (kissing, sex)
Lesion types/location: mouth, face, nose eyes; usually ABOVE waist, can be genital
Latency: look in dorsal root ganglia neurons or trigem
Treat: oral acyclovir or derivatives

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Recurrent HSV-1: herpes labialis (cold sores): lesion types, trigger, lesion characteristics, treat?

Lesion types: recurrence on lips, eyes, or inside mouth (vesicular); cold sores, “canker sores,” fever blisters
Triggers: fever, UV, hormones, stress, physical trauma
Lesion characteristic: secretions can spread virus without symptoms; contagious
Treat: acyclovir, zovirax, valtrex, famvir (prophylactic)

HSV keratitis and corneal scarring: infection type, cause, sequelae, disease mediated, treat?

Infection type: primary in eye occurring at birth from vaginal canal
Cause: HSV-1 or -2 recurrence
Sequelae: chronic can cause corneal scarring and vision loss
Disease: T cell infiltration destroys cornea
Treat: antivirals; might need corneal transplant!!!

Herpetic Whitlow: Acquiring, cause, who, what sites, treat, prevention

Acquire: direct contact (primary HSV-1 or -2 of non-mucosal sites)
Cause: bare hands into others’ mouths
Who: Dentists, hospital workers, wrestlers
Sites of recurrence: hands, legs, back
Treat: acyclovir and derivatives
Prevention: gloves

HSV-2: Primary genital herpes: lesion types and location, symptoms, treatment, other infections, highest risk?

LT and L: Vesicular, pustular, erythematous lesions on penis, labia, anus (usually below waist)
Symptoms: pain, itching, fever, headache, malaise
Treat: antiviral to shorten acute infection and prevent spread to brain
Other infections: HSV-1 and -2 coinfection common
Highest risk: congenital infection (highest risk to fetus)

HSV-2: Recurrent genital herpes: prodrome, lesions and locations, lesion characteristics, recurrence, antivirals,

Prodrome: itching, tingling at lesion site a day before outbreak
Lesions and location: vesicular, labia, penis, anus, mouth
Lesion chara: contagious, but shedding and transmission can occur without symptoms!!
Recurrence: frequency highly individual
Antivirals: prophylactic antiviral can reduce recurrence and transmission

Primary VZV: Varicella: transmission, incubation, latency, distinct, lesion chara, treat

Transmission: aerosol, highly contagious
Incubation: 1-2 week incubation period with contagiousness, fever, and malaise preceding and accompanying rash
Latency: dorsal root ganglion neurons
Distinct: rash “dew drops on rose petals”
Lesion chara: itchy, vesicular, scabs that could scar
Treat and prevention: vaccine (Varivax), acyclovir, Foscarnet

VZV REcurrence: Herpes zoster: prodrome, outbreak, lesion chara, seen in whoe, treatment, complications

Prodrome: burning, itching, tingling
Outbreak: single dermatome
Lesion chara: vesicular, extremely painful, pruritic
Who: elderly, immunocomp
Treat: acyclovir and derivatives
Comp: keratitis, retinitis, Bell’s, postherpetic neuralgia

HZO: herpes zoster ophthalmicus: affects where, what can happen, how to treat?

Affects where: 30% can affect face
What can happen: destroy retina and lead to blindness; all tissues of eye can be infected and damaged
Treat: aggressively

VZV vaccines: type, what can they prevent?

Type: live attenuated virus
Prevent: Varivax to prevent varicella (age 1-60, 80-90% effective); Zostavax to prevent zoster (>50, 50% effective)

EBV: primary infectious mono: infects where, restricted to, who tends to get it?

Infects: B cells and epi of oropharynx Restricted: humans (90% affected by adulthood) Who: childhood infections asymp, older teens with "mono"

EBV recurrences: who is it linked to? What is a major sequelae?

Who: Immunocompromised with recurrences linked to B cell cancers Major seq: Oral hairy leukoplakia with epi overgrowth caused by EBV with hairy/feathery lesions on tongue or buccal mucosa; associated with HIV, transplant, chemo

CMV: general, what differentiates from EBV? Treatment?

General: usualy asymp and acquired in childhood Different: Lack of SORE THROAT, presence of PETECHIAL rash and JAUNDICE differentiate Treat: Gancyclovir especially with immunocomp

Roseola: Exanthem subitum: cause, latency, transmission, typical presentation, what not to do

Cause: HHV6b and HHV7 Latency: CD4 T cells are site of latency Transmission: saliva (respiratory droplets) Presentation: 3 days of high fever, then faint rash on trunk What not to do: hold off on antibiotics!!!

Kaposi's Sarcoma: KSHV, HHV8: prevalence, evidence of, found where; recurrences

Prevalence: African, Mediterranean, homosexual pops Evidence: sexual transmission Found: B cells, endothelial cells Recurrences: Kaposi's, body cavity based lymphomas (BCBL), Castleman's disease, hyperplastic lymphadenopathy

Coxsackie Virus: family, skin manifestation, what else with transmission?

Family: small, naked, ssRNA viruses in enteroviridae Skin manifestation: herpangina (throat infection causing red-ringed blisters and ulcers on tonsils and soft palate) and hemorrhagic conjunctivitis (eye pain, then red water eyes with swelling, light sens, blurred vision); hand, foot, mouth disease (red blisters in throat, tongue, gums, hard palate, inside of cheeks, and palms of hands, soles of feet; think pre-school children and parents) Transmission: highly contagious, spread on hands and surfaces contaminated by feces and saliva, aersol spread from sneezes or coughs Treat with none, prevent with handwashing and sanitation

HPV: virus type, infects where, spread, treat, prevent

Virus type: Small, naked DNA virus Infects: skin, genitals, cervix, anus, mucosa Spread: direct contact Treat: chemical/surgical removal Prevent: gardasil, a vaccine for young women and also boys at age 11

Molluscum Contagiousum Virus (MCV): lesion characteristics, found where, lesions where, transmission, who do you see it, treat

Lesion chara: pearly, flesh-colored, raised, umbilicated Found where: anywhere on body in kids, anogenital in sexually active adults; rarely on palms, soles, mucosa, face or eyes Trasmit: skin-skin contact or fomites, tattos, wrestling Who: school-age, HIV pop Treat: surgery, CRYOTHERAPY along with Cidofovir

Variola Virus (Smallpox): look for, rash stages, treat

Look for: umbilicated papular rash on face and extremities Rash stages: papular, vesicular then pustular, scabs leaving pitted scars Treat: supportive care, vaccination

Vaccinia virus, what is it used for, given to who, possible vaccine reactions

Used for: modern vaccine strain Given to: military personnel, lab personnel Possible vaccine reactions: auto-inoculation from arm to eyes, generalized vaccinia (virus in body), eczema vaccinatum (contraindicated with eczema), progressive vaccina leading to vaccinia necrosum/gangrenosum (immunocomp, need Cidofovir but potentially fatal)

Measles: virus type, contagious, symptoms, key feature

Virus type: paramyxovirus, enveloped, neg strand RNA Cont: during incubation period Symptoms: cough, conjunctivitis, fever, rash (at this point not contagious) Feature: Koplik's spots, or small red spots with bluish centers on buccal mucosa

Rubella virus (German measles): virus type, spread, symptoms, treat, prevent

Virus type: togavirus, enveloped, pos strand RNA Spread: aerosol spread Symptoms: maculopapular rash, lymphadenopathy, arthralgia Treat: none Prevent: MMR vaccine