Dermatology Lecture 4: Viral Skin Infections
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Questions and Answers

What is a complication of HPV infection that affects nail health?

  • Cervical dysplasia
  • Pain during walking and sporting activities
  • Nail dystrophy and destruction (correct)
  • Viral warts transmission

    • What is the temperature used in Cryosurgery for wart removal?

  • 100ºC
  • -100ºC
  • 0ºC
  • -196ºC (correct)

    • What is the concentration range of salicylic acid ointment used for wart treatment?

  • 5-40% (correct)
  • 10-70%
  • 20-80%
  • 1-10%

    • What should be done before applying wart paint or paste?

    <p>Soften the wart by soaking in a hot soapy water bath</p> Signup and view all the answers

    What is the purpose of using a pumice stone or emery board?

    <p>To remove the old paint and dead surface skin layer</p> Signup and view all the answers

    What is the type of laser used to induce charring of the lesions?

    <p>CO2 laser</p> Signup and view all the answers

    What is the concentration of lactic acid used for wart treatment?

    <p>30-40%</p> Signup and view all the answers

    What is a contraindication for using podophyllin resin 25%?

    <p>Pregnancy</p> Signup and view all the answers

    What type of vaccine is used against HPV?

    <p>Polyvalent</p> Signup and view all the answers

    What is the causative organism of Molluscum Contagiosum?

    <p>Pox virus</p> Signup and view all the answers

    What is the incubation period of Molluscum Contagiosum?

    <p>2-6 weeks</p> Signup and view all the answers

    What is a characteristic feature of Molluscum Contagiosum lesions?

    <p>Umbilicated papules</p> Signup and view all the answers

    What is one of the treatment options for Molluscum Contagiosum?

    <p>Electrocautery</p> Signup and view all the answers

    What is used to treat Molluscum Contagiosum lesions on the face?

    <p>Topical tretinoin</p> Signup and view all the answers

    What is Herpes simplex characterized by?

    <p>Localized blistering</p> Signup and view all the answers

    What is an alternative treatment for refractory cases of Molluscum Contagiosum?

    <p>Immunotherapy</p> Signup and view all the answers

    What is the duration of treatment for recurrent episodes of herpes simplex?

    <p>5 days</p> Signup and view all the answers

    What is the dose of intravenous Acyclovir given for 7 days?

    <p>5 mg/kg/day</p> Signup and view all the answers

    What is the mechanism of action of Famcyclovir?

    <p>It is converted in the liver to an active metabolite (penciclovir)</p> Signup and view all the answers

    What is the primary cause of Warts (Verrucae)?

    <p>Human papilloma virus (HPV)</p> Signup and view all the answers

    How can herpes simplex be prevented?

    <p>By trying to avoid the precipitating factors</p> Signup and view all the answers

    Which of the following viruses is responsible for causing Molluscum Contagiosum?

    <p>Pox virus</p> Signup and view all the answers

    What is the mode of transmission of varicella-zoster virus?

    <p>Airborne respiratory droplets</p> Signup and view all the answers

    What is the incubation period for Warts (Verrucae)?

    <p>1-6 months</p> Signup and view all the answers

    Which type of wart is more common in children?

    <p>Plane warts (Verruca plana)</p> Signup and view all the answers

    What is the duration of contagiousness of chickenpox?

    <p>Until all the blisters have formed scabs</p> Signup and view all the answers

    What is the dose of Valacyclovir for 5 days?

    <p>500 mg twice daily</p> Signup and view all the answers

    What is the characteristic of Plantar warts (Verruca plantaris)?

    <p>Painful, tender, and growing inwards</p> Signup and view all the answers

    What is the indication for long-term suppressive therapy?

    <p>For frequent attacks</p> Signup and view all the answers

    What is the potential risk of Genital warts (Condyloma accuminata)?

    <p>Predispose to cervical carcinoma</p> Signup and view all the answers

    Which type of wart is asymptomatic and has a rough mamillated surface?

    <p>Common warts (Verruca vulgaris)</p> Signup and view all the answers

    How do Warts (Verrucae) typically spread?

    <p>Through direct or indirect contact with infected patient's things</p> Signup and view all the answers

    What is a complication of varicella infection, especially in immunocompromised and adult patients?

    <p>All of the above</p> Signup and view all the answers

    Why is aspirin not recommended for children with chickenpox?

