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Micro2 Unit 2 > viral infections of skin > Flashcards

viral infections of skin Flashcards

1
Q

what are the viral skin manifestations listed in order from most common to least?

A

Herpesviruses, coxsackie virus, HPV, poxviruses, measles and rubella

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2
Q

what are the sources of viral skin infections?

A

exogenous (from the environment) or endogeneous (from disseminated infection)

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3
Q

how do viruses infect the skin?

A

through breaks in skin integrity or mucous membranes

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4
Q

what are the endogenous causes of viral skin infection?

A

viremia or reactivation from latency

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5
Q

define dermatitis.

A

inflammation of the skin

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6
Q

what is exanthem?

A

an eruptive disease (infectious rash)

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7
Q

define macular, papular and vesicular.

A

macular is a flat discoloration, papular is a raised patch, vesicular is a raised, fluid filled blister

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8
Q

define erythema and petechiae

A

erythema is redness. petechiae are tiny dark spots due to localized hemorrhage

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9
Q

what is pruritis?

A

itching

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10
Q

what is a pustule? what does umbilicated mean?

A

a vesicle filled with pus. it is umbilicated if it has a dimple in the center

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11
Q

what type of virus are herpesviruses? how common are they?

A

large enveloped DNA viruses. most people are infected with greater than three kinds

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12
Q

how are herpesviruses transmitted?

A

by secretions and mucous membranes of an infected individual with primary or recurrence of a latent infection. asymptomatic shedding also occurs

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13
Q

where do herpesviruses establish latency?

A

in neurons or lymphocytes during primary infection

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14
Q

describe primary HSV 1. who does it infect?

A

usually in childhood. lesions on mouth and face (usually above the waist)

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15
Q

where does HSV 1 latency occur? how is it treated and how common is it?

A

in dorsal root ganglia
treat with oral acyclovir
50-80% of population is infected

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16
Q

what are some common names of recurrent HSV1? what percentage of people have recurrence

A

cold sores, canker sores or fever blisters

20% of people have recurrent lesions

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17
Q

what triggers HSV 1 recurrence? what is the treatment?

A

fever, UV exposure, hormones, stress and physical trauma

treat with acyclovir, zovirax, valtrex and famvir as needed or prophylactically

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18
Q

which herpesviruses cause keratitis and corneal scarring? when does primary infection occur? what causes the damage?

A

HSV 1 and 2
primary infection occurs at birth from vaginal mucosa
caused by infiltration of T cells into the cornea

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19
Q

what is herpetic whitlow? how is it treated?

A

primary HSV 1 or 2 on nonmucosal sites. risk factor is putting bare hands into people’s mouths. treat with acyclovir

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20
Q

describe primary HSV 2 lesions.

A

extensive vesicular, pustular and erythematous lesions on penis, labia, anus and possibly oral areas. accompanied by itching, fever malaise and headache

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21
Q

why is antiviral treatment important for primary HSV 2 lesions?

A

to shorten the acute infection and prevent spread to the brain (meningial involvement indicated by malaise and headache)

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22
Q

describe recurrent HSV2 lesions. why is treatment important?

A

prodrome accompanied by vesicular lesions. frequency is variable and prophylactic antiviral can reduce recurrences and transmission.

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23
Q

what is the risk for perinatal and congenital infection with HSV2?

A

most risk during primary infection congenitally. moderate risk for perinatal infection with recurrence

24
Q

what is the primary infection of vericella zoster virus? where is it latent and what is the recurrence?

A

chicken pox

latent in dorsal root gangial neurons and recurrs as shingles

25
Q

how is varicella transmitted? describe the rash and symptoms

A

aerosol transmission

fever and malaise precede and accompany rash of dew drops on rose petals on face and trunk (itchy)

26
Q

what are the complications of varicella?

A

visceral infection, dissemination to the brain, penumonitis and bacterial infection of lesions (increases in severity with age of primary infection)

27
Q

how is varicella treated?

A

prevented with varivax (vaccine) and treated with acyclovir and foscarnet

28
Q

describe herpes zoster.

A

prodrome followed by outbreak of vesicular, painful lesions on a single dermitome. more common in elderly and immunocompromised

29
Q

how is zoster treated? what are the possible complications?

A

acyclovir

keratitis, retinitis, bells palsy and postherpetic neuralgia

30
Q

what is herpes zoster opthalmicus? which tissue are effected? how is it treated?

A

shingles in the eye that can destroy the retina. effects all tissues of the eye and long lasting pain is common. treat aggressively with acyclovir and IV foscarnet

31
Q

describe the VZV vaccines. what kinds are there and at what doses?

