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بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. VIRAL INFECTIONS. Herpes simplex. Herpes zoster. Warts. Molluscum contagiosum. Small pox / Chicken pox. Measles / German measles. AIDS / Infectious mononucleosis. Roseola infantum / Kaposi sarcoma. Hand, foot & mouth disease.

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بسم الله الرحمن الرحيم

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  1. بسم الله الرحمن الرحيم

  2. VIRAL INFECTIONS

  3. Herpes simplex. Herpes zoster. Warts. Molluscum contagiosum. Small pox / Chicken pox. Measles / German measles. AIDS / Infectious mononucleosis. Roseola infantum / Kaposi sarcoma. Hand, foot & mouth disease. Herpangina / Erythema Infectiosum (5th disease). Orf / Burkitt’s lymphoma.

  4. Herpes Simplex (HS) Cause: HSV. Types: I & II. Incidence: Commonest. Sites: Skin & mucous membranes. Transmission: Skin-to-skin or skin-to-MM. IP: 3-5 days.

  5. Pathogenesis: Invades mucosal surface or traumatized skin Replication Primary infection Neural tissue (Dorsal root ganglia) Reactivation Recurrence Predisposing factors: • Fever / Fatigue / Food. • Trauma / UV /Stress . • Menstruation / Altered immune state.

  6. Oral mucosa:1ry Herpetic gingivostomatitis Age:1-5 years. Subclinical: 90 %. Clinically apparent: Tongue, pharynx, palate, buccal mucosa & surrounding skin. Accompanied by: Fever, sore throat, malaise, loss of appetite and lymphadenopathy Fever subsides after 3-5 days Recovery after 2 weeks. Recurrence: Lips or face / Oral mucosa.

  7. The lips:Recurrence of primary Age:Over 5 years. C/P: Unilateral or bilateral and symmetrical One week No scarring if secondary infection does not occur. Regional LNs: Enlarged if secondary infection. The face:Recurrence of primary Age:Over 5 years. C/P:Around orifices & on cheeks.

  8. The genitals: Sex:Both sexes. Common cause of:Genital ulceration. Males: Glans & shaft of penis + Urethritis. Females: Labia, vulva, vagina, perineum & cervix. C/P: Local or radiating pain may precede the lesions by 24 hours Intact vesicles Recurrent, irregular, superficial, grouped, soft ulcers Lymphadenopathy. Recurrent infection: Less severe.

  9. Complications: Serious neonatal infection. *Neonatal herpes simplex: Passage of fetus through birth canal Infection Fatal CS.

  10. Diagnosis: • C/P. • Tzanck smear. • Viral culture. • Serological test. • PCR. Complications: • Impetigo. • Eczema herpeticum. • EM. • Keratitis and corneal ulcers. • Encephalitis & meningitis.

  11. Treatment:Avoid precipitating factors if possible I) Local ttt:Mild cases a) Drying, soothing antiseptic lotions: Boric acid lotion / KMNO4 / Aluminum acetate lotion 10 %. b) Topical antivirals:Acyclovir cream / Pencyclovir cream. c) Topical antibiotics. d) Idoxuridine (IDU). II) Systemic ttt:Severe cases a) Acyclovir. b) Valacyclovir. c) Famcyclovir.

  12. Herpes Zoster (HZ) Cause: VZV. Sex: Both sexes. Age: Any age, more in adults.

  13. Pathogenesis:Recurrence 1ry is chickenpox Virus in dorsal nerve roots & dorsal root ganglia Reactivation Nerves Recurrence. Predisposing factors: • Trauma. • Drugs. • Diseases of the spine. • Malignant diseases.

  14. C/P: Pain Chest: 50 %.Face: Eye involvement. Unilateral grouped vesicles on erythematous base along distribution of a sensory nerve Local lymph nodes Vesicles dry up Recovery after 2-4 weeks May leave scars Permanent immunity

  15. Clinical types: • Ordinary vesicular type. • Bullous type. • Haemorrhagic type. • Gangrenous type. • Abortive type. • Generalized type. Complications: • Secondary infections. • Post-herpetic neuralgia. • Nervous system • Eye: HZ ophthalmicus.

  16. Treatment: General ttt: • Bed rest. • Ophthalmology consultation. Local ttt: • Antiseptic drying lotions: In vesicular stage. • Topical antibiotic ointments: In healing stage. Systemic ttt: • Analgesics. • Antibiotics. • Systemic acyclovir.

  17. Warts (Verrucae) Cause:HPV. Types:50. Age:Children & young adults. Sex:Both sexes. Transmission:Direct / Indirect / Autoinoculation. IP:1-6 months. Involution:2/3 of lesions within 2 years.

  18. Types: Common warts (Verruca Vulgaris): • Hands & fingers. • Asymptomatic / Skin-colored or darker / Firm / Rough hyperkeratotic mamillated surface. • Spread. Plane warts (Verruca Plana): • Face, neck, forearms & hands. • Asymptomatic / Skin-colored or darker / Flat-topped / Smooth & slightly elevated. • Koebner’s phenomenon. Filliform warts (Verruca Filiformis): • Sides of the neck and eyelids. • Long, thin thread-like skin growths. • Finger-like processes (Digitate warts).

  19. Plantar warts (Verruca Plantaris): • Soles of the feet. • Painful & tender / Black / Thick / Flattened & deeply embedded. • Against pressure points. Venereal warts (Condyloma Accuminata): • Skin and mucous membranes of genital organs of males & females. • Painless / Pinkish / Soft / Moist, foul-smelling & bleed easily. • Differentiated from Condyloma lata.

  20. Complications: • Spread:To same patient or to others. • Malignancy: HPV 6, 16 and 18.

  21. Treatment: • Electric cautery. • Cryocautery. • Chemical cautery: Carbolic acid / Glacial acetic acid / TCA / Salicylic acid / Cantharidin • Podophyllin resin: 25 % in alcohol or paraffin. • Autosuggestion & hypnosis. • Surgical excision.

  22. Molluscum Contagiosum Cause: Pox virus. Transmission: Direct & indirect. IP: 2-6 weeks. C/P: Shiny, pearly white, dome-shaped, sessile papules with a smooth surface and central umbilication. *Squeezing the lesion White cheesy material. Sites: • Face & neck: In children and young adults. • Genitals, lower abdomen & thighs: STD.

  23. Treatment: • Electric cautery. • Cryocautery. • Chemical cautery. • Laser treatment.

  24. THANK YOU

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