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RB Y2 Dermatology > Viral Skin Infections > Flashcards

Viral Skin Infections Flashcards

1
Q

what are chicken pox and shingles due to

A

varicella zoster virus

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2
Q

how does shingles occur

A

reactivation of dormant VZV in dorsal root ganglion - is dermatomal

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3
Q

shingles vaccine

  • type
  • schedule
  • side effects
  • contraindications
A
  • live attenuated
  • given SC
  • over 70 - catch up campaign
  • chicken pox is a rare side effect
  • as live contraindicated in IS, pregnancy and active infection
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4
Q

chicken pox symptoms

A
  • fever
  • itchy rash that starts on head/trunk then spreads
  • initally macular then papular and then vesicular
  • mild systemic upset
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5
Q

what are some 2y features of chickenpox

A

bacterial infection - due to scratching

pneumonitis

haemorrhagic

scarring encephalitis

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6
Q

haemorrhagic chickenpox

A
  • Thrombocytopenia and purpura
  • more common in IC etc
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7
Q

pneumonia as a complication of chicken pox

A

Chickenpox can spread to the lungs and cause pneumonia, more common in adults (smokers), pregnant people and those with weakened immune systems.

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8
Q

what is neonatal VSV

A

2y to chickenpox in mother in late pregnancy - may produce latency of VZV in the dorsal root ganglia of the foetus

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9
Q

what is the mortality of neonatal VSV like

A

higher than normal

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10
Q

how can you prevent neonatal VSV

A

varicella zoster immune globulin in susceptible women

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11
Q

who is shingles seen in

A

elderly and IC

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12
Q

shingles CF

A

tingling/pain that is greater with increasing age, followed by dermatomal rash

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13
Q

describe shingles pain

A

neuralgic - sharp and proximal along course of nerve

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14
Q

what is the complication that can occur if shingles lasts >4 weeks

A

post herpetic neuralgia - burning pain that lasts long after rash and blisters have disappeared

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15
Q

where does post herpetic neuralgia commonly affect

A

first branch of trigeminal nerve, but also V2 and V3

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16
Q

is scarring more common in shingles or chickenpox

A

chickenpox

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17
Q

herpes zoster ophthalmicus

A

zoster of CNVI (accounts for 20% of all shingles), affects the globe in 50%

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18
Q

waht is seen on the nose in herpes zoster ophthalmicus

A
  • Hutchison’s sign: the nasociliary branch of CNV1 supplies the tip of the nose, this is a strong risk factor for ocular involvement
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19
Q

what is ramsay hunt syndrome caused by

A

complication of shingles - dormant VZV reactivates in the geniculate ganglion of CNVII

also known as herpes zoster oticus/geniculate

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20
Q

ramsay hunt syndrome CF

A

severe otalgia followed by VII and other cranial nerve palsy

zoster vesicles around ear and deep meatus (ear canal)

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21
Q

what nerve supplies the sensation of taste to the anterior 2/3 of tongue

A

CNVII

this is why taste is lost in ant 2/3 of tongue in Ramsay Hunt Syndrome

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22
Q

what is idiopathic CNVII palsy called

A

bells palsy

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23
Q

what may recurrent herpes infection cause

A

bells palsy - herpes inflames CNVII

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24
Q

in ramsay hunt syndrome what can irritation of CNVIII cause

A

deafness, vertigo and tinnitus

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25
Q

VSV and HSV therapy

A

acyclovir - antiviral

  • oral for VZV, this reduces the incidence of post herpetic neuralgia
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26
Q

what is acyclovir

A

analogue of guanosine

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27
Q

what is the effect of acyclovir

A

doesnt eliminate virus - slows the growth and spread

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28
Q

presentation of erythema multiforme

A

multiple target lesions

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29
Q

what can erythema mulitforme be triggered by

A

hypersensitivity reaction triggered by

  • Herpes simplex virus
  • Mycoplasma pneumoniae bacterium
  • Co-trixomazole treatment
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30
Q

erythema multiforme major

A

more severe form - has mucosal involvement

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31
Q

what is the name for pox virus

A

molluscum contagiosum

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32
Q

describe molluscum contagiosum

A

grouped, pearly white or pink, firm umbilicated papules

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33
Q

molluscum contagiosum treatment

A

liquid nitrogen

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34
Q

who is molluscum contagiosum common in

A

children

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35
Q

can molluscum contagiosum be sexually transmitted

36
Q

what causes warts

A

HPV in keratinocytes

37
Q

who are warts common in

A

children and IS

38
Q

treamtent for warts

A

topical salicylic acid

39
Q

what are warts on feet called

A

verrucas

cauliflower appearance

40
Q

what does HPV also cause

A

head and neck cancer, cervical cancer, genital warts

41
Q

what types of HPV are responsible for what

A
  • Types 1-4 are responsible for warts/verrucas mainly
  • Types 6 and 11 are responsible for genital warts
  • Types 16 and 18 are mainly responsible for cervical cancer
42
Q

enteroviruses

A
  • Single stranded RNA viruses
  • Transmission route through intestine (enteric meaning intestine)
  • E.g. coxsackie, echovirus, poliovirus etc.
43
Q

what more serious problems can coxsackie virus B cause

A

myocarditis, pericarditis and meningitis

44
Q

what is herpangina

A

blistering, painful rash at back of mouth

45
Q

what is herpangina caused by

A

enterovirus (coxsackie or echovirus)

