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Flashcards in Viral Disorders of skin Deck (76):
1

Other names for Erythema Infectiosum?

-5ths disease -Slapped-cheek disease

2

Viral cause of Erythema Infectiosum?

Parvovirus B19

3

Predisposing conditions for Erythema infectiosum?

-Exposure -Late winter/early spring -Community outbreak

4

Treatment for Erythema infectiosum?

Supportive (NOT contagious once rash appears)

5

How long does Erythema infectiosum usually last?

A few days to several weeks

6

Clinical features of Erythema infectiosum? (In order of appearance)

-Incubation period of 4-14 days -Prodrome -burning, hot "slapped-cheek" -generalized reticular rash -may be asymptomatic

7

Complications with Erythema infectiosum?

-Recurrance (triggers: sun, exercise, bathing, stress) -Miscarriage -Hydrops fatalis in pregnancy

8

Definition of Hand, Foot, & Mouth Disease?

short-lived, contagious viral infection

9

Viral cause of Hand, Foot, & Mouth Disease?

-Coxsackie A 16 Virus -Enterovirus 71

10

Predisposing conditions of Hand, Foot, & Mouth Disease?

-Late summer/early fall -Children <5 -Household Contacts

11

Clinical features of Hand, Foot, & Mouth Disease? (in order of appearance)

-4-6 day incubation period -small vesicles form in mouth -square, yellow vesicles appear on hands, feet, and buttocks -vesicles --> bullae --> erosions

12

How long does Hand, Foot, & Mouth disease usually last?

7-10 days without complications

13

Treatment for Hand, Foot, & Mouth disease?

Symptomatic

14

Complications with Hand, Foot, & Mouth disease?

-Rare -Miscarriage -Fetal growth retardation

15

Definition of Herpes Simplex Virus?

Acute viral infection involving skin and mucous membranes

16

Viral cause of Herpes Simplex?

Herpes Simplex Virus 1 & 2

17

Predisposing conditions for Herpes Simplex?

-Direct contact -Droplet infection -Open skin

18

Clinical features for primary infection of Herpes simplex?

-Acute development of grouped macules --> painful vesicles --> eroding to crusts -possible prodrome -lymphadenopathy -lies dormant in dorsal root ganglia -many are asymptomatic

19

Clinical features for secondary infection of Herpes simplex?

-Reactivation of virus -Travels thru peripheral nerves -Predisposed via menses, fatigue, stress, trauma, sunlight -Fewer vesicles; localized -Rarely associated w/ constitutional symptoms

20

Where is Herpes simplex - primary infection - mostly manifested?

Facial/oral

21

Where is Herpes simplex - secondary infection - mostly manifested?

Genitalia

22

Treatment for Herpes simplex?

-Symptomatic -Topical/PO antivirals

23

Complications with Herpes simplex?

-Disseminated herpes simplex -herpetic whitlow -erythema multiforme

24

How to diagnose Herpes simplex?

-Clinical presentation -PCR -Tzanck smear -Serum assay

25

Definition of Varicella?

highly contagious viral infection resulting in lifelong immunity

26

Viral cause of Varicella?

Varicella zoster virus (Herpes virus 3)

27

Predisposing conditions to Varicella?

-Exposure

-Immunosuppression

28

Clinical features of Varicella?

-10-23 day incubation period

-HIGH contagiousness level

-Prodrome for 1-2 days

-Crops of pruritic macules --> teardrop vesicles --> crust over w/in 6-8 hours

-Surrounding erythema

29

Treatment for Varicella?

-symptomatic in uncomplicated cases

-antiviral agents if indicated

30

Distinguishing phrase for Varicella?

'Dew drop on a rose petal'

31

Complications of Varicella?

-Hemorrhagic varicella

-Secondary infection

-Encephalitis

-Pneumonia

-Myocarditis

-Hepatitis

-Can spread in utero during pregancy

-30% mortality to newborns

32

Definition of Herpes Zoster (Shingles)?

acute, unilateral, localized infection usually involving a single dermatome

33

Viral cause of Herpes zoster?

Reactivation of varicella zoster virus

34

Predisposing conditions for Herpes Zoster?

-Immunosuppression

-Localized trauma

-increased age (>70)

-lymphoma/malignancy

-radiation/chemotherapy

-steroids

-stress

35

Clinical features of Herpes Zoster?

-3-5 days of localized symptoms (PAINFUL)

-Red macule --> papular --> vesicular

-Surrounded by erythema

-Vesicles group over 2-3 weeks, become pustular, scab over

-Scabs fall off, leave white scar

-Fever, chills, etc. may precede eruption

36

Treatment for Herpes Zoster?

-PO Antiviral

-Gabapentin (nerve pain modulator)

-rest

-topical analgesics

-steroids

-sympathetic blocks

37

Complications with Herpes Zoster?

