Herpes Simplex
is a condition caused by the HSV-1
and HSV-2 viruses. These viruses are
small DNA viruses that infect mucocutaneous cells.
The conditions manifests as lesions,
which mainly affect areas
surrounding the mouth, lips,
eyes, and genitals, though they can
appear anywhere on the skin or
mucosa.
HSV-1 primarily
causes lesions on the oral mucosa. HSV-2 primarily affects the
genitals. Herpes simplex
virus is extremely contagious. The virus is spread
by direct contact with an individual
in the active or prodromal stage.
Lesions are usually small fluid
filled blisters (vesicles) that can
be single or multiple on a raised erythematous (red) base. The initial
eruption is usually self resolving
and of short duration. After that, the virus remains dormant in the
nerve cell ganglia, until a trigger
causes recurrence of the outbreak. Triggers
can include stress, illness,
high fever, sunburn, hormonal
alterations, or immune system
compromise. [1]
It is estimated that
20-40% of the US population has
recurrent HSV infections. It is more
common among individuals in the
lower socioeconomic class. Men have
a greater recurrence rate than
women. HSV-2 is four times more
likely to recur verses HSV-1. The
site of recurrence is always the
site of the original outbreak,
though lesions may spread. [2]
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Herpes Signs and Simplexs
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Lesions may appear
anywhere on the skin or mucous
membranes, and are most likely to
appear on the mouth (gingivostomatitis),
lips (herpes labialis), conjunctiva
(herpes keratoconjunctivitis), and
genitals (vulvovaginitis or
progenitalis). It is a distinction
of herpes simplex, that recurring
lesion are always at the same site as
the initial outbreak.
Each outbreak is
preceded by a prodromal period that
is characterized by tingling,
itching, and burning over the site of
the outbreak. 1-2 days later, the
vesicle will appear. These vesicles
are usually 0.5 to 1.5 cm in size
and often grow together to form a larger lesion. As they grow, the fluid increases and eventually
the vesicles break open and crust
over. Healing will begin after 10-12
days, but it may take as long as
three weeks for complete resolution
of the outbreak.
The lesions are
usually very painful. Primary
outbreaks are worse than
recurrences. Other symptoms (simplexs) that may
accompany the outbreak include; fatigue,
fever, muscle aches, weakness,
headache, and swollen lymph nodes. [3]
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