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Dermatology 1 > Viral Skin Diseases > Flashcards

Viral Skin Diseases Flashcards

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Dermatology Board Prep flashcards
1
Q

Herpes Simplex Virus: HSV-1 vs. HSV-2

A

HSV-1 primarily infects the orofacial, HSV-2 primarily the genital
**Both can cause to either location

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2
Q

Infection of HSV

A
  • via direct contact
  • virus transmitted up peripheral sensory nerve to ganglia where resides in latent stage
  • recurrent infection with reactivation of the virus when travels back to skin/mucous membrane
  • frequency of reactivation/recurrent infection varies greatly
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3
Q

S/sx of HSV

A
  • when initially infected, most have no findings/sx

- first clinical lesion is usually a recurrence

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4
Q

More severe s/sx of HSV

A

1% or less with more severe first clinical presentation, frequently with systemic signs and symptoms (for ex. gingivostomatitis, fever, lymphadenopathy, malaise)

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5
Q

Infectious nature of HSV

A

All persons infected with HSV1 and HSV2 are potentially infectious even if they have no clinical signs/sxs (asymptomatic shedding)

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6
Q

What is Tzanck smear?

A
  • scraping the base of a freshly ruptured vesicle and staining the slides with Giemsa or Wright stain
  • examine for the multinucleated giant cells
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7
Q

Dx of HSV

A
  • Viral cx takes several days

- DFA test and PCR are the preferred method for diagnosis

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8
Q

HSV lesion presentation

A
  • grouped vesicles on erythematous base
  • prodrome of tingling itching burning up to 24 hrs prior
  • vesicles break and form crusts or grouped erosions with scalloped border (genital)
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9
Q

Tx of HSV

A
  • depends on frequency of recurrences, severity of, etc
  • intermittent and suppressive therapy with acyclovir, famciclovir, valacyclovir, topical acyclovir and penciclovir
  • chronic suppressive therapy reduced asx shedding by almost 95%
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10
Q

Common triggers of HSV

A
  • UV exposure**
  • surgical
  • laser
  • dental procedures
  • stress
  • other viral infections
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11
Q

Define herpes gladiatorum

A
  • herpes transmitted between athletes involved in contact sports, wrestling.
  • across the thorax, ears, face, arms, and hands
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12
Q

Define herpetic whitlow

A
  • herpetic infection of finger/periungually

- can simulate a felon

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13
Q

What is disseminated HSV?

A

widespread with immunosuppression

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14
Q

Explain Herpes Zoster reactivation

A
  • After primary infection or vaccination, VZV latent in sensory dorsal root ganglion
  • Becomes reactivated, traveling down sensory nerve to skin, leading to the cutaneous eruption in the distribution of the affected sensory nerve(s)
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15
Q

MCC of Herpes Zoster

A
  • Immunosuppression and increased age MCC**

- Induced by trauma, stress, fever, radiation therapy, or immunosuppression

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16
Q

Pain with Herpes Zoster

A
  • pain often precedes: superficial itching, tingling, or burning to severe, deep, boring, or lancinating pain
  • tenderness and hyperesthesia of the skin
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17
Q

Clinical presentation of Herpes Zoster

A
  • Grouping of vesicles/pustules on erythematous base - nearly always unilateral limited to the area of skin innervated by one, two or more sensory ganglion
  • Thoracic (>50%), trigeminal (10 to 20%), lumbosacral, and cervical (10 to 20%)
18
Q

Trigeminal N and Herpes Zoster

A

Trigeminal nerve, particularly the 1st (ophthalmic) division- vesicles on the tip or side of the nose (Hutchinson’s sign), eye is more likely to be affected

19
Q

Define Ramsay Hunt Syndrome

A

Facial palsy with involvement of the ear and/or oropharynx with or without tinnitus, vertigo, and deafness d/t Herpes Zoster

20
Q

Visceral involvement with Herpes Zoster

A

Dissemination with immunosuppressed with necrosis of skin and scarring - can have visceral involvement.

