Viral skin diseases:Chicken Pox, Shingles, Parvovirus 819, HHV-6

What virus causes chicken pox and what kind of virus is it?
Varicella zoster virus, Herpesvirus(“Herpes zoster”)

Why is VZV unusual?
virtually all primary infections have signs and symptoms

What are the clinical manifestations of VZV?
Asymmetical vesicualar rash that have pruritic lesions.

How does the VZV infect?
Through conjunctiva or respriatory tract mucosa and replicates in regional lymph nodes leading to primary viremia. Secondary viremia from replication in spleen and liver(coincident with rash)

What is the incubation period of VZV?
15 days

What is the seasonal occurence of chicken pox?
Winter-spring

What’s the age of highest incidence of chicken pox?
5-9

How is chicken pox spread and not spread?
Spread by respiratory secretions. Not spread in scabs or crusts like smallpox can

When is VZV infected patient most contagious>?
1-2 days before lesion apperance

What Tx is NOT recommended in VZV and why?
Aspirin=Reyes syndrom risk

What causes shingles?
Recrudescence of VZV

How are lesions in shingles described?
Searing, burning, stabbing
Area of redness evolves to papules to vessicles in 24hr period

What is the most recognizable clinical feature of shingles?
Unilateral dermatomal distribution! Zoster=belt

How is shingles diagnosed?
Clinical findings, alterend immune status patients are prone

Shingles Tx?
Disease is self limited but painfuls to treat Px

What is most common complication of shingls?
Post herpetic nerualgia(usually elderly)

How can shingles be prevented?
Zostavax- a zoster vaccine to boost immunity in patients AGE 50 AND OLDER, A LIVE ATTENUATED VACCINE

What is the sequence of disease associated with HHV-6?
Fever followed by a rose colored rash

What is the most common age affected by HHV-6?
children 6months to 3 years

how long does the fever last in HHV-6?
Sustained fever for 2-5 days

What follows the prodromal period in parvovirusB195th disease?
Skin Rash, “slapped cheek apperance”
Maculopapular rash may involve limbs and trunk
Connective tissue manifestations-arthralgia

What is the age of highest incidence of Parvovirus B19?
School age children

What are the complications of parvovirus B19?
-Virus attacks erythroid progenitor cells causing anemia
-hydrops fetalis

How is Parvovirus B19 diagnosed?
Facial rash, lacey rash on body, detection of anti-B19 IgM

What is the apperance of orthopoxvirus virions?
Large and brick shaped

Where do orthopoxviruses replicate?
replicated in cell cytoplasm in “factories”

What are examples of orthopoxvirus?
Small pox(eradicated in 1977), monkey pox, vaccina(cow pox)

How can monkey pox be distinguished from other pox viruses?
PAGE of structural proteins

What is significant about the immunologic reaction to Vaccinacowpox?
Cross reaction between cowpox and smallpox allows use as smallpox vaccine strain.

Chicken Pox & Shingles

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