-post-herpetic neuralgia

-disseminated herpes zoster

-Ramsey-Hunt's syndrome

-Herpes zoster ophthalmicus (can lead to blindness)

-Bell's palsy

-cerebellitis

38

Prevention for Herpes Zoster?

Vaccine (must be >60 years)

39

Prevention for Varicella?

Childhood immunization (>12 mo.)

40

Definition of Molluscum Contagiosum?

self-limiting mucocutaneous viral infection

41

Viral cause of Molluscum Contagiosum?

Poxvirus

42

Predisposing conditions to Molluscum Contagiosum?

-Swimming pools

-children

-communal bathing

-atopic dermatitis

-close contact

-autoinoculation

43

Clinical features of Molluscum Contagiosum?

-Asymptomatic skin-colored papule

   -dome-shaped w/ central punctum

44

Treatment for Molluscum Contagiosum?

-Supportive

-topical tretinoin

-Aldara (immune modulator)

-Cantharidin (erodes area)

-liquid N2

-surgical/destructive tx

45

Complications of Molluscum Contagiosum?

Rare, but occasional scarring

46

Definition of Measles (Rubeola)?

highly contagious childhood viral infection; spreads from neck down

47

Viral cause of Measles?

Paramyxovirus group

48

Predisposing conditions of Measles?

-densely populated/socioeconomically depressed areas

-winter/spring

49

Clinical features of Measles?

-10-15 day incubation period

-Prodrome of 3 C's

   -cough, coryza, conjunctivitis

-"Koplik spots" - blue/white on buccal mucosa during prodrome

-red macules/papules on 4th day - face/neck/ears

-become papules, spread to trunk & limbs w/in 3-4 days

-lesions coalesce, clear in 3 days

-leaves brown stain behind

50

Treatment for Measles?

-Symptomatic

-Antibiotics if secondary infection develops

51

Complications for Measles?

-secondary bacterial infection

-post-infectious encephalitis

-myocarditis

-viral pneumonitis

-OM

-GI problems

-glomerulonephritis

52

Prevention of Measles?

Live-attenuated vaccine

53

Definition of Rubella?

common viral infection affecting skin, lymph nodes, and joints

54

Viral cause of Rubella?

Togavirus

55

Predisposing conditions for Rubella?

-alck of proper immunizations

-springtime

56

Clinical features of Rubella?

-Incubation period 14-21 days

-Prodrome follows

-Small, pink macules coincide with prodrome

   -begins on face/scalp, spreads down

-Macules become papular, then desquamate

-Papules fade w/in 3 days

-Red petechiae may occur on soft palate

57

Treatment for Rubella?

Symptomatic

58

Complications of Rubella?

Threat to unborn child

59

Prevention of Rubella?

MMR vaccination

60

Other terms for Rubella?

-German measles

-"3 Day Measles"

61

Other terms for Roseola Infantum?

-Childhood exanthem

-Exanthem subitum

-6th Disease

62

Viral cause of Roseola Infantum?

-Human Herpes Virus (HHV) 6 or 7

63

Predisposing conditions to Roseola Infantum?

-exposure

-6-24 month-olds, otherwise healthy

64

Clinical features of Roseola Infantum?

-incubation of 5-15 days

-high fever each night, no day fever

-followed by pink maculopapular rash 3-4 days later

   -usually trunk & neck

-otherwise asymptomatic

-febrile seizures common

65

Treatment of Roseola Infantum?

Symptomatic

66

Definition of Warts?

Common viral infections of skin and mucous membranes

67

Viral cause of warts?

Human papilloma virus (HPV)

68

Predisposing conditions of warts?

-Localized trauma

-immunosuppression

-communal bathing

69

4 different types of warts?

-Common

-Plane (flat)

-Plantar

-Mosaic

70

Characteristics of Common Wart?

-Skin-colored/pink

-Thrombosed capillaries (patches of black streaks)

-Papules, smooth --> rough

-Hands, anywhere

71

Characteristics of Plane (Flat) warts?

-Skin-colored, pink

-Smooth plaque surface (shiny)

-Face, hands, limbs

72

Characteristics of Plantar warts?

-Skin-colored

-thrombosed capillaries

-raised, rough, thick

-feet - can be painful

73

Characteristics of Mosaic warts?

-skin-colored

-thrombosed capillaries

-rough plaque

-soles, heels, palmar, periungual (skinfolds underneath nails)

74

Treatment of warts?

-spontaneous involution

-physical (N2, duct tape)

-chemical

-immunotherapy

-phototherapy

-chemotherapy

75

Complications of warts?

-recurrence

-spread to contacts/self-innoculation

-extension to tx periphery

76

Prevention of warts?

-keep surfaces clean/dry

-aqua socks/flip flops/slippers in common areas