Viral Pathogens of the Skin - HERMEL

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Can you name the Viral Pathogens of the Skin ?

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

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