A

live attenuated virus
varivax- prevent varicella (80-90% effective)
zostavax prevents zoster (give >50, 50% effective)
zostavas has 14 times higher dose than varivax

32
Q

what illness does epstein barr virus cause? who does it infect? what cells?

A

causes mononucleosis, infects most people in childhood. infects the B cells and the epithelia of the oropharynx

33
Q

where is EBV latent? what recurrences does it cause?

A

latent in the B cells. recurrences are linked to B cell cancers especially in the immunocompromised. (oral hairy leukoplakia)

34
Q

who does cytomegalovirus infect? what are the symptoms?

A

infects children with mononucleosis similar to EBV. There is no sore throat and there is a petechial rash and jaundice

35
Q

what viruses cause roseola? what cells does it infect?

A

HHV6b and HHV7

infects CD4 T cells (also site of latency)

36
Q

how is roseola transmitted? what are the symptoms? how is it often treated?

A

saliva
three day high fever followed by a faint rash on the trunk
children given antibiotics mistakenly and the rash is presumed to be an allergy to the antibiotic

37
Q

what virus causes kaposis sarcoma? where is it prevalent and what cells does it infect?

A

HHV8
prevalent in Africa, the mediterranean population
infects B cells and endothelial cells (site of latency)

38
Q

what other cancers are associated with HHV8?

A

body cavity based lymphomas and castleman’s disease (hyperplastic lymphadenopathy)

39
Q

what is the morphology of coxsackie virus?

A

small, naked ssRNA virus of the enterovirus family

40
Q

what are the skin manifestations of coxsackie virus?

A

herpangina- throat infection with red ringed blisters and ulcers on the tonsils and soft palate
hemorrhagic conjunctivitis- eye pain with red, watery eyes, light sensitivity and blurred vision

41
Q

what is hand, foot and mouth disease?

A

presentation of coxsackie virus with painful blisters in the mouth, on the palms and soles of the feet. common in preschool aged children and their parents

42
Q

how is coxsackie spread? how is it treated?

A

spread on hands and surfaces contaminated by feces and saliva. also aerosolized
no treatment

43
Q

what is the morphology of HPV and where does it infect?

A

small, naked DNA virus

infects skin, genitals, cervix, anus and mucosa

44
Q

how is HPV spread? how is it treated?

A

spread with direct contact
treat with chemical or surgical removal
prevent with gardasil

45
Q

what are the three pox viruses? why are they becoming more of a problem?

A

molluscum contagasiosum, monkey pox and smallpox

more of a problem because the smallpox vaccine is no longer being given which protected against monkey pox

46
Q

describe the appearance of molluscum contagiosum virus. where do they appear?

A

pearly appearing vesicle that is umbilicated without inflammation. found anywhere on the body (except face, mucosa, palms and soles) in children and on anogenital area in sexually active adults

47
Q

who is commonly affected by molluscum contagiosum virus?

A

school aged children and HIV positive population

48
Q

how is molluscum contagiosum virus treated?

A

with cidofovir. remove with surgery, cryotherapy or chemicals (recurs if “popped”)

49
Q

where does monkey pox occur and how is it transmitted?

A

in west and central africa
squirrels are the natural host and it also infects monkeys. transmitted through contact, aerosol, ingestion, needles or person to person

50
Q

what virus causes smallpox? what are the symptoms?

A

variola virus

fever, severe aching pains and prostration. umbilicated papular rash over face and extremities. death in second week

51
Q

how is smallpox treated?

A

supportive care and vaccination. eradicated from the wild with worldwide vaccination

52
Q

what virus is included in the smallpox vaccine?

A

vaccinia virus- mixture of variola and other poxviruses. live attenuated vaccine

53
Q

what are the possible complications from smallpox vaccine?

A

autoinnoculation of the eyes, generalized dissemination in the body, eczema vaccinatum (contraindicated for people with eczema), and progressive vaccinia (necrosis and gangrene in immunocompromised patients) all are recoverable except the last

54
Q

what is the morphology of measles virus? why does it spread so easily?

A

paramyxovirus enveloped with negative strand RNA

infectious during the incubation period

55
Q

what are the symptoms of measles virus?

A

cough, conjunctivitis, fever and rash (small red spots with bluish centers in mouth called koplik’s spots)

56
Q

what is the morphology of rubella virus?

A

togavirus, enveloped with positive strand RNA

57
Q

how is rubella sperad? what are the symptoms?

A

aerosol spread

maculopapular rash, lymphadenopathy and arthralgia (worse if congenital)

Micro2 Unit 2 (9 decks)

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