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| TEACHING THROUGH IMAGES |
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| Year : 2023 | Volume
: 3
| Issue : 3 | Page : 193-194 |
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Cutaneous viral infections in children
Shiwangi Rana
Department of Dermatology, AIIMS, Gorakhpur, Uttar Pradesh, India
| Date of Submission | 04-Jul-2023 |
| Date of Decision | 05-Jul-2023 |
| Date of Acceptance | 05-Jul-2023 |
| Date of Web Publication | 14-Aug-2023 |
Correspondence Address:
Dr. Shiwangi Rana
Department of Dermatology, AIIMS, Gorakhpur - 273 008, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ipcares.ipcares_160_23
How to cite this article:
Rana S. Cutaneous viral infections in children. Indian Pediatr Case Rep 2023;3:193-4 |
Cutaneous infections are one of the most common causes for dermatology consultation in the pediatric age group.[1],[2] The common cutaneous infections include bacterial, viral, and fungal infections. There is the lack of epidemiological data regarding exact incidence of these cutaneous infections, but most of the time, it can be missed, especially when the lesions are asymptomatic. Cutaneous viral infections are not uncommon and can be easily diagnosed by just paying attention to the lesion morphology without the need of any laboratory investigations. Although we can see exanthematous rash in many systemic viral infections, however, the common viral infections which classically involves skin are poxvirus, herpes simplex virus (HSV), varicella zoster virus (VZV), and human papilloma virus (HPV).
Molluscum Contagiosum: It is a benign viral infection caused by poxvirus family molluscum contagiosum virus, common in children of age group of 2–5 years,[3] autoinoculation being the most common cause of transmission. It has a long incubation period of 2 weeks–6 months. The lesions are classically present over the exposed site as pearly white umblicated papules. The papules can be present discretely or in groups. The patient is completely asymptomatic and treatment involves the use of destructive modalities such as needle exirpation electrocautery, and radiofrequency ablation. The topical treatment includes imiquad, 5 flourouracil, and tretinoin. Most of the time, the condition resolves spontaneously.
Herpes Virus Infection: Herpes simplex virus (HSV) belongs to α-subfamily of herpesviruses, there are two antigenic types of HSV, types 1 and 2. In children HSV 1 infection is more common, there is a history of fever and malaise before onset of lesions.[4] The classical lesions are small grouped vesicles on an erythematous base. These may be present on the hard and soft palate, gingiva, lips, buccal mucosa, tongue, floor of the mouth, and pharynx. Perioral lesions may occur and may extend some distance away from the mouth. Both HSV-1 and 2 occurs through exposure to contaminated secretions such as saliva on mucosal surfaces or traumatized skin. Treatment includes symptomatic management along with systemic antiviral drug (oral acyclovir) for a duration of 5–7 days.
Varicella Zoster Virus
VZV also belongs to α-subfamily of herpesviruses. Herpes zoster or shingles is due to reactivation of VZV from dorsal root ganglia of sensory nerves. The condition is not uncommon in children, but underlying immunodeficiency should be ruled out if it is recurrent or multi-dermatomal. There are painful, vesicular rash in a unilateral and dermatomal distribution but unlike adult there is no prodromal symptoms such as paresthesia or pain. Treatment includes antiviral therapy with oral acyclovir, the dosage, and duration is same as mention above. It has been found that the chances of postherpetic neuralgia decreases when antiviral treatment is started within 72 h.
| Human Papilloma Virus | |  |
The cutaneous lesions caused by HPV are mainly present in exposed areas as autoinoculation is the common mode of transmission. The HPV types 2 and 4 are most common, followed by types 1, 3, 7, 10, 26, 27, 29, and 57.[5] Clinical appearance can be defined by morphology like common warts, flat warts, filiform warts, punctate warts, pigmented warts or by location like palmoplantar warts, periungual warts, respiratory papillomatosis, oral papillomatosis (Heck disease), condyloma acuminatum, verrucous carcinoma. Lesions can be asymptomatic or can be painful if present over the soles.
The treatment includes destructive therapies such as keratolytic agents, cryotherapy, electrocautery, curettage, and laser treatment. Immuno-stimulation and immunomodulatory agents include imiquimod, sinecatechins, intralesional therapy (Candida antigen, the measles–mumps–rubella vaccine, trichophytin, and Bacille Calmette–Guérin vaccine).[6] Systemic immunologic agents such as levamisole, cemitidine, and zinc have variable response and can be added to prevent spread.
| Viral Exanthems | | |
Hand foot and mouth disease are caused by coxsackievirus A16 infection, it starts with a prodromal symptom of sore throat and dysphagia along with occasional fever or abdominal pain. 2–3 days later, a papular enanthem appears on the tongue and buccal mucosa, with occasional involvement of the palate, gums, and lips. The lesions then vesiculate and quickly become painful ulcers with an erythematous base. Blister can develop over hands, palms and soles. The treatment is symptomatic, all the lesions resolve without scarring in period of 7–10 days.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Hayden GF. Skin diseases encountered in a pediatric clinic. A one-year prospective study. Am J Dis Child 1985;139:36-8.  |
| 2. | Findlay GH, Vismer HF, Sophianos T. The spectrum of paediatric dermatology. Analysis of 10,000 cases. Br J Dermatol 1974;91:379-87. |
| 3. | Rogers M, Barnetson RS. Diseases of the skin. In: Campbell AG, McIntosh N, editors. Forfar and Arneil's Textbook of Pediatrics. 5 th ed. New York: Churchill Livingstone; 1998. p. 1633-5. |
| 4. | Xu F, Lee FK, Morrow RA, et al. Seroprevalence of herpes simplex virus type 1 in children in the United States. J Pediatr 2007;151:374-7. |
| 5. | Syrjänen S, Puranen M. Human papillomavirus infections in children: The potential role of maternal transmission. Crit Rev Oral Biol Med 2000;11:259-74. |
| 6. | Gibbs S, Harvey I, Sterling JC, et al. Local treatments for cutaneous warts. Cochrane Database Syst Rev 2003;(3):CD001781. |
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