Viral Derm Flashcards
(40 cards)
1
Q
ERYTHEMA INFECTIOSUM
- Definition
- Etiology
A
- childhood exanthem, 5ths disease
2. parvovirus B19 (highly contagious, droplet spread)
2
Q
ERYTHEMA INFECTIOSUM
- Predisposing conditions
- Clinical features
A
- exposure, late winter/early spring, community outbreaks
- incubated 4-14 days; prodrome (fever, malaise, HA, coryza) followed by burning, hot “slapped cheek” then generalized reticular rash 1-6 weeks; adult women may have arthralgia or be asymptomatic
3
Q
ERYTHEMA INFECTIOSUM
- Diagnosis
- Differential diagnosis
A
- appearance, serology
2. rubella, rubeola, scarlet fever, roseola, drug reaction, rheumatoid arthritis
4
Q
ERYTHEMA INFECTIOSUM
- Treatment
- Complications
A
- supportive (lasts a few days-weeks), NOT contagious once rash appears
- recurrence; triggers - sun, exercise, bathing, stress; miscarriage, hydrops fatalis in pregnancy
5
Q
HAND, FOOT & MOUTH DISEASE
- Definition
- Etiology
A
- short-lived contagious viral infection
2. Coxsackie A16 virus or enterovirus 71
6
Q
HAND, FOOT & MOUTH DISEASE
- Predisposing conditions
- Clinical features
A
- late summer/early fall, kids under 5, household contacts, passed by direct contact w/ nasal or oral secretions
- 4-6 day incubation then small vesicles form in mouth; rhomboid/square yellow vesicles appear on hands, feet, buttvesicles –> bullae –> erosions, 7-10 days w/o complications
7
Q
HAND, FOOT & MOUTH DISEASE
- Diagnosis
- Differential diagnosis
A
- serology, clinical presentation
2. herpangina, aphthous stomatitis, herpes simplex
8
Q
HAND, FOOT & MOUTH DISEASE
- Treatment
- Complications
A
- symptomatic; recurrence rare; isolate kids 3-7 days to prevent spread
- rare; miscarriage; fetal growth retardation in pregnancy
9
Q
HERPES SIMPLEX
- Definition
- Etiology
A
- acute, self-limiting viral infection involving skin and mucus membranes
- herpes simplex virus 1 and 2
10
Q
HERPES SIMPLEX
- Predisposing conditions
- Clinical features
A
- direct contact; droplet infection; open skin
- primary infection: acute development of grouped macules to painful vesicles that erode to crusts; prodrome possible; lesions resolve 2-6 weeks; lies dormant in DRG; many asymptomaticsecondary infect: reactivation of virus; travels through peripheral nerves; predisposed by menses, fatigue, trauma, stress; fewer localized vesicles; prodrome rare
11
Q
HERPES SIMPLEX
- Diagnosis
- Differential diagnosis
A
- clinical presentation, PCR, Tzanck smear/culture, serum assay
- herpes zoster, herpes gladiatorum
12
Q
HERPES SIMPLEX
- Treatment
- Complications
A
- symptomatic, topical/PO antivirals, L-lysine
- disseminated herpes simplex, herpetic whitlow (herpes on fingers that can cause circulation problems), erythema multiforme, Bell’s palsy
13
Q
VARICELLA
- Definition
- Etiology
A
- highly contagious viral infection resulting in lifelong immunity; chickenpox
- varicella zoster virus (herpesvirus 3)
14
Q
VARICELLA
- Predisposing conditions
- Clinical features
A
- exposure, immunosuppression
- 10-23 day incubation; contagiousness HI 2 days before symptoms until all crust; prodrome 1-2 days; crops of pruritic macules that become teardrop vesicles; surrounding erythema; crust over 6-8 hours; drop off within 1 week”dew drop on a rose petal”
15
Q
VARICELLA
- Diagnosis
- Differential diagnosis
A
- clinical presentation, PCR, culture, Tzanck smear, serology
- bullous impetigo, disseminated HSV, folliculitis, impetigo, measles
16
Q
VARICELLA
- Treatment
- Complications
- Prevention
A
- symptomatic in uncomplicated cases; antiviral agents if indicated
- hemorrhagic varicella, 2ary infection, encephalitis, pneumonia, myocarditis, hepatitis, acute hemorrhagic nephritis; can spread in utero during pregnancy; 30% mortality to newborwns
- childhood immunization
17
Q
HERPES ZOSTER
- Definition
- Etiology
A
- acute, unilateral, localized infection usually involving a single dermatome
- reactivation of varicella zoster
18
Q
HERPES ZOSTER
- Predisposing conditions
- Clinical features
A
- immunosuppression, localized trauma, increased age (70+), lymphoma/malignancy, radiation/chemo, steroids, stress
- 3-5 days localized painful symptoms; red macule rapidly becomes papular then vesicular; surrounding erythema; vesicles group over 2-3 weeks become pustular then scab; scabs fall off and leave white scar; constitutional symptoms may precede eruption
19
Q
HERPES ZOSTER
- Diagnosis
- Differential diagnosis
A
- clinical presentation, PCR, Tzanck smear, serology, culture
- HSV, contact dermatitis
20
Q
HERPES ZOSTER
- Treatment
- Complications
- Prevention
A
- PO antiviral, gabapentin, rest, topical analgesics; steroids?; sympathetic blocks