46
Q

what is hand foot and mouth disease caused by

A

enterovirus (coxsackie A virus in particular)

47
Q

clinical presentation of hand foot and mouth disease

A

vesicles in mouth and on hands and soles of feet

48
Q

what is erythema infectiosum also called

A

slapped cheek disease

49
Q

what causes erythema infectiosum

A

erythrovirus (formerly parvovirus) B19 - it is the most common manifestation in children

50
Q

what are some complications of erythrovirus B19

A

spontaenous abortion

aplastic crisis

chronic anaemia in IS patients

51
Q

what is the most common manifestation of erythema infectiosum in adults

52
Q

what is orf

A

para pox virus acquired from infected lambs

53
Q

what does 1y infection with syphillis cause

A

chancre - painless ulcer

54
Q

what does 2y infection with syphillis cause

A

red rash that is prominent on the soles of feet and palms of hands

55
Q

what does 3y infection with syphillis cause

A

CNS, cardio, gummatous

56
Q

what is a gumma

A

a non cancerous growth originating from 3y stage syphillis

57
Q

what is the bacteria responsible for syphilis as STI

A

treponema pallidum

58
Q

what do you treat syphilis with

59
Q

lyme disease

A
  • Initial characteristic erythema chronicum migrans rash – bullseye lesion
60
Q

what is the causative organism and vector for lyme disease

A

Borrelia burgdorferi

vector - ticks

61
Q

what is the therapy for lyme disease

A

doxycycline or amoxcillin

62
Q

what is Zika spread by

A

mosquito Aedes aegypti

63
Q

what are 2 complications of zika

A

guillan barré and microcephaly

64
Q

HSV infection -primary infection

A
  • commonly seen in pre school children
  • primary infection is often with gingivostomatitis
  • virus then remains latent but can be reactivated by stress etc as an inactive form remains in the dorsal root ganglia
65
Q

subsequent presentations of HSV

A

often with cold sores eg herpes labialis

66
Q

what is the worst end of spectrum of disease seen with HSV

A
  • gingivostomatitis - primary infection
  • get fever and local lymphadenopathy too
67
Q

which type of HSV is commonly acquried in childhood

A

type 1

  • main cause of oral lesions
  • spread by saliva etc
69
Q

herpetic whitlow

A
  • intensely painful red, swollen finger, may have blisters etc
  • due to HSV
70
Q

who is at particualr risk of herpetic whitlow

A
  • Occupational hazard of dentistry and anesthetics exposed to oral secretions
  • Also seen in thumb sucking children
71
Q

treatment of herpetic whitlow

A
  • Treatment is allowing virus to run its course, drainage runs the risk of bacterial infection
72
Q

eczema herpeticum

A
  • Develops when the virus infects large areas of skin, rather than being combined to a small area as in the common cold sore
  • disseminated viral infection characterised by fever and clusters of itcy blisters/punched out erosions
73
Q

what is eczema herpeticum often a complication of

A

atopic dermatitis

74
Q

which type of HSV causes eczema herpeticum

75
Q

who usually gets eczema herpeticum

A
  • More commonly seen in infants and children with atopic dermatitis, or when there are other reasons for breakdown of skin barrier e.g. burns, pemphigus vulgaris
76
Q

presentation of eczema herpeticum

A
  • Usually initially presents with a cluster of itchy and painful blisters
  • Monomorphic (all appear similar to each other) punched out lesions
77
Q

complications of eczema herpeticum

A
  • Can be life threatening
  • Secondary bacterial infection with Staph or Strep may lead to impetigo and/or cellulitis
78
Q

management of eczema herpeticum

A

acyclovir - IV if systemically unwell

79
Q

what serious complication can HSV cause in brain

A

encephalitis - spreads to CN ganglion

80
Q

prophylaxis of HSV

A

low dose acyclovir daily

81
Q

apthous ulcers

A
  • non viral and self limiting
  • Recurring painful ulcers of the mouth that are shallow, round or ovoid and have inflammatory halos. Heal without scarring
  • They are confined to the mouth and seen in the absence of systemic disease
  • Each ulcer lasts less than 3 weeks
82
Q

Behçet’s Disease

A
  • systemic autoimmune inflammatory condition of unknown cause
  • Classically, recurrent oral and genital ulceration and anterior uveitis
83
Q

what gene is behcets assoicated with

84
Q

other features of behcets

A
  • Skin lesions
  • Thrombophlebitis – inflammatory process that cause a blood clot to form
  • Arthritis
  • Can also involve visceral organs
85
Q

where is behctes most common

A

middle east and asia

86
Q

name some systemic diseases that cause non viral recurrent ulcers

A
  • Gluten-sensitive enteropathy (coeliac) or IBD (diarrhoea and weight loss)
  • Drug reactions
  • Reiter’s disease (arthritis)
  • Skin diseases

RB Y2 Dermatology (22 decks)

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