Week 3- Viral & Fungal Skin Infections

Question 1

Vesicles are ususally caused by which viruses?

Answer 1

• Herpes Simplex
• Varicella Zoster
• Poxviruses
• Coxsackie virus
• Entero/echo viruses

Question 2

What is the incubation period for chickenpox?

Answer 2

21 days

Question 3

Does chickenpox (varicella) start peripherally or centrally?

Answer 3

Centrally

It is very rare on the hands and feet.

Question 4

What is a complication of chickenpox?

Answer 4

Varicella Pneuomonitis

Question 5

What 2 dermatomal branches does Herpes Zoster usually manifest on?

Answer 5

1. T5-L2
2. The opthalmic branch of the trigeminal nerve

Question 6

What 2 ways can you diagnose Varicella infection?

Answer 6

1. Serology
   
   • VZV IgG- previous exposure - shingles likely.
   • VZV IgM - acute infection - chickenpox.
2. Direct Immunofluorescence
   
   • Viral swab the base of the lesion.

Question 7

What is the management for pregnant women who have been exposed to Varicella?

Answer 7

• If immune - no action
• If Unsure or not immunised- check VZV IgG
  
  • VZV IgG present - no action needed.
  • VZV IgG not present - Give VZV Antiboies.

Question 8

What skin infections can herpes simplex cause?

Answer 8

• Gingivostomatitis
• Genital infection
• Eczema Herpeticum
• Herpetic whitlow
• Erythema Multiforme (Mycoplasma and HSV are the most common cause)
• Cold sores

Question 9

What 2 skin infections does the Coxsackie Virus cause?

Answer 9

1. Hand Foot and Mouth
2. Herpangina

Question 10

What viruses cause maculopapular rashes?

Answer 10

• Rubella
• Parvovirus
• Entero/Echovirus
• Measles
• EBV
• CMV
• Dengue

Question 11

What is the usual manifestation for Slapped Cheek?

Answer 11

• Brief febrile illness withcough
• 7 days of feeling well
• Rash develops around cheeks and then 1-4 days later appears on the limbs.
• It lasts 1-3 weeks.

Question 12

What is a complication of Parvovirus B19?

Answer 12

Viral arthritis

It is non-destructive and can last up to 1 year.

Question 13

What virus is usually misdiagnosd as measles?

Answer 13

Roseola Infantum

(HHV6)

Question 14

In what condition do you get Koplick spots?

Answer 14

Measles

Question 15

Pityriasis Rosea present with a herald patch and then a maculopapular rash. How long does itlast for?

Answer 15

40 days and 40 nights :-)

Question 16

What is this and what is it’s treatment?

Answer 16

Pityriasis versicolor

Wood’s lamp=pale yellowfluorescence.

Treatment

• Selsun shampoo
• Ketoconoazole shampoo
• Lamisil
• Oral Imidazoles

Question 17

What is the treatment for molloscum contagiosum?

Answer 17

• Molludab in the UK
• Immiquimod -if they are widespread and many
• Topical acids - Salicylic or TCA
• Podophyllotoxincream
• Cryotherapy
• Adapelene (Retinoic acid)
• Curretage

Question 18

What is the most common cause of Erythema Multiforme?

Answer 18

HSV

Question 19

What is this and what is the treatment?

Answer 19

Tinea Capitis

Oral Griseofulvin 15-20mg/kg/day for 6-8 weeks.

(Hair usualy regrows after and close contacts should be treated with ketoconazole shampoo)

Question 20

What is this?

Answer 20

hyytr

It is usually wrongly diagnosed as a bacterial infection.

Treatment is with oral antifungals.