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DERMATOZE VIRALE

DV PROPRIU-ZISE: A. Epidermoviroze 1. Hiperplazice: infecie HPV (Papilloma virus uman) Veruci plane juvenile Veruci vulgare Veruci genitale / condiloame acuminate 2. Eritemato- scuamoase: Pitiriazis rozat Gibert (v herpetic 7) 3. Degenerative: Molluscum contagiosum (v molluscum contag.) 4. Exudative: nodulii mulgtorilor / paravaccina ectima contagiosum / orf (v ectimei contagoisum) exantemul veziculos cu stomatit (Coxsackie A16)

B. Epidermoneuroviroze: - herpes simplex - herpes zoster II. DETERMINRI CUTANATE N CADRUL FEBRELOR ERUPTIVE, ALTOR VIROZE rujeol, rubeol, varicel adenoviroze eritemul infecios (parvovirus) exantemul subit (virus herpetic 6) III. DERMATOZE CU POSIBIL ETIOLOGIE VIRAL Afte Eritemul polimorf

ETIOLOGIEVirusuri ADN: Papovavirusuri: HPV Herpesvirusuri: V herpes simplex, V varicelozosterian, CMV, EBV, HV-6, HV-7 Poxvirusuri: v vaccinei, v paravaccinei, v molluscum contagiosum, v ectimei contagiosum Parvovirusuri Virusuri ARN: Picornavirusuri: V Coxsackie A i B, Echovirusuri Rhabdovirusuri: V stomatitei veziculoase

PATOGENEZ Inoculare cutanat direct multiplicare viral hiperplazie K : veruci degenerescen celular: molluscum contagiosum infecie persistent inaparent clinic Infecie latent: herpes Infecie sistemic

aprare antiviral: anticorpi specifici, IgA, imunitate celular (LT) efect oncogen: HPV 16, 18, 31, 32 efect teratogen: CMV, V rubeolei

VERUCILE HPV: peste 100 subtipuri Infecie persistent Factor de risc pentru cancerul genital Epidemiologie: - Inciden, infeciozitate - Transmitere: direct, indirect, iatrogenie, traumatisme

Veruci plane juvenile.

VERUCI PLANE JUVENILE HPV 3,5,8,9,10 Aspect Topografie Diagnostic diferenial: hidradenoame, xantom plan, mastocitoz, lichen plan

Tratament: keratolitice, podofilin podofilotoxin (Condyline)

Veruci vulgare.

Hidradenoame

VERUCI VULGARE

Aspect Dimensiuni, grupare Topografie Variante clinice: mozaicate, filiforme, digitate, plantare

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.

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Veruci vulgare plantare .

Veruci vulgare plantare.

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Diagnostic diferenial Clavus

Fibrom

Tuberculoz verucoas

Tratament Criocauterizare Electrocauterizare Keratolitice Citotoxice: 5-fluoruracil Imunoterapie de contact Tratament general

VERUCI GENITALE / CONDILOAME ACUMINATE Epidemiologie Aspect Localizare Factor de risc oncogen: displazia cervical intraep. cc Diagnostic diferenial: carcinom, limfangiom, condiloma lata

.

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Condiloame acuminate

Condiloame acuminate perianale.

Condiloame acuminate aplatizate.

.Condiloame acuminate pe gland i prepu

Condiloame acuminate anogenitale.

Dg. Diferenial: condiloma lata / sifilide hipertrofice

Carcinom spinocelular in situ

Tratament Citotoxic: podofilin, podofilotoxin (Condilyne) Imunoterapie: imiquimod Electrocauterizare Tratament sistemic vacinoterapie

Veruci seboreice.

VERUCI SEBOREICE / KERATOZE SEBOREICE Caracter familial (AD) uneori Vrstnici Aspect, dimensiuni, topografie Semn Leser-Trelat Diagnostic diferenial Tratament

Veruci / keratoze seboreice

Veruc seboreic

Veruci seboreice.

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Molluscum contagiosum.

Etiologie: poxvirus (V. Molluscum contagiosum) Mod de transmitere Aspect, numr Topografie Vrsta Diagnostic diferenial: varicel, keratoacantom, xantom, V vulgare, noduli scabioi Tratament

Molluscum contagiosum.

Molluscum contagiosum.

Diagnostic diferenial

keratoacantom

xantoame

HERPES SIMPLEX HSV 1; HSV 2 Primoinfecia: cutanat Angin herpetic Gingivo- stomatit Kerato- conjunctivit Vulvo- vaginit Herpesul neo natal

Herpes simplex palpebral.

Herpesul recurent: - factori favorizani - Prodrom - Aspect; topografie; - Adenopatie

Herpes simplex.

Herpes simplex.

Herpes simplex.

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Herpex simplex oral

.

. Herpes genital

Herpes simplex genital.

Herpes simplex genital.

Complicaii: eczema herpeticum impetiginizare nevralgie eritem polimorf

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Eczema herpeticatum

Eczema herpeticatum.

Herpes impetinizat.

Eritem polimorf

Diagnostic diferenial: eczem, Z zoster, afte,eritem polimorf, impetigo Tratament: Acyclovir ; valaciclovir, famciclovir , brivudin - sulfat de zinc, Novastim, - vaccin, imunoglobuline

HERPESUL ZOSTER / ZONA ZOSTER V varicelo- zosterian Condiii de reactivare: intervenii ch, imunodepresie (Tu, SIDA, TBC) Prodrom

Herpes zoster.

- Aspectul erupiei: grupare, unilateral, adenopatie Leucodermie posteruptiv Nevralgie Afectare motorie: 5%

Nevralgia postzosterian

Topografie: intercostal Cervico- brahial Trigeminal: Z oftalmic cu leziuni oculare n 2/3 Lombo- sacrat; femuro- cutanat N facial: paralizie facial, triada Ramsay-Hunt Paraneoplazie

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Herpes zoster intercostal

Herpes zoster cu cicatrice hipertrofic.

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Herpes zoster fesier

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Herpes zoster coaps

Herpes Zoster.

Herpes Zoster.

Herpes Zoster.

Complicaii:

algii postzonatoase: 30% Afectare motorie Form hemoragic, necrotic Complicaii viscerale

Diagnostic diferenial: eczema, herpesul, varicela condiii dureroase, colica, pneumonie

Tratament: Acyclovir, Famciclovir, Valaciclovir, Brival antialgice; Doxepin; anticonvulsivante capsaicin topic

Afta. Etiologie Aspect clinic Forme clinice: Ulceraii aftoase majore (Sutton) Ulceraii herpetiforme

Afte.

.

Aft recurent

Boala Behcet: afte palatinale.

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Boal Behcet: afte genitale

Boal Behcet: hipopion.

Boal Behcet- afte genitale.