Dermatology · Viral Infections (Herpes, Warts, Molluscum)

A 19-year-old college wrestler develops grouped painful vesicles over the face and neck. Several teammates have similar lesions. Which mode of transmission best explains this outbreak?

  • A Airborne spread of varicella-zoster virus from a case of chickenpox
  • B Direct skin contact with HSV-1 shed from an infected lesion
  • C Autoinoculation of HPV-1 from plantar warts to the face
  • D Contact with fomites carrying molluscum contagiosum virus
Correct answer: B. Direct skin contact with HSV-1 shed from an infected lesion

Explanation

Herpes gladiatorum is HSV-1 infection transmitted by direct cutaneous contact during close-body sports such as wrestling and rugby (scrum pox in rugby players). Lesions appear on the head, neck and arms, sites of maximal skin-to-skin contact. Outbreaks among teammates are characteristic. Varicella spreads airborne and produces scattered polymorphic lesions rather than clustered vesicles at contact sites.

Reference: Rook's Textbook of Dermatology, 9th ed.

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