VIRAL SKIN CONDITIONS

Herpes zoster (shingles/zona)

Definition;
is a viral disease characterised by a painful skin
rash with blisters in a limited area on one side
of the body, often in a stripe. It is caused by
the varicella zoster virus that has become
latent in the nerve cell bodies following
chicken pox.
 HERPES- CONTD
• Incidence;
on a yearly basis, through out the world, the
incident rates ranges from 1.2 to 3.4 cases per
1,000 healthy individuals, increasing to 3.9 –
11.8 per year per 1,000 individuals among
those older than 65 years.
 HERPES -CONTD
• Clinical manifestations
Earliest symptoms are non – specific and include;
headache, fever, malaise
Later; sensation of burning pain, itching,
hyperesthesia
In most cases after 1-2 days or as long as 3 weeks –
appearance of characteristic rash. (the pain and
rash most commonly occurs on the torso, but can
appear on the face, eyes, or other parts of the
body.
 HERPES - CONTD
Diagnosis
 HERPES - CONTD
• Appearnce of the characteristic rash
• Tsanck smear diagnoses acute herpes virus
infection.
• Lab tests – VZV – specific IgM antibody in
blood
• Lymph collected from blister examined with
electron microscope for viral particles.
 HERPES -CONTD
• Treatment
Aims; to limit the severity and duration of pain,
shorten the duration of shingles episode and
reduce complications.
• Analgesics; severe pain – use morphine,
topical lidocaine and topical lotions
containing calamine can be used on
rash/blister for soothing.
• Steroids; oral corticosteroids.
 HERPES - CONTD
• Complications
Secondary bacterial infection
 HERPES SIMPLEX
Herpes simplex
 H. SIMPLEX- CONTD
• Is a viral disease caused by both herpes simple
virus type 1 and type 2
• Transmitted by direct contact with a lesion or
the body fluid of an infected person,
transmission also occurs through skin to skin
contact during period of asymptomatic
shedding.
Signs and symptoms
HSV infection causes several distinct medical
disorders namely;
• Herpetic gingivostomatitis
Herpes labialis
Herpes genitalia
Herpetic whitlow
Herpesviral encephalitis
Herpes esophagitis
 OTHER HERPES CONDITIONS
Others include;
• Herpes gladiatorum
• Herpetic conjuctivitis
• Herpes viral meningitis
etc
 Diagnosis
• Herpes is contracted through direct contact
with an active lesion or body fluid of an
infected person.
• Herpes transmission occurs between
discordant partners; a person with a history of
infection (HSV seropositve) can pass the virus
to an HVS seronegative person. The only way
to contract HSV 2 is through skin to skin
contact with an infected individual.
 DIAGNOSIS -CONTD
• Primary orofacial – clinical examinations
• Lab test – culture of the virus, direct
fluorescent antibody studies, skin biopsy and
polymerase chain reaction to test for presence
of viral DNA
• Serological tests to HSV
 Prevention and treatment
• There is no method to eradicate herpes virus
from the body, but antiviral medications can
reduce the frequency, duration and severity of
outbreaks. Eg acyclovir
• Analgesics to reduce pain and fever.
• Topical anesthetic treatments like lidocaine to
relieve itching and pain.
• Condoms and vaccine (herpevac).
Molluscum contagiosum (MC)
• Def;
is a viral infection of the skin or
occasionally of the mucous membranes. It
is caused by a DNA poxvirus called
molluscum contagiosum virus.
• Among the four types MCV 1 – 4, MCV-1 is
most prevalent and MCV -2 is seen in
adults and is often sexually transmitted.
Molluscum contagiosum (MC)
 Molluscum contagiosum- CONTD
Incidence
• Common in children, sexually active adults
and the immunodeficient
• Transimission includes sexual contact,
touching and scratching the bumps and the
scratching the skin. Handling of formites like
towels
 Diagnosis/Treatment
On clinical appearance and excision biopsy
Treatment
Not necessary, depend on location and number of
lesions. However, treatment is sought for the
following reasons:
• Medical issues
 bleeding
 Secondary infections
 Itching and discomfort
 Potential scarring
 Chronic keratoconjuctivitis
• Social reasons
 Cosmetic, embarrassment, social exclusion and fear of
transmission to others.
 TREATMENT- CONTD
• Cryotherapy; kill infected cells by freezing.
• Astrngents applied to surface to destroy
successive layers.
• Systermic treatment; cimetidine or
griseofulvin
 Common warts(verruca vulgaris)

• Common warts are benign non-cancerous skin

growths of the top layer of skin and mucous
membranes. They are skin coloured, rough to
the touch, dome-shaped, and usually grow
around the nails, on fingers or the back of
hands.
 Causes

• Human papilloma virus (HPV). More than

100 strains have been identified, and at least
60 are known to cause warts. Specifically,
types 1, 2, 4, 27, and 29 are the most frequent
HPV strains to infect people and cause a wart
to develop.
 Causes

• HPV strikes where the skin is broken, for

example cuts and scratches or where
fingernails have been bitten and skin has
been damaged in the process. Warts can
spread from person to person and from
one part of the body to the other. For
these reasons doctors recommend that if
you touch a wart you should wash your
hands immediately.
 Symptoms

• HPV causes unusual growth of cells at the base of the

outer layer of skin. Contrary to popular belief
common warts do not have deep roots; they stay on
the surface of the skin, and are completely harmless.

• Scientists believe that there are several reasons why

some individuals are affected by warts, and others
remain trouble free. These include: the type and
strength of the viral strain, the health of the exposed
person, and the strength of an individual’s immune
response.
 Symptoms

• Common warts appear mostly on the hands

and feet and are round, raised growths. They
are more common in young adults and
children. A common wart can range in size
from a pinhead to 10 mm.
 Symptoms

• Common warts are painless with one

exception. If the wart develops on the bottom
of the foot (known as a plantar wart), then the
pressure of walking on the wart causes it to
grow inward instead of outward and they are
often quite painful.
 Symptoms

• Other than plantar warts, common warts

rarely cause any other problems except for
being an eyesore, especially for the people
that are suffering with the common wart
 Treatment
• There is no overnight cure. One treatment option is to
ignore them. Warts eventually go away, though this
may sometimes take years for the immune system to
get rid of them. If you can’t bear to see common warts
on any part of your body then over the counter
ointments, plasters, and patches may work.

• Combination therapies are known to have reasonable

success rates, where two or more agents are
applied. freeze common warts with liquid nitrogen or
zap them with electricity or laser light.