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Chapter 8 : Viral Diseases of the Skin

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Abstract:

Viral infections cause a variety of cutaneous and mucosal manifestations that are either the result of primary viral replication within the epidermis or a secondary effect of viral replication elsewhere in the body. Three groups of viruses represent most primary epidermal viral replications: human papillomaviruses (HPV), herpesviruses, and poxviruses. Multiple virus families, including retroviruses, paramyxoviruses, togaviruses, parvoviruses, and picornaviruses, produce skin lesions secondarily. Other viruses, such as orthomyxoviruses and reoviruses, rarely induce skin lesions. Recognition of characteristic mucocutaneous manifestations of a variety of viral diseases is crucial. It either directly helps determine the etiologic agent or assists the clinician in deciding which additional diagnostic tests to order. Proper management of the patient can be initiated from the results of such tests.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 1
FIGURE 1

Pathways of the cutaneous immune response to infection with human papillomavirus (HPV), herpes simplex virus (HSV), and human immunodeficiency virus (HIV).

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 2
FIGURE 2

(a) Photomicrograph of condyloma acuminatum showing acanthosis, papillomatosis, and parakeratosis. (b) Condyloma acuminatum associated with human papillomavirus 6 (HPV-6).

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 3
FIGURE 3

Multiple primary squamous cell carcinomas associated with human papillomavirus 8 (HPV-8) on the forehead of a man with enterovirus (EV).

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 4
FIGURE 4

Variola major (smallpox).

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 5
FIGURE 5

(a) Photomicrograph of molluscum contagiosum (MC) demonstrating central umbilication and epidermal hyperplasia containing intracytoplasmic inclusions (Henderson-Paterson bodies) compressing nuclei. (b) Disseminated molluscum contagiosum in an AIDS patient.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 6
FIGURE 6

Nodular stage of orf on the hand of a shepherd from Mexico.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 7
FIGURE 7

First-episode genital herpes due to herpes simplex virus 2 (HSV-2) in a man who gave a history of always using condoms during sex.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 8
FIGURE 8

Recurrent herpes simplex virus 2 (HSV-2) infection of the buttock.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 9
FIGURE 9

Herpes whitlow due to herpes simplex virus 2 (HSV-2) in a health care worker following a puncture wound from a needle used to culture genital herpes.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 10
FIGURE 10

(a) Photomicrograph of erythema multiforme associated with herpes simplex virus 1 (HSV-1), showing subepidermal vesicles, necrotic keratinocytes, and balloon cell degeneration. (b) Erythema multiforme following an outbreak of herpes labialis.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 11
FIGURE 11

Photomicrograph of an ulcer resulting from herpes simplex virus 2 (HSV-2), in which multinucleated giant cells with eosinophilic intranuclear inclusions can be seen.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 12
FIGURE 12

Primary varicella in an adult Japanese man.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 13
FIGURE 13

Thoracic herpes zoster in an otherwise healthy man.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 14
FIGURE 14

Oral hairy leukoplakia associated with Epstein-Barr virus (EBV) in an AIDS patient.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 15
FIGURE 15

Papules of Gianotti-Crosti syndrome associated with Epstein-Barr virus (EBV).

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 16
FIGURE 16

Kaposi's sarcoma associated with human herpesvirus 8 (HHV-8) in an HIV-negative elderly Italian man.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 17
FIGURE 17

Photomicrograph of Kaposi's sarcoma associated with human herpesvirus 8 (HHV-8), demonstrating neovascularization, endothelial proliferation, and plump hyperchromatic atypical nuclei lining vascular spaces.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 18
FIGURE 18

Erythema infectiosum (fifth disease) associated with parvovirus B19.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 19
FIGURE 19

Measles in an infant.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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Image of FIGURE 20
FIGURE 20

Bacillary angiomatosis associated with in an human immunodeficiency virus (HIV)-positive man.

Citation: Nawas Z, Tyring S. 2017. Viral Diseases of the Skin, p 115-139. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch8
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