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Herpes Simplex Virus
Herpes Simplex Virus

Herpes Simplex Virus

Introduction

This is a viral infection commonly affecting the lips and perioral soft tissues presenting as papulovesicular lesions which ultimately ulcerate. The condition is recurrent following a primary herpes infection which occurs during childhood leaving herpes simplex viruses latent in the trigeminal ganglia. The primary infection affects mainly the gingiva and palate.

Pathophysiology

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Signs and symptoms

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Diagnostic criteria

• A prodrome of tingling, warmth or itching at the site usually precedes the recurrence
• About 12 hours later, redness appears followed by papules and then vesicles
• These vesicles then burst, weep, dry, scab and then heal
• The length of the cycle is variable (5–12 days mean time being 7 days)

Investigation

There are no investigations required unless patient has systemic diseases

Treatment

Non-pharmacological

    • Adequate hydration
    • Avoid salty and acidic drinks
    • Cover lesions on the lips with Petroleum jelly and control any underlying cause

Pharmacological

    HSV is a self-limiting condition but if persistent for 10 days or recurrent infection use medication:

    For Herpes Labials

    • Acyclovir cream apply 4 hourly for 5 days-

    For Herpes Stomatitis

    • Acyclovir (PO) 200mg 6 hourly for 5 days
    AND
    • Acyclovir cream 12 houlry for 5 days

    In immunocompromised patients

    • Acyclovir (PO) 400mg 5 times in 24 hours for 5 days

    For oral facial lesions of herpes zoster treat with

    • Acyclovir (PO) 400–800mg 5 times a day for 5 days.

    Pain control by analgesics

    • Paracetamol (PO) 1gm 8 hourly for 3 days
    OR
    • Diclofenac (PO) 50mg 8 hourly for 3 days
    OR
    • Ibuprofen (PO) 400 mg 8 hourly for 3 days

Prevention

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Updated on,

4 Novemba 2020, 08:59:15

References

1.STG
2. Web MD. Oral herpes. https://www.webmd.com/a-to-z-guides/oral-herpes#1. Accessed 04.11.2020

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