医学课件病毒性细菌性皮肤病 viral

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1、ViralDermatosesDepartmentofDermatologyXiaoSheng-XiangGeneralDescriptionDefinitionViraldermatosesarethecutaneousdiseasesresultingfromviralinfections.ClassificationofViraldermatosesHerpesvirusgroupHerpessimplesxVaricella(Chickenpox)HerpesZosterRosealaInfantum(Sixthdisease)Kaposi’ssarcoma

2、ClassificationofViraldermatosesPoxvirusgroupMolluscumcontagiosum,milker’snodulesPapovavirusgroupWarts(commonwarts,Flatwarts,plantarwarts,genitalwarts)ClassificationofViraldermatosesParvovirusErythemainfectiosum(fifthdisease)(B19virus)ParamyxovirusgroupMeasles,rubellaClassificationofViral

3、dermatosesPicornavirusgroup(enteroviruses)Hand-fooot–mouthdisease(coxackievirus)RetrovirusesAIDSHerpesSimplexEtiologyHerpesSimplexVirus(HSV):DNAVirusTwoantigenictypes:HSV-1,HSV-2HSV-1:lesionsonthelips,faceHSV-2:genitalherpesLesionsanywheremaybecausedbyeitherantigenictype.Transmission:Int

4、imatecontact(directinoculationthroughtraumatizedskin)PrimaryinfectionandrecurrentinfectionPrimaryinfection:firstinfectionAfterprimaryinfectionvirusmigratestotheneuronalcellsinganglionlatentinfectionlatentvirustoreactivatebytriggeringfactorsvirusparticlesmoveonthenervereplicateintheepithe

5、lialcellsrecurrentinfectionTriggeringfactors:fever,trauma,emotionalstress,menstruationEpidemiology85%ofadultsworldwideareseropositireforHSV-1.SeroprevalenceforHSV-2islower,appearattheageofonsetofsexualactivity.USA:~23%ofadultsareinfectedwithHSV-2Developingcountries:60~95%ofinfectionrates

6、ofHSV-2Incubativeorsubclinicalinfection:90%ofallinfectedClinialmanifestationFeaturesofthelesion:multiplesmallpapules,vesicles,clustedtogether.Maturelesion:groupedvesiclesand/orpustulesonanerythematousedematousbaseCommonsiteforlesions:face,lips,mouth,neck,anogenitalareaHealwithin1-2weeksD

7、iagnosisClinicalDiagnosisLaboratoryTestTzancksmear:takeasmearofcellsfromthebaseoftheskinlesionspreadthecellsonaglassslidestainwithwrightorGiemsaStainlookformultinucleatedgiantcellsNonspecific:HSVVZVAccuracyrate:60~90%Falsepositiverate:3~12%Detectionofvirusantigenofthelesi