Viral infections of skin Flashcards
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)
Exanthem is
an eruptive disease, infectious rash
Macular/macule is
flat, discolored patch
Papular/papule is
raised, discolored patch
Vesicle is
raised, fluid-filled blister
Erythema is
redness
Petechial/petechiae is
tiny, dark spots due to localized hemorrhage
Pustular/pustule is
vesicle filled with pus
Umbilicated is
pustule with dimple (umbilicus) in center
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
____ person that is ____ to an individual infected with ____ is at risk for acquiring what?
Naive; exposed; herpesvirus; infection
____ 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
When doe most people acquire a primary infection?
Childhood, but naive adults also susceptible
What can occur at any time and be transmitted to naive people?
Asymptomatic shedding!!!
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
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
