Viral Skin Infections

Description

This is a condition caused by the Varicella zoster virus (VZV). It is a common childhood infection. It is characterized by an itchy rash, which appears first on the trunk and spreads out to other parts of the body. Papules and crusts form within a few days. Fever may be present. When the blisters occur they are in crops. The rash lasts 2 to 4 weeks. The condition is usually more severe in the elderly.

 Investigations
Diagnosis is usually done clinically.

Treatment

Pharmacological
• Calamine lotion, topically twice daily
• Chlorpheniramine, adults; 4mg orally twice daily, children up to 10 years; 2mg orally twice daily
• Acyclovir, 400mg orally 5 times daily for 7 days
• Paracetamol, adults; 500mg - 1g orally 3-4 times daily, children; 10-
• 20mg/kg orally 3-4 times daily
Note: Advise patient to avoid sun exposure and bathing until the lesions start drying

Description

This is a condition caused by the resurgence of the Varicella zoster virus. It is characterised by burning pain before the vesicular rash appears. The rash is always unilateral and does not cross the midline (see section on malignancies)

Treatment

Pharmacological
• Paracetamol 500mg - 1g orally 3 - 4 times daily.
• Acyclovir 5%, topically 4 hourly for 10 days.
• Acyclovir 800mg orally 8hourly daily for 7 days.
• Carbamazepine 200-400mg orally 8 hourly daily or
• Gabapentin 300-600mg 8 hourly PO. (for post herpetic neuralgia)
• Treat secondary bacterial infection with appropriate antibiotics.
• Severe neuralgia should be referred to a neurologist.

Description

This is a condition caused by Herpes simplex virus (HSV) type 1 characterised by a vesicular rash around the mouth or genitalia. It is characterized by grouped vesicles on an erythematous base.

Treatment

Pharmacological
• Acyclovir 400mg four times daily for 5 to 7 days
• 5% Acyclovir cream, 4 hourly.
NB: For recurrent episodes, refer to the current National STI guidelines