Y2S1B1 - Cs - Viral Skin Infections

Front 1

Which HPV types are a/w each type of lesion?

a) Common wart (verrucae vulgaris)
b) Palmar/plantar wart
c) Flat/planar wart
d) Condyloma Acuminata

Back 1

a) HPV 2&4
b) HPV 1
c) HPV 3&10
d) HPV 6&11

Front 2

How are cutaneous warts transmitted?

Back 2

Via direct skin contact (person-to-person) and from contaminated surfaces/objects (pools or gyms)

Front 3

What are the clinical features of Verrucae Vulgaris (common warts)?

Back 3

-hyperkeratotic, exophytic, dome-shaped papules or nodules
-commonly on hands (or other sites prone to trauma)
-can spread via scratching
-

Front 4

Periungual common warts distort the nail and can look similar to what disorder?

Back 4

Squamous Cell Carcinoma

Front 5

What are the clinical features of palmar/plantar warts (verrucae plantaris et palmaris)?

Back 5

-endophytic (inward-growing)
-sloping sides and central depression
-"black spots/dots" on surface (thrombosed vessels)
-painful walking when on sole d/t deep inward growth

Front 6

What are the clinical features of flat warts (verrucae planae)?

Back 6

-smooth surface
-flat-topped
-tend to be numerous and linear
-commonly on forehead, around mouth, back of hands, shaved areas

Front 7

How is Condyloma Acuminate acquired?

Back 7

Sexual contact*

also called anogenital warts

Front 8

T/F

Warts are pretty easy to treat.

Back 8

False!

It is difficult

Front 9

What are some treatments for warts?*

Back 9

Main idea: stimulate immune system to eliminate warts.

-LN2 (liquid nitrogen)
-Cantharadin ("beetle juice")
-Mediplast - salicylic acid
-Topical retinoids
-Podofilox
-Imiquimod

Front 10

What causes Molloscum contagiosum?

Back 10

Poxvirus

Front 11

What are the clinical features of Molloscum Contagiosum?

Back 11

-Pink or flesh-colored
-dome-shaped, umbilicated central depression on papules or nodules*

Front 12

T/F

Molloscum Contagiosum can spread to other body areas, but is a weak virus.

Back 12

True!

Front 13

What are possible treatments for Molloscum Contagiosum?

Back 13

• Topical therapy
–Retinoids (Tretinoin, Adapalene, Tazarotene

• Physical destruction
-Cryotherapy (LN2, Light application)
–Electrosurgery
–Curettage

•Chemical destruction
–Blistering agent – cantharidin (small amount)

Front 14

What disease presents with fever, sore throat, and painful vesicles/erosions on the tongue, palate, buccal and gingival mucosa (vs. recurrent vermillion border)*?

Back 14

Primary Gingivostomatitis

Front 15

What are some triggers for reactivation of Recurrent Herpes Labialis?

Back 15

Spontaneously, secondary to trauma, UV radiation (sun exposure), infection or immunosuppression*

Front 16

In Recurrent Herpes Labialis, what usually occurs before a visible lesion?

Back 16

Prodrome of stinging, burning, itching d/t virus traveling back up nerve

Front 17

How many average recurrences are there per year in Recurrent Herpes Labialis?

Back 17

2-3ish

Front 18

What are the clinical features of Primary Genital Herpes?

Back 18

-multiple painful grouped vesicles and erosions, often bilateral, on anogenital mucosa
-painful inguinal lymphadenopathy
-possibly dysuria and vaginal/urethral discharge
-lesions more numerous and scattered

Front 19

Do symptoms tend to be more severe in Primary Genital Herpes or Recurrent Genital Herpes?

Back 19

Primary

Front 20

Which one has a shorter duration and more limited involvement of symptoms - Primary or Recurrent Genital Herpes?

Back 20

Recurrent Genital Herpes

Front 21

What are the clinical features of Recurrent Genital Herpes?

Back 21

Tender, grouped vesicles or erosions (erosions nonindurated, tender)

Front 22

A 17 yr old wrestler presents with small grouped vesicles on the face, lateral neck, and medial arms. This is most likely what disease?

Back 22

Herpes Gladiatorum

Front 23

What is Herpes Whitlow? What virus is usually the culprit?

Back 23

-Intense painful herpetic vesicular infection of the hand involving 1 or more fingers
-Typically affects the terminal phalanx

Usually HSV1 (sometimes HSV2)

Front 24

T/F

Neonatal Herpes Simplex is a/w significant mortality and morbidity.

Back 24

True!

Need to be treated promptly with IV Acyclovir!

Front 25

How is Varicella Zoster Virus usually spread?

Back 25

Via respiratory droplets, but sometimes by direct contact w/ vesicular fluid

Front 26

How long are chickenpox patients contagious?

Back 26

12 days prior to initial appearance of lesions to approximately 6 days after*

Front 27

What percent of chickenpox cases occurs in kids under 10?

Back 27

90%

Front 28

How is chickenpox different in adults than in children?

What is the most common serious complication in adults?

Back 28

Usually more severe clinical syndrome w/ prodrome, more compplications and more extensive eruption*

Can develop Varicelle pneumonia*

Front 29

What are the clinical features of chickenpox?*

Back 29

-Abrupt onset of lesions over thorax, scalp, mucous membranes
-Classic lesion: “dew drop on a rose petal”
-lesions in ALL stages of development (papules, vesicles, crust)*

Front 30

What is the treatment for chickenpox?*

Back 30

-Pruritis - bland antipuritic lotions (Sarna) or oral antihistamines
-Fever - antipyretics (NSAID’s)
-Secondary infection (scratching) - Antibiotics

Adults - Acyclovir 800 mg qid x 5 days from day 1
– Decreases time of illness
– Decreases time to healing
– Lessens symptoms

Front 31

Reactivation of Varicella Zoster Virus d/t stress, immunosuppression, fatigue, etc. leads to...

Back 31

Shingles (Herpes Zoster)

Front 32

What are the clinical features of Shingles?

Back 32

-begin as painful grouped vesicles on erythematous base, umbilicate or rupture to form crust
-unilateral, rarely cross midline

Front 33

What is Hutchinson's sign?

Back 33

When you see shingles lesions on the tip/side of nose*

This is a/w potentially serious ocular complications* d/t involvement of nasociliary branch of the ophthalmic division of the trigeminal nerve (V1)

Front 34

What is a possible complication of Herpes Zoster that can be prevented by early treatment?

Back 34

Post-Herpetic Neuralgia (PHN)

Front 35

What is the treatment for Herpes Zoster infection (and PHN)?

Back 35

-Start an antiviral within 24-72 hrs of onset of rash*
–Acyclovir 800 mg 5x/day x 7 days
–Famciclovir 500 tid x 7 days
–Valacyclovir 1 gm tid x 7 days

-Acute pain management – important!!