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Bullous Viral Eruptions

»What do herpes simplex (HSV) virus and varicella-zoster virus (VZV) have in common?
»What happens during primary HSV infection?
»What about recurrent infection?
»What is the difference between a primary and an initial HSV infection?
»How is HSV transmitted?
»How long is incubation period for HSV (i.e., the time from initial infection to appearance of vesicles)?
»Define asymptomatic shedding.
»Can you be infected with HSV and not know it?
»How do HSV-1 and -2 differ?
»How do you diagnose HSV infection?
»How is a Tzanck smear performed?
»What are the drugs of choice for treatment of HSV?
»When is chronic suppressive therapy indicated?
»Are patients with genital herpes at greater risk for becoming infected with the human immunodeficiency virus (HIV)?
»What recommendations can you make to a patient with genital herpes to reduce the risk of transmission to his or her partner?
»Can HSV infect the skin in areas other than around the mouth or anogenital areas?
»How does a baby get herpes? Is it a serious problem?
»Describe the natural history of varicella.
»What is shingles?
»Can herpes zoster be recurrent?
»What is disseminated zoster?
»Is herpes zoster contagious?
»What is postherpetic neuralgia?
»How do you diagnose VZV infection?
»What is the treatment for varicella?
»How about herpes zoster?
»Should I be concerned about the patient with herpes zoster involving the tip of the nose?
»Who should get the herpes zoster vaccine?
»What is hand, foot, and mouth disease?
»What is orf?

 
 
 

Can HSV infect the skin in areas other than around the mouth or anogenital areas?


A, Herpetic whitlow. B, Eczema herpeticum (Kaposi’s varicelliform eruption) in a patient with atopic dermatitis. (Panel A courtesy of the Walter Reed Army Medical Center teaching files; panel B courtesy of Scott D. Bennion, MD.)
Fig. 25.2 A, Herpetic whitlow. B, Eczema herpeticum (Kaposi’s varicelliform eruption) in a patient with atopic dermatitis. (Panel A courtesy of the Walter Reed Army Medical Center teaching files; panel B courtesy of Scott D. Bennion, MD.)
HSV infection may involve and recur at any location on the mucocutaneous surface. HSV infection of the hand or fingers, known as herpetic whitlow, is usually the result of autoinoculation from another site of infection (Fig. 25-2A). Herpes gladiatorum is a problem most commonly seen in athletes who participate in close contact sports such as wrestling. Typically transmitted from active herpes labialis or asymptomatic shedding in oral secretions of an infected opponent, herpes gladiatorum often affects the head, neck, or shoulders. Eczema herpeticum, also known as Kaposi’s varicelliform eruption, represents a cutaneous dissemination of HSV (Fig. 25-2B). It may develop as a complication of a localized HSV infection in patients with atopic dermatitis or other underlying skin disease.