Viral Diseases

Viral Diseases-

-Condyloma Acuminatum-

-may occur in the oral or genital epithelium

-HPV is the causative organism

-They can present from oral gentile contact and usually present flat papillomatous plaques or nodules with a glandular surface

-early lesions can be visualized by using 5% acetic acid

-lesions more advanced have a cauliflower appearance

-Exanthems-

-an infections generalized skin eruption associated with a primary systemic infection. 

-most common they are viral in nature, but can be associated with bacteria and parasites.  

-Examples of Exanthems-

-Rubella

-Measles

-Hand Foot and Mouth Disease

-Erythema Infectiosum

-Rubella-

-erythematous macules and papules appearing initially on the face and then inferiorly to the trunk and extremities

-Usually takes about 24 hours

-posterior auricular lymph node and posterior cervical lymph nodes can be enlarged

-see in patients not immunized

-Measles-

-highly contagious childhood viral infection

-presents with fever, coryza, cough, congestion, conjunctivitis, and Koplik spots

-see in patients that are not immunized

-caused by measles virus and paramyxovirus

-erythematous papules appear on the face and neck where they spread to the trunk and arms

-Hand Foot and Mouth Disease-

-multiple superficial erosions and small vesicles surrounded by erythematous halo.  

-lesions are painful

-occur on the hands, feet, and mouth (herpetic gingivostomatitis)

-caused mainly by cocksackie virus

-very contagious

-Erythema Infectiosum (Fifth's Disease)-

-caused by the Parvovirus

-get diffuse erythema and edema to the cheeks

-get a "slapped cheek" appearance

-prodrome of fever, malaise, headache, coryza, and sore throat

-management is symptomatic

-Herpes Simplex Virus-

-transmission is skin to skin, skin to mucosa

-presents as grouped vesicles on a erythematous base usually initially

-can have isolated lesions and varying degrees of ulceration

-HSV1-oral mucosal

-HSV2-genital

-Diagnosis is made my clinical suspicion confirmed with viral culture or antigen detection

-Treatment-acyclovir, valacyclovir, and famciclovir

-Molluscum Contagiosum-

-a self limited epidermal viral infection

-characterized by skin colored papules that are often umbilicated 

-can occur in children

-In HIV infected individuals can occur on the face 

-caused by poxvirus

-contagious can be transferred from skin to skin contact

-Aldara cream applied qHS 3 times a week for up to 1-3 months can help

-Varicella-

-highly contagious primary infection caused by the herpes zoster virus

-characterized by crops of pruritic vesicles that evolve to pustules, crusts, and ulcers.  

-the infection can have mild constitutional symptoms of fever, malaise and URI symptoms

-also called chicken pox

-acyclovir can shorten duration of illness of started early

-Herpes Zoster-

-is a dermatomal infection caused with reactivation of the varicella zoster virus characterized by unilateral pain in vesicular or bullous eruption limited to a dermatomal distribution

-major complication is post herpetic neuralgia

-acyclovir and antivirals can shorten duration of symptoms if started in the first 48 hours

-Verrucae-

-they are cutaneous human papilloma virus infections

-firm papules 1-10 mm are hyperkeratotic, cleft surface, and have vegetations 

-Verruca Plantaris (Plantar Warts)

-Verruca Plana (Flat Warts)

-can treat with salicylic acid or lactic acid

--Imiquimod cream can help

-Cryosurgery or electrosurgery for larger lesions