Viral Pathogens of the Skin - HERMEL

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Can you name the Viral Pathogens of the Skin ?

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Herpetic _____: Often seen in health care workers; causes painful ulcerations on fingers (can also be caused by HSV-2).
Smallpox Variola ____: 1% mortality rate. Caused by less virulent strains, or infection in a partially immune host
Category A bioweapons that may produce cutaneous manifestations include agents causing anthrax, plague, _______, tularemia, and certain viral hemorrhagic fevers.
Fever before rash in ________.
______ Differentials: chickenpox, vaccinia (cowpox) and other poxvirus diseases [esp. with travel history and/or animal exposure], herpes simplex, measles, acne, insect bites.
Diagnosis of HSV.
Diagnosed histologically from findings of large eosinophilic vacuolated cells. Treatment are ablative techniques (curettage, electrocautery or liquid N2)
Varicella zoster: The rash is more pronounced on _____ and trunk
(enlarged keratinocytes with clear haloes and shrunken nuclei) are characteristic of HPV infection.
HSV is ______ and results in cell death, leading to ulceration
HPV _____ wart: They appear as individualized papules or nodules with a rough surface.
Fever and rash concurrent in _______.
A _____ (papilloma) is a benign, self-limited proliferation of skin that generally will regress over time.
The most common complication of herpes zoster, occurring in 10–18% of patients.
Pathogen of farm animals; occasionally infects humans (farm workers or veterinarians). Causes solitary cutaneous vesicular mass that later develops a central necrosis, typically on
______ is an AIDS-defining illness and is the most common neoplasm in HIV+ pts
A second VZV vaccine (Zostavax) was developed to prevent shingles/PHN by boosting a waning cell-mediated immune response to VZV with advancing age greater than _____years old.
_____, attenuated viral vaccine available for chicken pox (Varivax). Recommended for children at 12 and 18 mos.
A common, benign, self-limiting infection in children; typically in the 2-5 year age group.
Herpes _____: characterized by herpes lesions clustering most often on the neck, chest, face, stomach, and legs of wrestlers and high school athletes
HPV: Virus persists in the ____ cell layer
A reactivation of VZV that affects mainly the flanks and can be excruciating.
____ patients: Get disseminated infection of HSV involving respiratory, GI tract, or liver
Enveloped, icosahedral ds DNA viruses.
HPV _____ warts are slightly raised, of skin color or pigmented with flat, slightly rough surface. The face and back of hands are the most common locations.
Nonenveloped dsDNA viruses. Causes persisten infections (even after resolution)
Smallpox Variola ______: has characteristic vesicular rash and ~30% mortality rate
HPV _____ wart: Found more in adolescents and young adults on the plantar region of the foot. Caused mainly by HPV type 1. They are commonly painful.
HSV: Primary (as opposed to reactivation infections) tend to be more severe and have more ______ symptoms (headache, fever, lymphadenopathy, etc).
Bacterial _______: Caused by Staphylococcal colonization of a lesion, from scratching.
_______ Vaccine: Live virus vaccine consists of vaccinia, the causative pathogen of cowpox. Vaccine should be given within 4 days of exposure.
_____ infection of HSV: Virus enters cutaneous neurons, and migrates to ganglion where it enters a latent state.
Varicella zoster: Early ______ therapy is beneficial in reducing acute pain for HZ. Pts will generally also require analgesics. NSAIDS are usually ineffective, and opioids may be r
Effective HAART prevents the development of, and treats _____ in in HIV+ pts; modifying immunosuppressive regimen in transplant pts
_______: Like HSV, especially dangerous to immunocompromised pts, who may develop severe pneumonitis, encephalitis, hepatitis or systemic disease
HSV: _____ is the drug of choice. Valacyclovir, famciclovir and penciclovir (topical) are also used.
Virus is highly transmissible via airbrone droplets.
HPV does not _______ its genome into host cell DNA, but exists as a separately replicating episome (akin to plasmid replication in bacteria).
Causes the development of Kaposi’s sarcoma (KS) in pts with depressed cellular immunity, especially AIDS pts
_______ infection: as per HSV. Visceral dissemination is associated with a mortality rate of 5- 15%.
dsDNA enveloped virus: member of Poxvirus family. Only one serotype. Spread by aerosoles.
Causes nodular, smooth umbilicated papular eruptions with a dimple or pit in the center, generally on the face, trunk, genitals or extremities.
Rare infection of humans. The virus naturally infects nonhuman primates in the tropical rain forests in Africa.
HSV: Virus travels up the ____ to the root ganglion, where it enters a latent (non-lytic) state.
Typically have a carpet-like (verrucous) surface.
Rash clearly follows a single dermatome
HPV: Viral replication causes ____ and prickle cell (stratum spinosum) layers to thicken, with overproduction of keratin (keratosis).
Usually diagnosed from clinical signs (rash, pocks). Electron Microscopy is the gold standard.
Mortality rate for chicken pox is ~3-9/100,000; up to 15% in children with ___ cell defects.

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