Viral Skin Infections - Wright Flashcards
HSV-1: where does it cause lesions?
perioral, lips, oral cavity
HSV-2: where does it cause lesions?
genital area
It takes two to get an STD
How is HSV transmitted?
Direct contact
History of primary HSV infection?
Pain, burning, and tingling in the area. Possible fever, malaise, LAD
What happens symptomatically as HSV recurs?
The symptoms tend to get milder
Appearance of HSV infection?
clusters of monomorphous vesicles with an erythematous base; “punched out” lesions and crusted papules
What petry dish technique is used to dx HSV?
Tzanck smear, you will see multinucleate giant cells
Should you culture/PCR HSV?
Yes
What is herpes zoster commonly known as?
Shingles
What increases your chances of VZV reactivation?
Age over 60, immunosuppression
Where does VZV lay dormant?
Dorsal root ganglia
What are some triggers for VZV reactivation?
Trauma, stress, fever, radiation, immunosuppression
Clinical appearance of VZV?
grouped vesicles following a DERMATOME; most commonly on the trunk
What is positive Hutchinson’s sign? What does this mean (THIS IS ON THE TEST)?
Vesicles at the tip/side of the nose; indicates the nasociliary branch of V1 is involved
Why is a positive Hutchinson’s sign a bad thing?
It increases the patient’s risk of blindness
What is a common complication of VZV after it resolves?
Postherpetic neuralgia (continued nerve pain) in 5-20% of patients, typically over 40
Differentiating between HSV and VZV on history and physical alone?
HSV is not as painful, doesn’t follow a dermatome
Is there a vaccine for VZV? Who should get it?
Yes, Zostavax; those 60 and older
What is molluscum contagiosum?
Cutaneous infection caused by the pox virus
What is the course of molluscum contagiosum? What will it leave behind?
Resolves spontaneously in months to years; can leave behind a depressed scar
Clinical manifestation of mollscum contagiosum?
pink to skin-colored, 2-10 mm, dome-shaped, waxy papules, commonly with CENTRAL UMBILICATION
Where does molluscum contagiosum commonly present?
Face, upper chest, extremities
Treatment of molluscum contagiosum?
No clear evidence to support any one therapy.
She did talk about a drug called Cantharidin. MOA is to essentially cause blister of molluscum, dries up then falls of
What causes warts (verrucae)
HPV
What are the oncogenic strains of HPV? (she said to know this)
16, 18, 31, 33
What do common warts look like? Where are they most common?
Single/multiple skin-colored, hyperkeratotic papules or plaques, might have black dots; most common on the HANDS (but can be anywhere)
What are the “black dots” you see in warts?
Thrombosed capillaries
What are filliform warts?
Warts that look like fingers; commonly around the eye or mouth
Describe flat warts. Where are they most common?
Smooth, skin-colored to slightly tan/pink flat-topped thin papules (3-5mm); legs (most common), face, arms, neck
What facilitates the spread of flat warts?
Shaving
Where are plantar warts found?
Plantar foot, toes
What is commonly seen in the plantar wart?
The black dots
What is characteristic of the appearance of anogenital warts?
Can form large masses resembling cauliflower
What is the best treatment for warts? Patients don’t like this answer
Over the counter therapies
What are the 2 HPV vaccines?
Gardasil (16, 18, 6, 11) and Cervarix (16 and 18)