- post-herpetic neuralgia, disseminated herpes zoster, Ramsey-Hunt’s syndrome, herpes zoster ophthalmicus (pt should see eye doc right away), Bell’s palsy, cerebellitis
- vaccine > 60yrs
21
Q
MOLLUSCUM CONTAGIOSUM
- Definition
- Etiology
A
- self-limiting mucocutaneous viral infection
2. poxvirus
22
Q
MOLLUSCUM CONTAGIOSUM
- Predisposing conditions
- Clinical features
A
- swimming pools, children, communal bathing, atopic dermatitis, close contact, autoinoculation, HIV
- asymptomatic skin-colored papule; dome-shaped with central punctum (umbilicus); can occur anywhere
23
Q
MOLLUSCUM CONTAGIOSUM
- Diagnosis
- Differential diagnosis
A
- clinical features, biopsy, microscopic eval of central core
- keratoacanthoma, basal cell carcinoma, flat/genital warts, herpes
24
Q
MOLLUSCUM CONTAGIOSUM
- Treatment
- Complications
A
- supportive; topical tretinoin (RetinA); Aldara, Cantharidin, liquid N2; surgical/destructive treatment in genital region
- rare, scarring, can induce dermatitis
25
MEASLES (Rubeola)
1. Definition
2. Etiology
1. highly contagious childhood viral infection
| 2. paramyxovirus group
26
MEASLES (Rubeola)
1. Predisposing conditions
2. Clinical features
1. densely populated and socioeconomically depressed areas; winter/spring
2. 10-15 day incubation then prodrome of 3 Cs (cough, coryza, conjunctivitis); "Koplik spots" (blue white) on buccal mucosa during prodrome then disappear at peak of rash; red macules, papules begin 4th day on face/neck/behind ears; spread to trunk and limbs 3-4 days; lesions coalesce then clear in 3 days and leave behind brown stain
27
MEASLES (Rubeola)
1. Diagnosis
2. Differential diagnosis
1. antibody titers, clinical presentation
| 2. viral exanthem, scarlet fever, drug eruption, rubella, mono
28
MEASLES (Rubeola)
1. Treatment
2. Complications
3. Prevention
1. symptomatic, antibiotics if 2ary infection develops
2. 2ary bacterial infection, post-infectious encephalitis, myocarditis, viral pneumonitis, OM, GI problems, glomerulonephritis
3. live-attenuated vaccine
29
RUBELLA (German measles, 3 day measles)
1. Definition
2. Etiology
1. common viral infection affecting skin, lymph nodes and joints
2. togavirus
30
RUBELLA (German measles, 3 day measles)
1. Predisposing conditions
2. Clinical features
1. lack of proper immunizations, springtime
2. incubation 14-21 days followed by prodrome (malaise, fever, HA etc); very small pink macules with prodrome begin on face/scalp and spread downward; become papular then desquamate; papules fade in 3 days; red petechiae occur on soft palate (Forchheimer spots)
31
RUBELLA (German measles, 3 day measles)
1. Diagnosis
2. Differential diagnosis
1. antibody titers, clinical presentation
| 2. viral exanthem, measles, scarlet fever, drug eruption
32
RUBELLA (German measles, 3 day measles)
1. Treatment
2. Complications
3. Prevention
1. symptomatic
2. threat to unborn child (miscarriage, stillbirth
)3. MMR immunization
33
ROSEOLA INFANTUM
1. Definition
2. Etiology
1. childhood exanthem AKA exanthem subitum, 6th disease
| 2. HHV-6 or HHV-7
34
ROSEOLA INFANTUM
1. Predisposing conditions
2. Clinical features
1. exposure, 6-24 months old, otherwise healthy
2. no URI sxs, incubation 5-15 days, high fever each night x3 days followed by pink maculopapular rash on trunk and neck 3-4 days later; febrile seizures common
35
ROSEOLA INFANTUM
1. Diagnosis
2. Differential diagnosis
3. Treatment
1. clinical presentation, cultures, serology
2. rubella, rubeola, erythema infectiosum, scarlet fever
3. supportive
36
WARTS
1. Definition
2. Etiology
1. common viral infection of skin and mucus membranes
| 2. human papilloma virus
37
WARTS
1. Predisposing conditions
2. Clinical features
1. localized trauma, immunosuppression, communal bathing
2. Common: skin colored, pink, thrombosed capillaries; papules smooth then rough; hands or other body areas
Plane/Flat: skin colored, pink; smooth plaque; face, hands, limbs
Plantar: skin colored, thrombosed capillaries; raised, rough; feet
Mosaic: skin colored, thrombosed capillaries; rough plaque; soles, heels, palmar, periungual (along skin of nails)
38
WARTS
1. Diagnosis
2. Differential diagnosis
1. appearance, clinical presentation, disruption of skin lines
2. seborrheic dermatitis, squamous cell carcinoma, melanoma
39
WARTS
1. Treatment
2. Complications
3. Prevention
1. spontaneous involution; physical (duct tape, liquid N2, excision); chemical (tretinoin, cantharidin); immunotherapy (imiquimod); phototherapy; chemotherapy (5-FU, bleomycin)
2. recurrence, spread to contacts/self, extension to treatment periphery
3. keep surfaces clean/dry, aqua socks/flip flips in common areas
40
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