Virus diseases and the skin

Abstract

This book gives information on virus diseases which produce lesions of the skin and includes reference to conjunctiva and mucosa when they are appreciably affected by virus disease. The first five chapters deal with general aspects of virus infection, and the succeeding ten cover specific virus infections of the skin. The introduction considers the structure of viruses, and is illustrated by diagrams and photomicrographs. The process of replication is described without recourse to biochemical detail, and a simplified classification of human viruses is assembled in tabular form. Host defence and pathogenesis are subjects usefully covered, and some aspects of the problem of persisting virus infection are discussed. Techniques for laboratory diagnosis are described in brief with illustrations that are useful for those not familiar with such techniques. The chapter on treatment makes reference (without detail) to amantadine, methisazone, idoxuridine, cytosine arabinoside, and adenosine arabinoside. Acyclovir is mentioned but its value, limitations, and clinical use are not covered. Infections with herpes simplex virus, varicella zoster virus, Epstein-Barr virus, measles, and rubella are given a chapter each. The chapter on enterovirus infections includes reference to diseases due to coxsackie virus (herpangina; hand, foot, and mouth disease; lymphonodular pharyngitis), echovirus, and other viruses of the group. A brief account of variola is included for historical interest because of occasional accidental infection and because of the possibility that animal pox viruses might infect man, mutate, and produce disease of comparable severity. Cow pox, orf, milker's node, and molluscum contagiosum complete the list of pox virus diseases. The chapter on human papillomavirus deals with wart lesions of various forms and in various sites including the palate. Genital warts receive brief consideration, but no mention is made of the flat warts of the cervix or of the problem of cervical dysplasia. In connection with herpes genitalis and genital warts, the importance of excluding other sexually transmitted diseases is not discussed. The questions so often raised by sufferers are not given sufficient emphasis in this book, and those engaged in genitourinary medicine will have to look elsewhere for further details of these virus diseases. The penultimate chapter deals with skin diseases that are probably of viral origin, such as roseola infantum, erythema infectiosum, pityriasis rosea, pityriasis lichenoides, and lichen planus. Finally the authors discuss virus infections that may show rashes but do not generally occur in sufficient frequency, or are not sufficiently characteristic, to be pathognomonic. Hepatitis B virus and papular acrodermatitis of childhood, Marburg disease, Lassa fever, other viral haemorrhagic fevers are included in this chapter. Among the togavirus infections, with names evocative to the reviewer, are dengue, West Nile fever, chikungunya, and O'nyong-nyong fever. This little book makes accessible to the clinician information that he might not easily track down. A wider knowledge of a number of the conditions covered would be essential for those working in genitourinary medicine, but the book would be a useful addition to the library. In future editions one would hope for colour plates, because the figures in the book probably do not do justice to the original photographs.