Viral skin conditions

Question 1

Which virus group causes warts?

Answer 1

Human Papillomavirus

Question 2

4 features of common warts

Answer 2

Most common in kids + YA
Commonly resolve spontaneously
Elevated, hyperkeratotic skin papules with a rough greyish-white or light brown surface.
“Cauliflower-like” surface

Question 3

Tx for common warts

Answer 3

Cryotherapy

Debridement + Topical salicylic acid

Question 4

Common sites of common warts

Answer 4

Hands
Knuckles
Knees

Question 5

4 features of plantar warts

Answer 5

Small area of thickened skin covering small black dots produced by thrombosed capillaries
Often painful
Soles + palms
Grouped = Mosaic pattern

Question 6

Tx for plantar warts

Answer 6

Topical salicylic acid

Cryotherapy

Question 7

4 features of skin lesions in molluscum contagiosum

Answer 7

Pearl-like, smooth, firm papules
Umbilicated
Whit, translucent or slightly yellow
In clusters of <20 on trunk/ extremities

Question 8

Transmission of molluscum contagiosum

Answer 8

Direct skin contact

Contagious for as long as lesions are visible

Question 9

What family of viruses does molluscum contagiousum belong to?

Answer 9

Poxviruses

Question 10

Ix for molluscum contagiousum

Answer 10

Dermoscopy

Question 11

Tx for molluscum contagiosum

Answer 11

Self-limiting, spontaneously resolving in 1-2 years
Topical Potassium Hydroxide (if desire tx)
Cryotherapy (if small no.)

Question 12

4 features of primary type 1 HSV infection

Answer 12

Whitish vesicles evolve to yellowish ulcers on the tongue, throat, palate + inside the cheeks
Fever
Swollen gums, painful eating
Lymphadenopathy

Question 13

Ix for HSV

Answer 13

Swab blister fluid

PCR

Question 14

3 features of primary type 2 HSV infection

Answer 14

Painful vesicles, ulcers, redness + swelling around the genitals
Fever
Tender inguinal lymphadenopathy.

Question 15

3 features of secondary HSV infection

Answer 15

Irregular cluster of small, closely grouped, often umbilicated vesicles on a red base.
Itching or burning
+/- fever, pain + lymphadenopathy

Question 16

Tx for HSV

Answer 16

Acyclovir PO

Question 17

Complication of HSV in those with atopic eczema

Answer 17

Eczema herpeticum

Question 18

3 features of eczema herpeticum

Answer 18

EMERGENCY- spreads quickly
Widespread eruption, often involves face
Extensive crusted papules, blisters + erosions
Systemically unwell with fever, lymphadenopathy + malaise

Question 19

Tx of eczema herpeticum

Answer 19

Acyclovir PO/ IV

+/- Abx

Question 20

3 features of chickenpox

Answer 20

Primary = Varicella
Prodrome: fever, malaise, pharyngitis
Vesicular pruritic rash (Macule-Papule-Vesicle)

Question 21

3 features of shingles

Answer 21

Reactivation of VZV = Herpes zoster

Question 22

3 features of the rash in shingles

Answer 22

Erythematous maculopapular rash- clear vesicles- pustulate + crusts
Dermatomal distribution, NOT crossing midline
Pain + pruritus

Question 23

Tx for VZV

Answer 23

Famciclovir / Valacyclovir PO

Analgesics

Question 24

What complication may arise if the trigeminal nerve is infected by VZV?

Answer 24

Blepharitis
Conjunctivitis
Corneal ulceration
Blindness.

Question 25

Reason for taking antivirals with shingles

Answer 25

Reduce risk of post-herpetic neuralgia