    <p>Because it may cause Reye syndrome</p> Signup and view all the answers

    What is the recommended treatment for itching in chickenpox?

    <p>Calamine lotion and oral antihistamines</p> Signup and view all the answers

    What is the recommended vaccine for immunocompromised patients and non-immune adult females?

    <p>Live attenuated varicella vaccine</p> Signup and view all the answers

    What is the triggering factor for herpes zoster?

    <p>All of the above</p> Signup and view all the answers

    What is the clinical picture of herpes zoster?

    <p>Unilateral groups of vesicles on erythematous and edematous base</p> Signup and view all the answers

    What is a complication of herpes zoster?

    <p>All of the above</p> Signup and view all the answers

    What is the duration of herpes zoster?

    <p>2-4 weeks</p> Signup and view all the answers

    Study Notes

    Viral Skin Infections

    • There are four main viral skin infections: warts, molluscum contagiosum, herpes simplex, and chicken pox and herpes zoster caused by varicella zoster virus (VZV).

    Warts (Verrucae)

    • Caused by human papilloma virus (HPV)
    • Involve both skin and mucous membranes
    • Mode of infection: direct or indirect contact with infected patient's things
    • Incubation period: 1-6 months
    • Clinical picture:
      • Asymptomatic skin-colored papules with rough, mammillated surface
      • May take filiform or digitate shapes
    • Types of warts:
      • Common warts (Verruca vulgaris)
      • Plane warts (Verruca plana)
      • Plantar warts (Verruca plantaris)
      • Genital warts (Condyloma accuminata)

    Complications of HPV Infection

    • Infectious to patient and others
    • Periungual warts can cause nail dystrophy and destruction
    • Painful plantar warts interfere with walking and sporting activities
    • Oncogenicity; predispose to cervical carcinoma

    Treatment of Warts

    • A. Destructive Therapy:
      • Electrocautery
      • Cryosurgery
      • Chemical cautery
      • Lasers
    • B. Topical treatment:
      • Salicylic acid ointment
      • Lactic acid
      • Combination of salicylic acid and lactic acid
    • Immunotherapy may be combined with destructive methods in refractory cases
    • Oral administration of acitretin or isotretinoin in refractory cases
    • HPV vaccination is highly effective and is now approved in more than 100 countries for the immunization of prepubertal girls and boys

    Molluscum Contagiosum

    • Causative organism: Pox virus
    • Mode of infection: direct or indirect contact
    • Incubation period: 2-6 weeks
    • Clinical picture:
      • Shiny, pearly white, dome-shaped papules with a smooth surface and central umbilication
      • Involves non-genital skin or genital skin (STD)
    • Treatment:
      • Electrocautery
      • Cryotherapy
      • Laser treatment
      • Topical treatment

    Herpes Simplex

    • Causative organism: Herpes simplex virus (HSV)
    • Mode of infection: direct or indirect contact
    • Incubation period: 2-6 weeks
    • Clinical picture:
      • Localized blistering
    • Treatment:
      • Oral antiviral medications: acyclovir, valacyclovir, and famcyclovir
      • Intravenous acyclovir for severe cases
    • Antiviral drugs cannot eradicate the virus from its resting stage within the nerve cells, but can shorten and prevent attacks

    Varicella-Zoster Virus (VZV)

    • Primary infection: Chickenpox (varicella)
    • Mode of transmission: airborne respiratory droplets or through direct contact with the fluid from the open sores
    • Clinical picture:
      • Fever, flu-like symptoms, then vesicular rash involving the whole body
      • Complications: secondary bacterial infection, lesions may heal with scarring, central nervous system complications
    • Treatment:
      • Symptomatic therapy is usually all that is required
      • Oral acyclovir in people older than 12 years, and in immunocompromised patients
      • Vaccination with live attenuated varicella vaccine is available and recommended especially for immunocompromised patients and non-immune adult females
    • Herpes Zoster:
      • Reactivation of VZV in dorsal root ganglia nerve cells
      • Triggering factors: pressure on the nerve roots, spinal surgery, fever, malignancy
      • Clinical picture: unilateral groups of vesicles on erythematous and edematous base, along distribution of one or more sensory nerves
      • Complications: secondary infection, eye complications, post-herpetic neuralgia

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    Description

    This lecture covers the most important viral skin infections, including warts, molluscum contagiosum, herpes simplex, and chicken pox and herpes zoster. It discusses the causes and characteristics of each infection.

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