Orolabial Herpes, Herpetic Whitlow, Genital Herpes Lesion and Natural Treatment

Orolabial Herpes, Herpetic Whitlow, Genital Herpes Lesion and Natural Treatment

Lesions on the lips and face = HPV – 1, the initial infection is usually asymptomatic Gengivostomatitis occurs chiefly in children and young adults, most often just like bacterial tonsilopharyngitis The most common form of orolabial herpes is cold sore or fever blister caused by recurrent HSV1 (95%).

Manifestations: - Grouped blisters on erythematous base on the lips, cheeks, eyelids, intraoral.

Prodromal symptoms:- tingling, burning, itching in 24 hrs. In most patients recurrent orolabial herpes is more a nuisance than a disease.

Treatment

Lips : In our setting Gentian, violet 0.5% is effective and if available sunblocks reduces recurrence. Eg. Zinc oxide paste , zinc oxide ointment or zinc oxide and topical antiseptic or antibiotic e.g betadine ointment 3 times daily for bacterial super infection.

For recurrent infections Acyclovir 200mg PO for 5 days can be given.

Herpetic Whithlow


Infection of pulp of fingertips, it could appear after touching a primary lesion of ones owns lesion or that of others.

In children – HSV – 1, Adults – HSV – 2, common in females Health workers may acquire and transmit it.

Genital Herpes (herpes progenitalis)


Usually due to HSV - 2 causing 85% ( >15% can be caused by HSV -1) of initial infections and up to 98% of recurrent lesions

In the mid 1980’s because of the change in the sexual behavior, the prevalence of HSV – 1 began to increase. In developed countries up to 40% of the anogenital herpes in women is caused by HSV – 1
HSV – 1 is associated with less recurrence rate than HSV – 2


Genital herpes → transmitted by skin-to-skin contact

Incubation Period: 5 days

Asymptomatic shading occurs in all sites (vagina, cervix, and mucous membranes) even through normal appearing skin and mucous membranes. Grouped blisters and erosions in the vagina, vulva, penis … continues to develop in 7 – 14 days. Lesions are bilateral and symmetrical, inguinal lymph nodes may be enlarged, fever and flu like symptom may be there. Pain, dysuria, and dysparunia may also be observed.

Previous HSV – 1 lessens the severity resembling recurrent genital herpes. Most HSV – 2 will have recurrence even if the initial infection was asymptomatic which is estimated to be 6 times more frequent than HSV – 1

Recurrence:


Nature: 24 hrs prodromal symptoms → 24 hrs vesicles appear → 24 – 36 hrs ulceration → 2 – 3 days healing: TOTAL: 7 days recurrence


Sites and clinical presentation:


- Genitalia and upper buttocks are the common sites for occurrence
- Healing without scar
- Social stigma – the emotion from recurrent lifelong disease
- Guilt
- Blamefulness of the presumed source (i.e. partner)

Frequency:


6 – 12 times a year → deserve prophylaxis

Treatment of Genital herpes


Betadine or potassium solutions sitz baths 3 times daily. Gentian violet 0.5%, Zinc oxide and castor oil to sooths. Alternatively betadine ointment or oxytetracycline ointment 3 times daily.

Acyclovir cream can also be given 5 times daily. Severe infections or infection in immunodeficient patients: if available give acyclovir 200 -400 mg 5 times daily for 5-10 days
OR Famciclovir 250mg orally three times a day for 7--10 days, OR Valacyclovir 1 g orally twice a day for 7--10 days.

Neonatal Intrauterine


HSV -2 - 70%
HSV -1 - 30%

Intrauterine: Rare but devastating neonatal infection, encephalitis

Risks: active lesion in the mother (30 – 50% rate of acquisition)

Recurrence: 2 – 5%

In all cases, CS delivery is mandatory. Manifestations: Skin vesicles, Encephalitis, Hepatitis, Pneumonia, Coagulopathy Mortality rate (M/R) >50% in ideal setting. Without skin infection, it is difficult to diagnose.

Orolabial Herpes, Herpetic Whitlow, Genital Herpes Lesion and Natural Treatment 2018-12-24T05:05:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni