Viral exanthem

Question 1

Molluscum contagiosum

Answer 1

Pox virus

umbilicated

no systemic manifestations

Heals on its own

Question 2

Hand-foot-mouth disease

Answer 2

Coxsackievirus A type 16
Enterovirus 71

macular to vesicular w/ erythematous halo
tender, fades w/o pigment

vomiting and cns sx (rare)

Question 3

HSV1, 2

Answer 3

latent in ganglia

mucocutaneous
“Dewdrop on a rose petal”
rapid rupture –> leaves gray-white ulcer
painful

Question 4

Varicella Zoster

Answer 4

HHV-3
Acute - spreads via resp route

Varicella
- dif stages at same time (macule – papuple – vesicles – crusted papule)
2 dose vaccine around age 1

Zoster
- single, unilateral dermatomal distribution 
neuralgia
Centripetal 
Pain management!
1 dose vaccine greater than 50 yo

Question 5

Roseola infantum

Answer 5

HHV-6

Acute febrile illness w/ or w/o rash

high fever –> rash –> fever resolves

rash: neck/trunk –> extremities

less than 3 yo: febrile seizures

Question 6

HHV-7

Answer 6

95% adults
ubiquitous
assoc w/ Pitryiasis rosea

Question 7

HHV-8

Answer 7

–> Kaposi Sarcoma: vasc. malignancy assoc w/ AIDs

Question 8

Measles (Rubeola)

Answer 8

Paramyxovirus

Unvaccinated children. Endemic areas.

Prodromal phase: 3 C’s
Cough
Coryza
Conjunctivitis

fever greater than 104 — Rash
spread: resp droplets

Most contagious!

Mucocutaneous:
- Koplik spots on buccosal mucosa. BEFORE the rash

Rash - forehead to trunk/extremities

“Grains of salt surrounded by a red halo”

Complications: pneumo, otitis media, myocarditis, subacute sclerosing panencephalitis. (immunocompromised)

VitA
MMR vaccine
strictly human virus – eradication possible

Question 9

Rubella (German measles)

Answer 9

Toga virus

“little red”

spread transplacentally/resp droplets

milder sx than measles

Complications;

• Spontaneous abortion
• Congenital rubella:
• • Cataracts, heart disease, deafness
• • microcephaly (w/in 1st 8 wks of pregnancy)

“Blueberry muffin lesions” –> EMH

Question 10

Erythema infectiosum

Answer 10

Parvovirus B19

“Fifth disease”
replicates in erythroid precursors (affects reticulocytes, platelets, and Hb)

“slapped cheek”. fades
rash on proximal extremities/trunk – Classic lacelike reticular pattern after fading

spread: resp secretions
age: 4-10

Adults: arthralgia

Complications

• aplastic crisis in anemic, imm comp ptns
• preggo: - non-imm fetal hydrops, fetal demise

Self limited in healthy ptns

Question 11

Small pox

Answer 11

Variola virus

Eradicated

Contagious
Fever, vesicular + pustular eruption, high mortality, Bioterrorism