Viral Skin Diseases

1. Viral Skin Diseases

2. Herpes Simplex Virus

3. HSV-1 & HSV-2 • Frequently benign but can cause severe diseases. • The clinical course is characterized by 2 stages: a primary infection and recurrent episodes.

4. Pathophysiology • The virus enters the host through either a break in the skin or intact mucus membrane. The virus invades sensory neurons and is transported to the sensory ganglia where it lies dormant.

5. Symptoms • At first there is a burning, itching, tingling sensation in the area where the lesion will form. • There is also pain, fever, swollen lymph nodes and malaise. • The lesion appears as vesicle 1-3 mm in diameter. • The boarder around the vesicle may be red and inflamed.

6. Fully developed lesions has a crusty cover and if there is pus under the crust that may indicate a secondary bacterial infection. • The whole symptomatic process typically lasts 10-14 days and heals without scarring.

7. Recurrence • UV radiation, stress, fatigue, burn, fever, injury, menstruation, dental procedures, infectious disease and immunosuppresion.

8. Types: • Herpes Simplex Labialis. • Herpetic Gingivostomatits. • Herpetic whitlow. • Anorectal herpes. • Genital ulcers (HSV2). • Eczema herpeticum.

9. Herpes Simplex Labialis

10. Herpetic whitlow

11. Eczema herpeticum • All over the skin • Usually found in children

12. Genital herpes

13. Rectal herpes

14. Herpes gladiatorum • Head, neck and chest • Usually contracted by wrestlers

15. Treatment: Acyclovir 200 mg/5 times a day for 5 days.

16. Chickenpox • Chickenpox is a highly contagious disease that causes skin lesions in children. • Transmitted through direct contact with lesions and respiratory secretions. • Chickenpox is caused by the varicella-zoster virus (VZV).

17. Symptoms • I.P; 10-23 days • Chickenpox causes a red, itchy rash on the skin that usually appears first on the abdomen or back then spreads to almost everywhere else on the body, including the scalp, mouth, nose, ears and genitals.

18. The rash begins as multiple small, red papules that look like insect bites. They develop into vesicles filled with clear fluid. • The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs. • Some kids have a fever, abdominal pain, sore throat, headache, or a vague sick feeling a day or 2 before the rash appears.

20. Treatment: • Only symptomatic.

21. Herpes Zoster (Shingles) • Herpes zoster is caused by the same virus as chicken pox (VZV). • Zoster typically causes more pain and less itching than chicken pox. A person may feel burning, itching, tingling. These symptoms are typically present for 1-3 days, before a red rash appears in the same area. • Then groups of vesicles appear, which generally last for 2-3 weeks.

22. Clinical Types: • Ordinary H.Z. • Disseminated H.Z. • Ophthalmic H.Z. • H.Z. oticus.

27. Complications • Postherpetic neuralgia (PHN). • Severe disease may show hemorrhagic, bullous and gangrenous lesions. • Motor involvement: facial palsy. • Ocular complications: uveitis, keratitis and conjunctivitis.

28. Treatment: Acyclovir 800 mg/5 times a day for 7-10 days.

29. Warts • Warts are caused by human papilloma viruses (HPV).

30. Clinical Varieties: • Common warts

31. 2. Filiform warts;

32. 3. Plan warts;

33. 4. Plantar warts;

34. 5. Condylomata accuminata;

35. Treatment: • Electrocautry. • Cryosurgery. • Keratolytic therapy; 5-20% salicylic acid and 5-20% lactic acid in flexible collodion. • Podophyllin resin 25%. • Laser therapy.

36. Molluscum Contagiosum • The infecting virus is a pox virus called the molluscum contagiosum virus(MCV). • Molluscum contagiosum lesions are flesh-colored, dome-shaped, and pearly in appearance. They are often 1–5 millimeters in diameter, with a dimpled center.

38. Treatment: • Cryotherapy. • Removal with sharp curette. • Electrocautry. • Topical tretinoin.

39. THE END