Viral Infections

There are many viral infections ranging from the common to the rare, from the mild to the severe and from those causing just skin infection to those with associated systemic disease.

Nonspecific viral rash

This is a widespread reddish rash sometimes seen in viral infections. It is accompanied by the common symptoms of a viral infection, such as fever and headache. The rash develops rapidly and appearance of rash varies.

Local viral infections
Herpes simplex

Primary infection occurs through a break in the mucus membranes of the mouth or throat, via the eye or genitals or directly via minor abrasions in the skin.

Initial infection is usually asymptomatic, although there may be minor local vesicular lesions.

Reactivation of latent virus leads to recurrent disease

Herpes zoster

A person should be affected by chicken pox prior to get Herpes zoster. It appears as unilaterally distributed, grouped and fluid filled lesions. It is associated with pain and burning sensation.

Molluscum contagiosum

This is a skin infection caused by a DNA pox virus that affects both children and adults.

Transmission is usually by direct skin contact and has occurred in contact sports and by sharing baths, towels and gymnasium equipment. Outbreaks in schools are well recognized.

Autoinoculation produces linear shiny or skin colour lesions.


Warts are caused by human Papillomavirus. Common warts appear as papules and nodules with a keratotic or rough surface. They occur anywhere but are most common on the hands in young people and children.

Other types include: Filiform warts - these are small finger-like warts consisting of hyperkeratotic projections.

Viral infections that produce rashes

There are a number of viral infections that may cause a rash - most of them typically in childhood. Examples include:

  • Measles
  • German measles (rubella)
  • Chickenpox
  • Fifth disease (erythema infectiosum)
  • Roseola
  • Pityriasis rosea
  • Echovirus and adenovirus infections
  • Epstein Barr virus of infectious mononucleosis
  • Primary HIV infection

Other viral infections with skin involvement

Hand, foot and mouth disease

Herpes gladiatorum

The name implies association with martial arts. In association with rugby it is called 'scrum pox'.

Transmission is primarily by direct skin-to-skin contact and abrasions may facilitate a portal of entry. The majority of lesions occur on the head or face, followed by the trunk and extremities.

A prodromal itching or burning sensation is followed by clustered vesicles on an erythematous base which heals with crusts over about 1 to 2 weeks. Less often, headache, malaise, sore throat and fever may be reported.

Frequently Asked Questions

Herpes, Varicella and Zoster

Que - 1 : Are Herpes, Varicella and Zoster contagious?

Ans: Yes, they are contagious – can spread from one person to another. They are communicable diseases.

Que - 2 : How do they spread?

Ans: They spread by droplet infection from one person to another; close contact, overcrowding, poor hygienic conditions can predispose to spread of these infections. Herpes can spread by sexual contact.

Que - 3 : How does these infections present?

Ans: Multiple fluid filled lesions associated with burning, itching, and pain.

Que - 4 : Does viral infections recur?

Ans: Yes, they recur. Frequent episodes are known to occur. Dermatologist has a protocol to manage such recurrences and advice specific antiviral drugs.

Que - 5 : Who are at risk of developing the infection?

Ans: Children, old age, immunocompromised patients, diabetics, malignancies and patients on chemotherapy are associated with viral infections.

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