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Viral exanthem

Abraham M Korman, Ali Alikhan, Benjamin H Kaffenberger
Although classic viral exanthems of childhood are well described, they are rarely differentiated in adults. Laboratory techniques for viral identification have advanced without substantial literature to suggest how a dermatologist ought to conduct a cost-effective and diagnostic viral panel. Certain clinical features such as petechiae, vesicles, and dusky macular or morbilliform exanthems point strongly toward a viral exanthem. Differentiation of drug and viral causes of morbilliform eruptions has proven difficult...
March 2017: Journal of the American Academy of Dermatology
R Fölster-Holst, V Zawar, A Chuh
Paraviral exanthems are distinct skin diseases due to infections with different viruses. Although no virus has been identified so far in some exanthems, the main age of manifestation, the clinical course of the exanthem, and the extracutaneous symptoms are suggestive for a viral genesis. While many viral infections are a direct result of the infection, paraviral exanthems reflect the response of the immune system to the infectious pathogens. Viruses cannot be identified in the skin. Typical paraviral exanthems include Gianotti-Crosti syndrome, pityriasis rosea, pityriasis lichenoides, papular-purpuric gloves and sock syndrome, and asymmetrical periflexural exanthema...
February 13, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Mark R Wick
Some cutaneous inflammatory disorders are typified by a predominant or exclusive localization in the dermis. They can be further subdivided by the principal cell types into lymphocytic, neutrophilic, and eosinophilic infiltrates, and mixtures of them are also seen in a proportion of cases. This review considers such conditions. Included among the lymphoid lesions are viral exanthems, pigmented purpuras, gyrate erythemas, polymorphous light eruption, lupus tumidus, and cutaneous lymphoid hyperplasia. Neutrophilic infiltrates are represented by infections, Sweet syndrome, pyoderma gangrenosum, and hidradenitis suppurativa, as well as a group of so-called "autoinflammatory" dermatitides comprising polymorphonuclear leukocytes...
December 14, 2016: Seminars in Diagnostic Pathology
James Guoxian Huang, Allen Eng Juh Yeoh, Paul Anantharajah Tambyah, Mas Isa Suhaila
We report the diagnostic and therapeutic challenges in an unusually fulminant presentation of measles, presenting as severe necrotizing bronchiolitis with secondary hemophagocytic lymphohistiocytosis (HLH) in the absence of classical clinical features in an immunocompromised host on maintenance chemotherapy. Our patient had presented with features of a viral pneumonitis without the classical exanthem, in combination with HLH. Although rhinovirus-induced HLH was highly unusual, the positive rhinovirus swab result had distracted us from the eventual diagnosis...
January 2017: Journal of Pediatric Hematology/oncology
Cristiane N Soares, Patrícia Brasil, Raquel Medialdea Carrera, Patricia Sequeira, Ana Bispo de Filippis, Vitor A Borges, Fernando Theophilo, Mark A Ellul, Tom Solomon
BACKGROUND: Zika virus (ZIKV) was first identified in the Americas in 2015, when an outbreak of an exanthematous illness occurred in Brazil. Subsequentely, there was an increase of microcephaly cases, suggesting an association between ZIKV and this neurological complication. Currently, ZIKV has been recognised as causing a wide range of neurological complications including Guillain Barré syndrome, and myelitis. OBJECTIVES: In this report, we describe the first fatal case of encephalitis in a 47 years old non pregnant woman, infected during the Brazilian zika epidemic of 2016...
October 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Matthew P Vasievich, Jose Dario Martinez Villarreal, Kenneth J Tomecki
The popularity of international travel continues to increase among Americans, even though they often experience subsequent illness on return from their journey. The pathogens responsible are not necessarily endemic to the destination itself but are often the result of poor sanitary conditions or activities engaged in while away. Skin disease ranks third among all medical concerns in returning travelers. This review addresses the pathogenesis, epidemiology, clinical presentation, and treatment of the most common skin diseases in returning travelers: insect bites and bedbugs, cutaneous larva migrans, scabies, tungiasis, myiasis, leishmaniasis, viral exanthems, and marine envenomation...
