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Z Year 2 BRS MSK > Skin infestations and infections 3 > Flashcards

Skin infestations and infections 3 Flashcards

1
Q

What is herpes simplex virus?

A

Primary and recurrent vesicular eruptions

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2
Q

Where does Herpes simplex virus favour?

A
  • orolabial

- genital regions

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3
Q

When can transmission occur in herpes simplex virus?

A

even during asymptomatic periods of viral shedding

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4
Q

How is HSV-1 spread?

A

direct contact with contaminated saliva / other infected secretions

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5
Q

How is HSV-2 spread?

A

sexual contact

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6
Q

Where does herpes simplex virus replicate?

A

at mucocutaneous site of infection

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7
Q

How does herpes simplex virus travel?

A

by retrograde axonal flow to dorsal root ganglia

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8
Q

When do the symptoms of herpes simplex virus come?

A

with 3-7 days of exposure

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9
Q

What is herpes simplex virus preceded by?

A

-tender lymphadenopathy
-malaise
-anorexia
± Burning, tingling

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10
Q

What are the symptoms of herpes simplex virus?

A

Painful rouped vesicles on erythematous base to ulceration / pustules / erosions with scalloped border

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11
Q

When is there resolution of herpes simplex virus?

A

Crusting and resolution within 2-6 weeks

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12
Q

What are orolabial lesions like in herpes simplex?

A

often asymptomatic

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13
Q

What is genital lesions like in herpes simplex?

A

often excruciatingly painful→ urinary retention

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14
Q

What are the systemic manifestations of herpes simplex?

A

aseptic meningitis in up to 10% of omen

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15
Q

What can causes reactivation of herpes simplex virus?

A
  1. spontaneous
  2. UV
  3. fever
  4. local tissue damage
  5. stress
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16
Q

What is eczema herpeticum, in herpes simlpex virus?

A
  • emergency

- Monomorphic, punched out erosions (excoriated vesicles)

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17
Q

What is herpetic whitlow?

A

•HSV (1>2) infection of digits – pain, swelling and vesicles (vesicles may appear later)

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18
Q

What is the misdiagnosis of herpetic whitlow like?

A
  • Misdiagnosed as paronychia or dactylitis

* Often in children

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19
Q

What is herpes gladiatorum?

A
  • HSV 1 involvement of cutaneous site reflecting sites of contact with another athlete’s lesions
  • Contact sports e.g. wrestling
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20
Q

When does neonatal HSV infection happen?

A
  • Exposure to HSV during vaginal delivery – risk higher when HSV acquired near time of delivery
  • HSV 1 or 2
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21
Q

What is the onset of neonatal HSV like?

A
  • Onset from birth to 2 weeks

* Localised usually – scalp or trunk

22
Q

What can happen in neonatal HSV?

A
  • Vesicles → bullae erosions

* Encephalitis → mortality >50% without treatment, 15% with treatment → neurological deficits

23
Q

What is the treatment of neonatal HSV?

A

IV antivirals

24
Q

What are the types of HSV?

A

Severe or chronic

25
Q

Who gets HSV?

A

Immunocompromised patients e.g. HIV / transplant recipient

26
Q

What is the most common presentation of HSV?

A
  • chronic, enlarging ulceration

- multiple sites or disseminated

27
Q

What type of lesions are in HSV and what systems can be involved?

A
  • Often atypical e.g. verrucous, exophytic or pustular lesions
  • Involvement of respiratory or GI tracts may occur
28
Q

What is the diagnosis of HSV?

A

Swab for Polymerase chain reaction

29
Q

What is the treament of HSV?

A

•Don’t delay

  1. Oral valacyclovir or acyclovir 200mg five times daily in immunocompetent localised infection
  2. Intravenous 10mg/kg TDS X 7-19 days
30
Q

What are the different types of varicella zoster virus?

A

Dermatomal

  • Single dermatome
  • Multidermatomal
  • treat with iv antivirals
31
Q

What causes hand foot and mouth disease?

A
  1. Coxsackie A16, Echo 71
  2. An acute self-limiting coxsackievirus infection
  3. Echo 71 (associated with a higher incidence of neurological involvement included fatal cases of encephalitis)
32
Q

What are the symptoms of hand foot and mouth disease?

A
  • Prodrome of fever, malaise, and sore throat
  • Red macules, vesicles (typically gray and eliiptical), and ulcers develop on buccal mucosa, tongue, palate and pharynx, and may also develop on hands and feet (acral and volar surfaces).
33
Q

How is hand foot and mouth disease spread?

A

direct contact via oral-oral route or oral faecal route

34
Q

Which viruses cause morbilliform (measles-like) eruptions?

A

•Measles, Rubella, EBV, CMV, HHV6 & HHV7 cause morbilliform (measles-like) eruptions

35
Q

What other agents cause morbilliform rashes?

A
  • Leptospirosis

* Rickettsia

36
Q

Which disorders mimic morbilliform eruptions?

A
  1. Drug eruptions (most commonly)
  2. Pityriasis Rosea
  3. Arthropod reactions
  4. Early guttate psoriasis
  5. Viral morbilliform reactions
37
Q

What causes petechial/purpuric eruptions?

A
  1. Coagulation abnormalities - TTP, ITP, DIC
  2. Vasculitis
  3. Infections
  4. Viruses - Hepatitis B, CMV, Rubella, Yellow fever, Dengue fever, West nile virus
  5. Bacterial (BREN) - Borrelia, Rickettsia, Neisseria, Endocarditis
  6. Other infections - Plasmodium falciparum, Trichinella
  7. Other - TEN, Ergot poisoning, Raynauds
38
Q

What is Gianotti-Crosti syndrome aka papular acrodermatitis of childhood?

A

viral eruption that causes and acute symmetrical erythematous papular eruption on face, extremities and buttocks – usually in children aged 1-3 years

39
Q

What causes Gianotti-Crosti syndrome?

A
  1. EBV (most common)
  2. CMV
  3. HHV6
  4. Coxsackie viruses A16, B4 and B5
  5. Hepatitis B
40
Q

What is another word for erythema infectiosum?

A

Parvovirus B19

41
Q

What initially happens in erythema infectiosum?

A

mild fever and headache

42
Q

What happens a few days later in erythema infectiosum

A
  • A few days later – ‘slapped cheeks’ for 2-4 days

* Then reticulated (lacy) rash of chest and thighs in 2nd stage of disease

43
Q

What is roseola infantum called?

A

exanthem subitum aka 6th disease

44
Q

Who does roseola infantum affect and what are the first signs?

A
  • Children

* 2-5 days of high fever

45
Q

What are the signs of roseola infantum and how long does it last?

A
  • Followed by appearance of small pale pink papules on the trunk and head
  • Lasts hours to 2 days.
46
Q

What causes roseola infantum?

A

HHV6 and HHV7 (less commonly)

47
Q

What is Orf caused by?

A

parapoxvirus

48
Q

When do people get Orf?

A

Direct exposure to sheep or goats

49
Q

How does Orf present?

A
  • Dome-shaped, firm bullae that develop an umbilicated crust.
  • Usually develop on hands and forearms
50
Q

How long does Orf last?

A

resolve without therapy in 4-6 weeks

Z Year 2 BRS MSK (18 decks)

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