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Session 2 CM derm4
CM- Derm -4- nonbacteria- vesicular/pustular
| Question | Answer |
|---|---|
| What are the two types of Herpes Simplex | HSV-1 and HSV-2 |
| Which herpes virus typically is responsible for oral lesions | HSV-1 |
| Which herpes virus causes 90% of genital herpes | HSV-2 |
| Where do herpes simples infections typically occur | mucosal surfaces or sites of abraded skin |
| What is the characteristic sign of herpes | small grouped painful vesicles |
| What cell type does herpes simplex infect | herpes infects sensory and autonomic nerve endings |
| When the virus enters the nucleus of nerve cells what can occur | it can lay dormant to reactivate later |
| Can a person with herpes autoinoculate ie spread the infection from one area of their body to another | yes, herpes is very contagious and autoinnoculation can occur |
| This generally occurs with the first HSV infection, w/ crops fo painful grouped vesicles, which may rupture to form erosions with crusts, fever, malaise and lymphadenopathy generally seen in children | Acute Herpetic Gingivostomatitis |
| What is recurrent herpes labialis | re-occurrence of herpes outbreak with fever blisters and sores on outer lips with oral sparing, Generally starts with prodrome of stinging burning and tingling. heals in 10 days. Viral shedding stops after crusts form |
| when does viral shedding stop with recurrent herpes labialis | after crusts form |
| what is the percent of hsv infected individuals that have recurrences on average of 2/yr | 40% |
| What are the characteristics of primary herpes genitalis | multiple erosions on external genitalia occur 1 week after exposure viral shedding ends after 11 days pain, itching , dysuria, inguinal adenopathy heals in 2-3 weeks |
| What percent of women with Primary Herpes Genitalis have cervical lesions as well | 90% |
| When does viral shedding end with Primary Genital Herpes | around 11 days after |
| what percent of first episode cases of genital herpes is actually caused by HSV-1 not HSV-2 | 50% |
| which type of herpes HSV-1 or 2 has less frequent genital recurrences | HSV-1 |
| What percent of women with recurrent herpes genitalis will have cervical lesions | 10% which is much less common than primary herpes genitalis |
| What is the average number of recurrences with recurrent herpes genitalis | 4 recurrences on average per year |
| What are the main characteristics of recurrent herpes genitalis | mild to moderate pain for 1 week decreased local symptoms lesions only cover 10% of original area |
| what is the HSV infection of fingers or hands called how long does primary infection last | herpetic whitlow 2-6 weeks |
| who primarily is infected with herpetic whitlow | medical or dental professionals |
| how does an individual contract herpetic whitlow how can it be prevented | inoculation on abraded skin or broken skin when touching herpes lesion. WEAR GLOVES |
| What is the secondary HSV infection called with patients with atopic dermatitis | Eczema Herpeticum |
| What are the characteristics of eczema herpeticum | widely spread eruption with punched out erosions in areas of previously abnormal skin associated with fever, malaise and lymphadenopathy |
| How are herpes lesions diagnosed | History and clinical features Tzanck Prep tissue culture fluorescent antibodies PCR assays (not FDA approved) |
| what is the treatment for HSV | acyclovir famiciclovir valacyclovir |
| is topical treatment for HSV effective | no |
| What disease is caused by varicella-zoster virus | Chickenpox |
| how contagious is varicella virus | highly contagious 87% |
| When is varicella conatgious | infectious 2-3 days before exanthem and 5 days after |
| what is the incubation of varicella | 14 days |
| how is varicella acquired and transmitted | transmitted by the respiratory tract |
| what is the prodrome of varicella | fever, chills, malaise, headache with a rash that begins on face and spreads to trunk |
| what si the classic s/sx of varicella | vesicles surrounded by erythema dew drops on rose petal |
| How do the vesicles appear in varicella, and are they all in the same stage | appear in crops which soon crust over and you can have vesicles in all stages of healing |
| Apart from skin where else can varicella vesicles be found | may affect mucous membranes |
| What are the common complications of varicella and what groups are most likely to have complications | secondary bacteria infection secondary bacterial pneumonia, otitis media, suppurative meningitis more complication in adults, pregnant women and immunocompromised |
| what is typical treatment for varicella | calamine lotion, antihistamines, oatmeal bath, and acyclovir for adults because of likelihood of complications |
| What is the disease that is the reactivation of varicella, presents with unilateral, dermatomal, grouped vesicles, does not cross midline, | Herpes Zoster |
| where does majorit of herpes zoster occur | thoracic region |
| What is hutchinson;s sign | where herpes zoster affects nasal tip, with opthalmic involvement. Needs to be evaluated for herpes keratitis which can be potentially binding. |
| what are the complications of herpes zoster | post herpatic neuralgia dissemination occurs in 2-10% visual impairment meningoencephalitis |
| autoimmune vesicular dermatitis, grouped vesicles on elbows, knees, buttocks, shoulders and scalp marked pruritis, association with gluten sensitive enteropathy, lupus, thyroid disease, and lymphoma | dermatitis herpetiformis |
| what is the treatment for dermatitis herpetiformis | gluten free diet, dapsone, colchicine, |
| attachment between keratinocytes | desmosomes |
| attachement between keratinocyte and basement membrane | hemidesmosomes |
| Disease with FLACCID blisters throughout, widespread erosions, crusts and scarring involves oral mucosa frequently, autoantibodies to desmoglein 3 | pemphigus vulgaris |
| What do the autoantibodies to desmoglein interfere with | desmosome function causing keratinocytes of the suprabasal layer to detach from each other acantholysis |
| what is the treatment for pemphigus vulgaris | high dose prednisone. |
| Disease marked by Tense blisters in flexural areas, common autoimmune disease in elderly, mucous membrane usually spared, autoantibodies to hemidesmosomes | bullous pemphigoig, causes seperation from basement membrane |
| treatment for bullous pemphigoid | prednisone, azathioprine, cclphosphamide, mycophenylate, dapsone, tetracycline, nicotinamide, |
| Self-limited recurrent symmetric target lesions on acral extremities, may involve oral mucous membranes, associated with recurrent HSV infections usually resolves in 2-4 weeks | erythema multiforme |
| disease marked by severe widespread blistering, mucosa involved, eyes airways GI tract has a high mortality often caused by sulfa drugs, antivonvulsants, nsaids | stevens-johnson/TEN |
| what is the treatment for Stevens-johnson disease | admit to burn unit or MICU, supportive care, IVIG eye respiratory care |
Created by:
smaxsmith
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