October 2016: American Journal of Clinical Dermatology
Rose Xavier, Bobby Abraham, Vinod Jacob Cherian, Jobin I Joseph
Necrotising fasciitis (NF) is an extremely rare complication of a rather common paediatric viral exanthem varicella. Delayed diagnosis and treatment can lead to significant morbidity and mortality. Laboratory risk indicator of NF score aids in early clinical diagnosis in suspected cases of post-varicella NF thus enabling timely intervention. Surgery delayed for more than 24 hours, is an independent risk factor for death. Surgical debridement with good antibiotic coverage is the definitive treatment for NF.
January 2016: African Journal of Paediatric Surgery: AJPS
Regina Fölster-Holst, Vijay P Zawar, Antonio Chuh
INTRODUCTION: Paraviral exanthems are skin diseases suspected to be caused by viruses, with a single virus-exanthem relationship not universally accepted. Although most paraviral exanthems are self-remitting, accurate diagnoses are important as some patients might develop complications. Some of the differential diagnoses might cause serious complications, and some paraviral exanthems might lead to complications for at-risk groups such as pregnant women. Moreover, some paraviral exanthems might be symptomatic such as the development of severe pruritus, with relief of such being crucial in the plan of management...
June 2016: Expert Review of Anti-infective Therapy
Antonio Chuh, Vijay Zawar, Gabriel F Sciallis, Werner Kempf, Albert Lee
Many clinical and laboratory-based studies have been reported for skin rashes which may be due to viral infections, namely pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), papular-purpuric gloves and socks syndrome (PPGSS), and eruptive pseudo-angiomatosis (EP). Eruptive hypomelanosis (EH) is a newly discovered paraviral rash. Novel tools are now available to investigate the epidemiology of these rashes. To retrieve epidemiological data of these exanthema and analyze whether such substantiates or refutes infectious etiologies...
March 21, 2016: Infectious Disease Reports
Francesco Drago, Sanja Javor, Giulia Ciccarese, Aurora Parodi
Gianotti-Crosti syndrome (GCS) is a self-limiting exanthem of acute onset with a characteristic acral distribution, usually occurring in children. It is characterized by symmetric pink to red-brown papular or papulovesicular lesions that are a few millimetres in diameter, distributed on the face, buttocks and limbs. It may be accompanied by low-grade fever, hepato-splenomegaly and lymphadenopathy. GCS is considered a unique cutaneous response to viral infection, mostly associated with hepatitis B virus and Epstein-Barr virus (EBV), but other viruses, bacterial infections and recent immunizations may be inciting factors...
May 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Priya Ramdass, Sahil Mullick, Harold F Farber
In the vast world of skin diseases, viral skin disorders account for a significant percentage. Most viral skin diseases present with an exanthem (skin rash) and, oftentimes, an accompanying enanthem (lesions involving the mucosal membrane). In this article, the various viral skin diseases are explored, including viral childhood exanthems (measles, rubella, erythema infectiosum, and roseola), herpes viruses (herpes simplex virus, varicella zoster virus, Kaposi sarcoma herpes virus, viral zoonotic infections [orf, monkeypox, ebola, smallpox]), and several other viral skin diseases, such as human papilloma virus, hand, foot, and mouth disease, molluscum contagiosum, and Gianotti-Crosti syndrome...
December 2015: Primary Care
Yael Renert-Yuval, Eytan Marva, Merav Weil, Lester M Shulman, Nilsu Gencylmaz, Sivan Sheffer, Dana G Wolf, Vered Molho-Pessach
Hand foot and mouth disease (HFMD) is an acute childhood viral exanthem usually associated with coxsackievirus A16 or enterovirus 71. Atypical HFMD associated with coxsackievirus A6 was reported recently. The aim of the current study was to describe coxsackievirus A6-associated atypical HFMD in a series of 8 toddlers who were referred with idiopathic extensive eruptions. Demographic and clinical characteristics, Reverse transcriptase-real-time PCR (RT-PCR) results for enterovirus and phylogenetic analysis for the coxsackievirus A6 strains were recorded...
May 2016: Acta Dermato-venereologica
Walid Ibrahim, Abdel-Naser Elzouki, Ahmed Husain, Lubna Osman
BACKGROUND: Neurologic complications can occur with varicella zoster virus (VZV) infection, usually after vesicular exanthem. A review of the literature revealed 3 cases of viral meningitis associated with 6th nerve palsy but without significantly increased intracranial pressure. CASE REPORT: We report a case of a previously healthy 15-year-old girl with aseptic meningitis as a result of reactivated-VZV infection with symptoms of increased intracranial pressure and reversible 6th cranial nerve palsy but without exanthema...