21
Q

What is MC complication of Herpes Zoster?

A

Post herpetic neuralgia-pain persists for months or years, especially in the elderly

22
Q

Herpes Zoster vaccine

A
  • Prevention with vaccine (Zostavax) rec 60 yrs or >.

- Reduce the risk herpes zoster by 51% and the risk of postherpetic neuralgia by 67%

23
Q

What causes warts?

A

HPV (Human Papillomavirus) infection- >100 types

24
Q

Define verruca vulgaris

A

discrete, round skin colored, papillomatous papules

25
Q

Define verruca plana

A

minimally pigmented flat topped papules

-light brown-ish discoloration

26
Q

Define verruca plantaris

A
  • bottom of the foot

- multiple black dots on surface are thrombosed capillaries

27
Q

Which HPV strains are known to cause cancer?

A

HPV 16, 18, 42-45 associated with cervical carcinoma, SCC to genitalia, vagina, rectal mucosa and nasopharyngeal carcinomas

28
Q

HPV vaccine

A

HPV vaccine, Gardisil/Cervarix for girls 11-26 yo and boys from age 9

29
Q

Tx of warts

A

refer to Letassy’s lecture

30
Q

Etiology of molluscum contagiosum

A
  • D/t Poxvirus - up to 4 types
  • Sharply circumscribed, superficial, pearly, dome-shaped papillae: often umbilicated Contagious
  • Teens and adults to genital area is considered an STD
31
Q

Tx of molluscum contagiosum

A
  • Spontaneous resolution 6mo-2yr
  • Tx with blistering agent cantharidin, LN2, curette, topical retinoids
  • *Encourages eczema flares surrounding
32
Q

List the disorders associated with HIV/AIDS

A
  • Kaposi sarcoma
  • Oral hairy leukoplakia
  • Eosinophilic folliculitis
  • Seborrheic dermatitis
33
Q

Kaposi sarcoma etiology

A
  • *Most frequent AIDS-associated tumor in homosexual patients
  • Classic KS is a Caucasian in 60s with a Mediterranean or Jewish background
  • More rapid course and multifocal dissemination in HIV
34
Q

Kaposi Sarcoma appearance

A
  • Erythematous to violacious (violet in color) macules progressing to plaques/nodules
  • Predilection to hard palate, face and trunk
35
Q

Dx of Kaposi Sarcoma

A

biopsy

36
Q

Oral hairy leukoplakia etiology

A
  • Manifestation of EBV mainly in HIV but also other immunosuppressed
  • > 1/3 AIDS patients
  • Usually asx
37
Q

Oral hairy leukoplakia appearance

A
  • Poorly demarcated gray to white corrugated plaques usu on lateral tongue
  • Not removed by scraping with tongue blade
38
Q

Is oral hairy leukoplakia suggestive of malignancy?

A

**Not a premalignant condition but can indicate poorer HIV prognosis

39
Q

Etiology of Eosinophilic Folliculitis

A
  • Chronic pruritic dermatosis in HIV or transplant pt

- Th count <200

40
Q

Appearance of Eosinophilic Folliculitis

A
  • *Very pruritic** small pink to red, edematous, folliculocentric papules
  • Pustular lesions uncommon
  • Above nipple line of chest, back, neck and arms
41
Q

Dx/Tx of eosinophilic folliculitis

A
  • Bx for dx

- Tx topical steroids + antihistamines; oral prednisone; Itraconazole 200 mg BID; phototherapy; oral antivirals

42
Q

Seborrheic Dermatitis etiology

A
  • One of the most common skin manifestations in HIV (83%)***
  • Can occur at any stage.
  • Frequently occurs early in infection
  • More extensive presentation which may include forehead and malar areas, chest, back, axillae, and groin
  • Refractory to treatment

Dermatology 1 (19 decks)

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