Viral Skin Infections

Question 1

What is erythema multiforme

Answer 1

A hypersensitivity reaction, most commonly triggered by viruses

Question 2

Causes of erythema multiforme

Answer 2

Infections - HSV
Bacteria - mycoplasma pneumoniae, Streptococcus 
Idiopathic 
CTD 
Sarcoidosis 
Malignancy 
Drugs

Question 3

What drugs can cause erythema multiforme

Answer 3

sulphonamides, penicillins, phenytoin, allopurinol, carbamazepine, NSAIDs, OCP

Question 4

Presentation of erythema multiforme

Answer 4

Target lesions with erythema
Initially on back of hands and feet
Spreads to torso
Mild itch

Question 5

Tx of erythema multiforme

Answer 5

Topical emollient + TCS or OCS

+ anti-virals if HSV cause

Question 6

What is molluscum contagiosum

Answer 6

a common viral skin lesion seen in childhood

Question 7

Presentation of molluscum contagiosum

Answer 7

multiple small pink papules with central dimple
look fluid filled but are solid
Koebner’s phenomenon - lesions are seen at the site of injuries

Question 8

Tx of molluscum contagiosum

Answer 8

No Tx - self limiting and will resolve spontaneously

2. Curettage

Question 9

Virus causing chicken pox

Answer 9

Varicella Zoster virus

Question 10

Presentation of chicken pox

Answer 10

Crops of blisters that follow :
macules - papules - vesicles - scabs - recovery

Generalised rash and fever

Itch

Question 11

Tx of chickenpox

Answer 11

low risk of severe disease: supportive care (paracetamol etc)

higher risk of severe disease: oral antivirals (aciclovir)

Question 12

Complications of chickenpox

Answer 12

secondary bacterial infection
pneumonitis - inflammation of the alveoli walls “varicella pneumonia”
haemorrhage
encephalitis

Question 13

Virus causing Shingles

Answer 13

Varicella Zoster (aka Herpes Zoster)

Question 14

The virus causing Chickenpox and Shingles is the same, so how do they present differently?

Answer 14

Shingles is reactivation of Chickenpox that occurs in later life

Question 15

Presentation of shingles

Answer 15

Dermatomal distribution of lesions

Tingling pain - erythema - vesicles - crusts

Question 16

What is Ramsay Hunt Syndrome

Answer 16

a complication of shingles where there is:

1. vesicles and pain the auditory canal and throat
2. 7th cranial nerve palsy
3. irritation of CN 8 (deafness, tinnitus, vertigo)

Question 17

Tx of shingles

Answer 17

Aciclovir

Question 18

What is the cause of warts?

Answer 18

Human Papilloma Virus within keratinocytes

Question 19

HPV types causing genital warts

Answer 19

6 and 11

Question 20

HPV types causing cervical Ca

Answer 20

16 and 18

Question 21

Tx of warts

Answer 21

wait and see - often resolve spontaneously

topical salicylic acid for at least 3 months

cryotherapy

Question 22

What is herpangina

Answer 22

blistering rash at the back of the mouth

Question 23

cause of herpangina

Answer 23

enterovirus

Question 24

Tx of herpangina

Answer 24

self-limiting - tends to resolve within 7 days

Question 25

what is erythema infectiosum also known as

Answer 25

slapped cheek disease

Question 26

cause of erythema infectiosum

Answer 26

parvovirus B19

Question 27

presentation of erythema infectiosum

Answer 27

intense erythema on cheeks and proximal limbs

Question 28

Tx of erythema infectiosum

Answer 28

paracetamol and supportive therapy

ibuprofen

Question 29

what is Orf

Answer 29

a virus found in sheep

Question 30

given what Orf is, who normally presents with the virus

Answer 30

farmers - presents on the hands

Question 31

Tx of Orf

Answer 31

self-limiting