2015: American Journal of Case Reports
Beth S Ruben, Wesley Y Yu, Fan Liu, Sam V Truong, Kevin C Wang, Lindy P Fox
BACKGROUND: Cytarabine-induced toxicity manifests as various cutaneous morphologies. A generalized papular purpuric eruption has not been well described. OBJECTIVES: We aimed to characterize a distinct cytarabine-related eruption. METHODS: We reviewed all cases of cytarabine-related toxicity with papular purpuric eruptions or violaceous erythema at the University of California, San Francisco between 2006 and 2011. RESULTS: Sixteen cases were identified...
November 2015: Journal of the American Academy of Dermatology
Esra Adışen, Meltem Önder
Viruses are considered intracellular obligates with a nucleic acid, either RNA or DNA. They have the ability to encode proteins involved in viral replication and production of the protective coat within the host cells but require host cell ribosomes and mitochondria for translation. The members of the families Herpesviridae, Poxviridae, Papovaviridae, and Picornaviridae are the most commonly known agents for the cutaneous viral diseases, but other virus families, such as Adenoviridae, Togaviridae, Parvoviridae, Paramyxoviridae, Flaviviridae, and Hepadnaviridae, can also infect the skin...
July 2015: Clinics in Dermatology
Charles Grose, Erin M Buckingham, Wallen Jackson, John E Carpenter
Autophagy has been intensively studied in herpes simplex virus type 1 (HSV-1), a human alphaherpesvirus. The HSV-1 genome encodes a well-known neurovirulence protein called ICP34.5. When the gene encoding this protein is deleted from the genome, the virus is markedly less virulent when injected into the brains of animal models. Subsequent characterization of ICP34.5 established that the neurovirulence protein interacts with BECN1, thereby inhibiting autophagy and facilitating viral replication in the brain...
April 3, 2015: Autophagy
Daniel Ventarola, Lindsey Bordone, Nanette Silverberg
Hand-foot-and-mouth disease is a viral exanthem caused, primarily by Coxsackie A16 and enterovirus 71 with typical clinical features of fever, painful papules and blisters over the extremities and genitalia and an enanthem involving ulceration of the mouth, palate, and pharynx. Other enteroviruses have recently been noted to cause severe neurologic illness and paralysis (enterovirus 68) with variable cutaneous features. A recent outbreak of Coxsackie A6 infection has been seen worldwide with cases reported in the United States, Japan, Southeast Asia, and Europe...
May 2015: Clinics in Dermatology
Yoshiki Kawamura, Ai Nakayama, Taichi Kato, Hiroki Miura, Naoko Ishihara, Masaru Ihira, Yukitoshi Takahashi, Kazumi Matsuda, Tetsushi Yoshikawa
BACKGROUND: Human herpesvirus 6B (HHV-6B) is the causative agent for exanthem subitum. HHV-6B was associated with mesial temporal sclerosis (MTS), leading to mesial temporal lobe epilepsy (MTLE). In this study, we sought to elucidate the pathogenic role of HHV-6B in patients with MTLE. METHODS: Seventy-five intractable MTLE patients, including 52 MTS patients and 23 non-MTS patients, were enrolled in this study. Resected hippocampus, amygdala, and mixed samples of amygdala and uncus samples were examined by real-time polymerase chain reaction (PCR) and reverse-transcriptase PCR to detect viral DNA and messenger RNA (mRNA), respectively...
October 1, 2015: Journal of Infectious Diseases
Scott B Halstead
After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga...
April 2015: Emerging Infectious Diseases
Noha Botros, Lorenzo Cerroni, Allam Shawwa, Peter J Green, Wenda Greer, Sylvia Pasternak, Noreen M Walsh
Angioimmunoblastic T-cell lymphoma (AITL), an uncommon variant of peripheral T-cell lymphoma, affects the skin in approximately 50% of cases. Its protean clinical and histopathological cutaneous manifestations pose a challenge in diagnosis, particularly when these precede the diagnosis of AITL on a lymph node biopsy. In this retrospective study, we compared 11 cases of AITL with cutaneous manifestations (mean age 67 years; male:female ratio 1:0.8; 24 skin biopsies) with 20 control cases of inflammatory and non-AITL lymphomatous diseases (mean age 52 years; male:female ratio 1:1...
April 2015: American Journal of Dermatopathology
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