Derm viruses Flashcards by Joe Cioccio

How does a wart actually form in HPV infections?

when the virus infects basal cells (stratum basale) it stimulates cell division

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How do ya differentate smallpox from chickenpox clinically?

synchronous lesions in smallpox, variable staged lesions in chickenpox

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Between chickenpox and smallpox, which has lesions that would more closely resemble molluscum?

smallpox because they are often umbilicated

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Name 2 derm viruses that may result in the formation of syncytia

Herpes and measles

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Regarding the appearance of the rash (not evolution of) how is measles different from german measles?

Germn measles is lighter in color (pink)

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What is the most important historical feature of HHV-6?

Extremely high fever that abruptly stops and then there is a maculopapular rash

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Compare and contrast the incubation period of measles and german measles

German measles is 2-3 weeks, measles is only 9 days

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What virus causes hand, foot, and mouth? What kinda, sorta, but not really all that similar disease is caused by fungus?

Coxsackie A16; two foot, one hand which is a tinea infection

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What is the key feature of ALL herpes viruses?

latency! i.e. nerve ganglia for HSV and VZV, B cells for EBV, etc? B/T cells for HHV-6

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What viral family is measles in?

paramyxoviridae

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How are HPV and MCV transmitted?

direct contact and fomites

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What profession may be likely to get Orf infections?

Taxidermists

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Where will you find a Cowdry Type A body? What does it tell you about the entirety of the herpesviridae family?

Intranuclear, HERPES VIRUSES REPLICATE IN THE NUCLEUS

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Genetic makeup of A) B19 B) HHV-6

A) naked ssDNA B) enveloped ds DNA

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How does Dr. Kell pronouce “rash”?

Raysh

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Name the 3 enveloped DNA virus families

Hepadnaviridae, herpesviridae, and poxviridae

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Please describe the evolution of the measles illness

Starts with a cold/flu like Sx 9-10 d after infection, in this they will have the classic cough, conjunctivitis, coryza, and PHOTOPHOBIA? Then they will get the rash behind ears and down (with koplick spots in mouth) 3 days later and it will progress to the feet by 6 d

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Severe complications of viral infection of eczematous skin occur with ________

HERPES!

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Which strains of HPV are responsible for plantar warts?

1 and 4, flat and grow inward

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If you are not vaccinated against VZV, what is the probability you will be infected when exposed to someone with it?

90%

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When did routine smallpox vaccinations stop in America? When was it GLOBALLY eradicated?

1972, 1979

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What is the transmission of A) measles B) rubella and C) B19

ALL = RESP DROPLETS

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What kind of virus is molluscum contagiosum?

enveloped DS DNA virus (complex shape)

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What is the most common complication of shingles?

post-herpetic neuralgia

What is the vaccine type for measles?

MMR, live-attenuated

What cells are infected by HPV? B19?

HPV infects basal cells of skin, B19 infects erythroid progenitor cells

What is erythema infectiosum? Exanthem subitum?

B19, HHV-6

Which of the childhood exanthems will have a multinucleate giant cell under microscopy?

measles

In what sense is the rash of B19 similar to that in lupus?

It is on the face and is sensitive to sunlight

What family of virus is measles? German measles?

rubeola = paramyxoviridae, rubella = togaviridae

Describe how HPV infects

it is a naked dsDNA virus that infects the basal layers of skin but replicates in the mature layers

What kind of virus is orf and how is it transmitted?

enveloped DS DNA virus; sheep, goats, and reindeer

What virus causes herpangina?

Coxsackie A--this is basically hand, foot, and mouth without the hand and foot. And it isn't caused by the same serotype? So I guess it's actually completely different. Whatever.

How is HPV transmitted?

direct contact and fomites

What virus causes herpetic whitlow? Population at risk?

HSV; dental hygenists who don't understand the concept of a glove

Where do the following replicate A) HPV B) HHV-6 C) B19 D) HHV-8

A) mature keratinocytes (infects basal) B) T and B cells C) erythroid precursor cells D) vascular endothelial cells

Which strains of HPV are responsible for dysplasia of the cervix and white plaques

16 and 18

What is the genetic makeup for HHV-6 and HHV-8?

ds DNA, enveloped

What kind of virus is smallpox?

small pox = enveloped dsDNA

What is the major demographic you are concerned about in terms of complications, for B19?

sickle cell (and, though not mentioned, thalassemias as well)

Name the 3 naked DNA virus families

Papovaviridae, Adenoviridae, and Parvoviridae

Which strains of HPV are responsible for warts on fingers and knees?

2, 3, 10

What kind of virus are the Coxsackie viruses?

naked ss RNA picornaviruses

Name the 3 dermatologic viruses that do not involve systemic spread

Molluscum contagiosum (can be a marker of HIV), HPV, and ORF

What are the 2 major complications of measles?

Pneumonia and Subacute Sclerosing Panencephalitis

Which strains of HPV are most responsible for genital warts

6 and 11

How is smallpox transmitted? Chickenpox?

RESPIRATORY DROPLETS

How is smallpox transmitted? How does it spread throughout the body?

Respiratory droplets, spreads via lymphatics

Which dermatologic virus is vaccinated using a vaccine containing a different virus than that which is being vaccinated against?

Smallpox is vaccinated for with a live cowpox vaccine

If you have a biopsy with syncytia (and it is a derm question) how can you differentiate between herpes and measles WITHOUT clinical Hx?

Look for a Cowdry Type A body in the newclaus

Name the 4 dermatologic viruses that have systemic spread and an infectious rash

HSV-1,2, VZV, Variola, and Coxsackievirus

Genetic makeup of A) Measles B) rubella and C) B19

A) enveloped ssRNA B) enveloped ssRNA C) naked ss DNA

Why is possible to achieve lifelong immunity with measles?

there is only 1 antigenic type of measles

What kind of virus is measles? What family? What is the transmission? Incubation period?

enveloped ssRNA, paramyxoviridae, respiratory droplets, 9-10 d

What family is molluscum contagiosum in?

poxviridae

Name the 4 dermatologic viruses that have systemic spread and a non-infectious rash

HHV-6, HHV-8, measles, and rubellla

If a woman has rubella while pregnant, what is the likely outcome for the baby?

low birth weight, cataracts, deafness, MR, heart defects, diabetes (mulberry muffin)

What virus causes a blistering "rash" and is a picornavirus?

Coxsackie A and A16

Name the classic 5 childhood exanthems

rubella (german measles), rubeola (normal measles), roseola (HHV-6), chickenpox (VZV), and 5th disease or Parvovirus B19