Herpes Simplex

It occurs after stress, for instance, a psychogenic stress, injury, fever, particularly malaria, pneumonia, meningitis, general illness, debility, etc. the virus of herpes is ubiquitous; it is more prevalent in the temperate climate and the cold season. This accounts for the layman's name of 'Cold Spots'

There are two distinct antigenic types of herpes simplex virus: HSV-1 and HSV-2. while HSV-2 is responsible for genital herpes simplex, all other clinical varieties are due to HSV-1. development of carcinoma may be related to HSV-2 infection of the cervix.

Symptoms of Herpes Simplex

The course of herpes is about 7 to 14 days. There is usually no scarring except when secondary infection occurs. Occasionally, hyperpigmentation or depigmentation may follow.

Besides the common herpes simplex affection, primary infection may manifest in the following three ways:

I. Gingivo-stomatitis or vulvo-vaginitis or kerato-conjunctivitis associated with fever, malaise, regional lymphadenopathy .

2. Herpetic whitlow-painful vesicula-pustular eruption around the nailfold, often associated with regional lymphadenopathy .

3. Eczema herpeticum type or Kaposi's varicelliform eruption.

Recurrent herpes implies relapsing type of herpes simplex occurring on the same site -usually perioral and genitalia. Local resistance is low; emotional stress, exposure to cold and lack of personal hygiene tend to bring on an attack.

Erythema multiforme may be a complicationat times.

Herpes progenitalis implies herpes simplex lesions on the genitalia. It is transmitted sexually. In the male, the lesions are on the glans, prepuce or body of the penis; in the female, on the labia, vaginal wall and cervix. The eruption on the genitalia is painful, and may cause a constitutional upset. Genital herpetic lesions rupture early producing erosions, which at times, are in a circinate pattern. The common predisposing causes of recurrent genital herpes are phimosis, lack of personal hygiene, discharge per vaginum anq sexual neurosis. Furthermore, recurrent herpes progenitalis is responsible for syphilophobia in some cases.

Buccal herpes is rare in adults but common in infants as aphthous stomatitis which involves the mucous membrane of the-palate, cheeks and tongue.. Because of moisture and friction, the vesicles get rapidly eroded producing painful, superficial erosions on erythematous bases accompanied by constitutional upset.

Prognosis of Herpes Simplex

In an individual attack of herpes the prognosis is gopd, in the sense that lesions heal up nicely and no scarring results. Only in recurrent herpes is the treatment rather unsatisfactory, and the malady can become a nuisance especially in herpes progenitalis.

Treatment of Herpes Simplex

Locally, any antiseptic and astringent application is sufficient; the lesions soon dry up, secondary infection is prevented. Author prefers the use of lotion silver nitrate I% and savlon cream (P) or dequadin paint (P), spirit camphor or pure alum applied repeatedly has been found to abort attacks in the early stages. Application of anesthetic ether has been also advocated by pressing a cotton swab soaked in anesthetic ether for 5 minutes on 2 consecutive days. Prior application of 1 per cent lignocaine will minimize the pain.

.In recurrent herpes which is a knotty problem, an attempt must be made to raise the general resistance and to eliminate the precipitating causes like chronic rhinitis, phimosis, debility, anxiety, stress etc. Other measures recommended are as follows: