o Self resolving disease, benign

o protein
o L2- Minor capsid protein Pathophysiology
- Target epidermal keratinocytes
Host cells and Papilloma virus - Typical inclusion bodies
- Hyperplastic (Similar to Papilloma virus)

Treatment:
- Curettage, cryosurgery
- Topical agents
- Self limiting disease (unsightly, covered in loose fitting
bandage)

Measles Virus
Transmission: most contagious of all infectious diseases (9/10)- high rate
of contagion
- direct contact with infectious droplets
- From airborne spread when an infected person breathes,
Viral replication:
coughs, sneezes
- basal layer cells replicating and as they differentiate thru the super-basal,
- Remains infection in air up to 2 hours
granular and cornified layer (inside to outside of epidermis)
Symptoms
- When infected with papilloma virus, the viral genome is present in the basal cells
- Characterized by a prodrome: before rash appearance
- Red areas: infected with papilloma virus, the basal cells will replicate and the virus
o Fever (as high as 105F)
genes are going to be expressed including E6 and E7 genes will be expressed
o Malaise
- First genes that are expressed E6 and E7 will cause the cells to replicate outside
o 3Cs: coryza, cough, and conjunctivitis (these
the bounds of
- viral particles from cornified layer, the keratinized skin cells get sloughed off of symptoms are indicative that they have measles
epidermis before the rash appears)
- Diagnosis o Koplik spots- pathognomonic enanthema: whitish
- clinical presentation lesions on soft palates, hard to see, not true vesicles
- Histology (think measles, even if the rash hasn’t developed
Treatment and you see kolpik spots)
- Topical Application of caustic agent (compound W)
- Cryotherapy: warts frozen with liquid nitrogen but warts can’t be fully
eliminated bc

- for long periods

- common in infections in kids: kids going to school are covered Koplik spots
by loose fitting bandage
- Followed by a maculopapular rash
Clinical presentation: o Appears ~14 days after exposure
o Self limiting disease: Cluster of lesions, Papular o Spreads from head  trunk  lower
extremities

o Smooth (warts are scaly and rough) and

umbilicated in the center
o Raised and shiny appearance
o Cluster lesions: 6-8 in Localized areas on pts bodies
 - : abrupt onset of fever 40C (104F)
- Last 3 days, development of rash: maculopapular exanthem
- Rash

Diagnosis:
- Based on clinical presentation
- Roselola infantum, 6th disease
Treatmtent:
- Symptomatic
- 1st day of rash kolpik spots on buccal mucosa and small and Complications:
discrete appearance of rash rash keeps developing  3rd day - Immunologically suppressed patients
confluent and discrete macupapules
- Rash is related to vasculitis and antigen antibody complex
deposition, this is why it takes 14 days after primary infection
to develop full blown rash
Complications:
- otitis media, bronchopneumonia, laryngotracheobronchitis,
and diarrhea
- One out of every 1,000 - acute encephalitis, which often
results in permanent brain damage
- One to three out of every 1,000 children will die from
respiratory and neurologic complications
- Subacute sclerosing panencephalitis (SSPE) - rare, but fatal
degenerative disease of the central nervous system that
generally develops 7 to 10 years after measles infection

Individuals at high risk for severe illness and complications from

measles:
- Infants and children aged <5 years
- Adults aged >20 years
- Pregnant women
- People with compromised immune systems, such as from
leukemia and HIV infection
Diagnosis
- Laboratory confirmation is essential
- Detection (measles virus is RNA virus)
o Measle-specific IgM antibody in serum
o Measles- RNA- real time PCR (RT-PCR)
- Urine samples
o May also contain the virus
o Collecting both respiratory (nasal-pharyngo) and
urine samples can increase likelihood of detection
Treatment:
- No specific antiviral therapy
- Supportive care to help relieve symptoms and address
complications such as bacterial infections
- Severe measles cases among children
o Treated with Vitamin A (dec severity of infx) 
administered immediately on diagnosis and
repeated the next day
Prevention: Vaccination
- combination measles-mumps-rubella (MMR) vaccine
- combination measles-mumps-rubella-varicella (MMRV)
- approximately 97% effective
- For people w/o evidence of immunity  administer MMR
within 72 hrs of initial measles exposure or give them IG
within 6 days of exposure