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43 Cards in this Set
- Front
- Back
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Epidermal tumors caused by the human papillomavirus (HPV)
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Verrucae
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HPV is a nonenveloped, ______-stranded _NA virus that replicates in epithelial cells
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HPV is a nonenveloped, double-stranded DNA virus that replicates in epithelial cells
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3 common types of cutaneous warts:
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common, plantar, flat
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MC cutaneous wart type
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common
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What do common warts look like
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Disrupt the normal lines of fingerprints
‘Red dots’- thrombosing capillary loops…..not “seeds” |
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Periungual warts will spread... to where?
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perioral
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Important points about wart treatment
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There is no ‘one time’ treatment to clear up warts- very important that you make this clear to your patients!!!!
Adequate response to therapy requires patient participation The actual method you choose is not as important as the frequency of the treatment and having patients participate in the procedure |
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Destructive treatment of warts
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Salicylic acid, BCA/TCA
Cryotherapy (Greenfield's TOC) Cantharidin (for children) Surgical excision ***** (don't do) Laser ablation Electrosurgery |
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Immunologic treatment of warts
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Interferon alfa
Imiquimod Cidofovir |
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Chemotherapy for warts
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Bleomycin
5FU Podophyllin |
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Why not cut out a wart?
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the virus may not reside ONLY in wart.
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On average, how long does it take for a wart to go away?
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6 months. Self-limiting
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Flat warts, verruca plana, can form along a line of trauma. What's the term for that?
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Koebnerization
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HPV type : condyloma accuminata
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HPV types 6, 11 most commonly
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HPV types strongly related to dysplasia and carcinoma
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Types 16, 18, 31, and 33
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Gardasil targets what types of HPV
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HPV 16, 18, (70% of cases of cervical cancer), and types 6, 11 (90% of gential warts)
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Timing and cost of HPV
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Administered in 3 shots over 6 months (age 11)
Cost $360 |
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What's this?
Smooth, small, dome- or finger-shaped lesions Located around the corona Arise after puberty 18-40 Lesions are angiofibroma No treatment necessary |
Pearly Penile Papules
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What is treatment of condyloma
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Cryosurgery
Podophyllin (Condylox) Trichloroacetic acid Electrosurgery Surgical excision Laser ablation Cantharadin Imiquimod (immune response modifier) |
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What's this?
Self-limited epidermal viral infection Flesh-colored to pink umbilicated papules, usually grouped Can have central keratotic plug Seen in children and sexually active adults |
Molluscum Contagiosum
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More points about molluscum contagiosum. What type of virus? transmission? koebnerization? when do they resolve?
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MCV is a pox virus
Transmitted via skin-to skin contact Can koebnerize Can be extensive in HIV+ patients Usually resolve in 6 months |
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Treatment of molluscum
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Cryosurgery
Podophyllin Cantharone Tretinoin Benzoyl peroxide |
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As the viral lesions heal they tend to hypertrophy and crust over. Don't worry why?
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Represents ‘immune response’ to therapy
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The most prevalent STD
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Herpes
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Describe Herpes lesions
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Grouped vesicles on a erythematous base
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A kid's first exposure of HSV-1 on the oral mucosa
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Primary herpetic gingivostomatitis
Fever, lymphadenopathy, headache Vesicles erode, then crust over and heal in 2-4 weeks |
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MC trigger of erythema multiforme (target lesion)
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Herpes
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Where do Herpes lesions recur?
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at site of innoculation
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Herpes infection of the fingers
Usually comes from contact of labialis lesions |
Herpetic Whitlow
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What's this?
Most commonly associated with eczema but can be seen with other disorders Associated with fever, malaise, irritability Lesions are not ‘grouped’ but disseminated |
Eczema Herpeticum
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Describe varicella rash
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Successive crops of pruritic vesicles that evolve to pustules, crusts and scars
Initial lesions are usually papules and are not usually observed, quickly evolve into vesicles “dewdrops on a rose petal” |
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Transmission of varicella
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Transmitted via airborne droplets and direct contact
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Complications in children from varicella
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bacterial superinfections, encephalitis, Reye’s syndrome
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Complications in adults from varicella
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: Prolonged recovery, pneumonia (16%), encephalitis, arthritis, carditis, orchitis
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Does varicella immunization last forever?
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Unknown
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Does vaccinated person get zoster?
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yes. rate unknown
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Treatment of varicella
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Acyclovir started within 24 hours of the development of the rash has been shown to be beneficial
Valacyclovir and Famcyclovir are not approved but are effective treatments Most children just require symptomatic therapy Must avoid aspirin |
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Stages of zoster
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Prodromal stage: Neuritic pain precedes eruption by 3-5 days
Active vesiculation: 3-5 days Crust formation: day 2 - 3 weeks Postherpetic neuralgia: months to years |
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Hutchinson’s Sign
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Nasocilliary branch of the trigeminal nerve is involved
Refer to Ophthalmology |
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Treatment of postherpetic neuralgia
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Corticosteroids have been used with antivirals to reduce PHN
Ticyclic antidepressants (nortriptyline) and gabapentin have been shown to be helpful Lidocaine patches and capsaicin cream |
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Prevention of zoster?
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Frequent contact with children seem to decrease the incidence of zoster
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MC location of zoster eruptions
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thoracic region
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Treatment for zoster
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Treatment should be started as soon as diagnosis is considered. If started within 72 hrs it will accelerate healing, decrease duration of pain and decrease frequency of PHN
Acyclovir 800mg qid 7-10 days Valacyclovir 1000mg tid 7 days Famciclovir 500mg tid 7 days |
