16 Questions
What is the meaning of the Greek word 'herpein'?
To creep
Which of the following is NOT classified as an infectious cause of vesiculo-bullous lesions?
Pemphigus
What is the classification of Epidermolysis bullosa?
Genetic
Which of the following viruses is NOT known to infect humans?
Human herpesvirus 9
What is the number of known herpesviruses that infect humans?
8
What is the mode of transmission of herpesviruses?
Direct contact and saliva
Which of the following is classified as a predominantly bullous lesion?
Pemphigus vulgaris
What is the total number of known herpesviruses?
80
What is the result of the primary HSV-1 infection in the oropharyngeal region?
Fever, malaise, and regional lymphadenopathy in the mouth
Why does primary HSV infection seldom occur in the first 6 months of life?
The infant is protected by the maternal antibodies
What is the incubation period of HSV infection?
2 days to 3 weeks
What is the characteristic of primary herpetic gingivostomatitis?
Multiple tiny to moderately large, yellow-coloured vesicles
What is the fate of the HSV infection after the primary lesion has healed?
The virus travels along the nerve pathway and lies dormant
What is the site of latency for HSV-1 and HSV-2?
Trigeminal ganglia for HSV-1 and sacral ganglia for HSV-2
What is the age range when primary HSV infections are most commonly seen?
2-3 years
What is the characteristic of the ulcers in primary herpetic gingivostomatitis?
Painful and covered by a greyish coloured membrane
Study Notes
Multiple Ulcerations
- Vesiculo-bullous lesions are classified according to their course, etiology, and clinical presentation
- Acute Multiple Ulcers:
- Acute herpetic stomatitis
- Erythema multiforme
- Herpes zoster infections
- Cytomegalovirus infections
- Coxsackie virus infections
- Necrotizing ulcerative gingivitis (NUG)
- Allergic reaction
- Chronic Multiple Ulcers:
- Pemphigus Vulgaris
- Bullous Pemphigoid
- Cicatrical Pemphigoid
- Epidermolysis bullosa
- Linear IgA disease
Classification by Course (Burket)
- Acute Multiple Ulcers:
- Acute herpetic stomatitis
- Erythema multiforme
- Herpes zoster infections
- Chronic Multiple Ulcers:
- Pemphigus Vulgaris
- Bullous Pemphigoid
- Cicatrical Pemphigoid
- Epidermolysis bullosa
- Linear IgA disease
Classification by Etiology
- Genetic:
- Epidermolysis bullosa
- Immunobullous:
- Pemphigus
- Pemphigoid
- Bullous form of Lichen planus
- Infectious (Viral):
- Herpes simplex
- Varicella-Zoster infection
- Hand, foot & mouth disease
- Herpangina
- Measles (Rubeola)
- Miscellaneous:
- Erythema multiforme
Classification by Clinical Presentation
- Predominantly Vesicular:
- HSV infection
- Varicella infection
- Hand, foot and mouth disease
- Herpangina
- Dermatitis herpetiformis
- Predominantly Bullous:
- Pemphigus Vulgaris
- Bullous Pemphigoid
- Benign mucous membrane pemphigoid
- Bullous lichen planus
- Erythema multiforme
- Stevens-Johnson syndrome
- Bullous impetigo
- Epidermolysis bullosa
- Linear IgA disease
Herpesviruses
- The word "herpes" comes from the Greek word "herpein", meaning "to creep"
- At least 8 of the 80 known herpesviruses infect humans
- Herpesviruses that infect humans:
- Herpes Simplex Virus (HSV-1 and -2)
- Varicella Zoster Virus (VZV)
- Cytomegalovirus (CMV)
- Epstein-Barr Virus (EBV)
- Human Herpesvirus 6 (HHV-6)
- Human Herpesvirus 7 (HHV-7)
- Human Herpesvirus 8 (HHV-8)
Herpes Simplex Virus Infections
- HSV-1: oropharyngeal regions (infections above the waist)
- HSV-2: anogenital infections (infections below the waist)
- Incubation period: 2 days to 3 weeks
- Primary HSV infection: rare in the first 6 months of life due to maternal antibodies
- Clinical features:
- Fever
- Malaise
- Anorexia
- Irritability
- Regional lymphadenopathy
- Gingivitis
- Erythematous and boggy gingiva
- Multiple tiny to moderately large vesicles that rupture to form shallow painful ulcers
- Fate: heals in about 2 weeks without scarring, with the virus lying dormant in the trigeminal ganglia afterward
Test your knowledge of Multiple Ulcerations, Vesiculo-Bullous Lesions, and their classification according to Burket's course. This quiz covers various types of acute and chronic multiple ulcers, including herpetic stomatitis, erythema multiforme, and pemphigus vulgaris.
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