Viral Skin Infections Lecture Powerpoint

Question 1

Wart definition

Answer 1

Benign roliferation of skin and mucosa caused by HPV transmitted via direct or indirect contact

Question 2

HPV subtypes associated with malignancy (6)

Answer 2

6, 11, 16, 18, 31, 35

Question 3

Heck disease/focal epithelial hyperplasia

Answer 3

A rare manifestation of HPV of the oral mucosa with an infecetion of some subtypes of HPV

Question 4

Common warts on the hands and feet are typically what subtype? (2)

Answer 4

2,4

Question 5

Deep palmoplantar warts/myrmecia and what subtype causes it?

Answer 5

Sharp calloused warts that grow deep and are more painful than common warts, tend to occur in weight bearing areas, caused by subtype 1 predominantly

Question 6

Butcher’s wart and what subtype causes it?

Answer 6

Cutaneous skin condition among butchers and other meat handlers caused by HPV subtype 7 that infects the skin

Question 7

Most warts spontaneously resolve within…

Answer 7

…2 years

Question 8

When should warts be treated? (4)

Answer 8

-if present for more than 2 years -if spreading or symptomatic -if psychosocial or employment ramifications -if concern for malignancy

Question 9

First line of treatment for warts

Answer 9

Salicylic acid topical repeatedly (might supplement with adhesiotherapy as well)

Question 10

Cryotherapy

Answer 10

Use of liquid nitrogen in multiple treatment sessions to destroy a wart often done in conjugation with other treatments

Question 11

Verruca vulgaris

Answer 11

Common wart, usually asymptomatic but painful at times and appears as a hyperkaratotic papule with rough irregular surface and often seen on hands and knees but can occur anywhere, resoves without intervention

Question 12

Verruca plantaris

Answer 12

Plantar warts that typically manifest as small growths on sole of foot, may be painful, often occur at pressure points, typically treated if painful or spreading

Question 13

Filform (digitate) warts

Answer 13

Long slender growths with stalk like appearance that manifest on areas of thin skin (such as face) and commonly bleed, often need treatment

Question 14

Some rare forms of warts or those that do not resolve are common feature of a ___ patient

Answer 14

HIV positive

Question 15

Verruca planus

Answer 15

Flat warts that frequently appear on back of hands, shins, and face, appear as flesh colored flat topped papules and can become very confluent

Question 16

Subungal and periungal warts

Answer 16

Warts that appear around or under the fingernail, more resistant due to barrier and painful to treat due to proximity to sensitive nail bed, laser therapy might be an option

Question 17

Whats the concern of untreated subungal or periungal warts?

Answer 17

Damage to nail matrix causes permanent and irreversible nail disfigurement

Question 18

Genital warts (condylomata acuminata) are most often these 2 subtypes

Answer 18

6 and 11

Question 19

Condylomata acuminata

Answer 19

Genital warts, can be found in any area of sexual contact, can be asymptomatic or cause burning, itching, tenderness

Question 20

Concerns of pregnancy and genital warts

Answer 20

-Neonates may acquire infection when passing thru infected birth canal so depending on number of lesions may advise C section to avoid transmission to neonate

Question 21

2 biggest treatments for genital warts

Answer 21

-surgical excision (lowest recurrence rate) -cryotherapy (safe even during pregnancy)

Question 22

Molluscum contagiosum

Answer 22

Caused by a DNA poxvirus strictly in humans, has distinct appearance of single or multiple umbilicated (caseous plug, distinct clinical diagnosis) papular lesions round, dome shaped and waxy

Question 23

Majority of molloscum contagiosum infections are caused by type ___ poxvirus

Answer 23

1

Question 24

How is molluscum contagiosum spread? What are 3 distinct disease patterns prevalent?

Answer 24

-Direct contact or fomites -children (fomites), immunocompetent adults (STI), and immunocompromised children or adults (widespread)

Question 25

Both molluscum contagiosum and HPV can undergo spread to different parts of the body via…

Answer 25

…autoinoculation

Question 26

Molluscum contagiosum spares the ___ and ___ (most of the time)

Answer 26

palms, face

Question 27

Most effective treatment for molluscum contagiosum

Answer 27

Curettage, most of the time spontaneously resolves tho

Question 28

HSV 1 is typically presenting as ___ and HSV 2 as ____, but….

Answer 28

orofacial, genital, starting to see more and more crossover

Question 29

Herpes simplex virus

Answer 29

An infectious DNA virus of which humans are the only natural reservoir, invades NS and goes into latency until reactivation, spread via close personal contact, 90% of adults seropositive for HSV1 by 50’s and don’t realize it (very VERY common)

Question 30

HSV primary infection

Answer 30

Tends to be accompanied by systemic signs, sometimes not even manifesting lesions and thus aren’t diagnosed

Question 31

Herpes labialis

Answer 31

Herpes around the lips, most common recurrent HSV 1 infection

Question 32

Herpetic whitlow Herpes gladiatorum

Answer 32

-HSV of finger following inoculation from self or other -Face, arms, neck, and trunk infection from contact sport players

Question 33

HSV gold standard diagnositc test

Answer 33

Isolation of virus by culture

Question 34

Tzank smear

Answer 34

A quick rapid means of testing HSV but does not distinguish between 1 and 2

Question 35

A serologically negative patient but viral culture positive patient for HSV indicates the patient is undergoing…

Answer 35

…primary infection

Question 36

Treatments for HSV (4 of the same family and 1 fun fact about each(

Answer 36

-Pencyclovir (only topical prep) -Acyclovir (5 times a day dosing) -valancyclovir (better dosing) -famciclovir (better bioavailablilty)

Question 37

Varicella zoster virus causes these 2 infections with skin manifestations

Answer 37

Varicella (chicken pox, initial exposure) herpes zoster (shingles) reactivation of virus

Question 38

Characteristic rash of varicella zoster virus

Answer 38

“Dewdrop on roses” maculopapular lesions

Question 39

Herpes zoster appearance

Answer 39

Vesicular rash in a single dermatome that almost never crosses dermatomes and rarely crosses to multiple dermatomes

Question 40

Post herpatic neuralgia

Answer 40

Complication of herpes zoster that can last for years

Question 41

Herpes zoster opthalmicus

Answer 41

Reactivation of the herpes zoster virus in trigem nerve that can cause occular involvement

Question 42

Starting antiviral therapy within 72 hours of shingles outbreak…

Answer 42

…can limit risk of post herpatic nerualgia

Question 43

What condition is this?

Answer 43

Filiform wart

Question 44

What condition is this?

Answer 44

Molluscum contagiosum