Herpes Simplex (Viral Skin Infection)

Question 1

Background

Answer 1

HSV type 1 mainly affects the face. Type 2 mainly affects genital skin.
The virus is inoculated into the affected area and is more likely with minor injury.

Type 1 HSV occurs mainly in infants and young children

Oral hsv 1 can be self limiting and mild.

Other virus is Varicella-zoster virus

Question 2

Signs and Symptoms/Diagnosis

Answer 2

Genital:
Blisters that quickly burst, dysuria vaginal discharge,
Can be asymptomatic.
1st ep - headache, fever
Diagnosis - history taking, examination,

Oral/face:
Burning, tingling, itching, vesicles that rupture.
Diagnosis - history taking, examination,

Ocular:
Eye associated issues diagnosis same as others and slit lamp

Question 3

Treatment

Answer 3

Self care advise (all):
Saline bath - wash affected area with saline
OTC analgesia
Topical petroleum jelly or a Topical anaesthetic - Dysuria
Increase fluid intake
Avoid tight clothes on genital lesions

Genital:
FIRST EP - Avoid sex,
Won’t attend sex health specialist:
(5 day courses)
1st line - Aciclovir 400mg TDS or valaciclovir 500mg BD
2nd line - aciclovir 200mg 5/day or famciclovir 250mg TDS
- can extend to 10 days if healing incomplete or new lesions.

Immunocompromised/untreated HIV /genital herpes mild/uncomplicated:
1st line - aciclovir 400mg five/day 7–10 days, OR
valaciclovir 500–1000mg BD 10 days, OR
famciclovir 250–500mg TDS 10 days.

RECURRENT Genital:
Same drugs - doses/Days may vary.

Oral/Face:
Oral aciclovir or valaciclovir- check age, preference, cost, doses etc

Ocular:
REFER and give self care advise

Question 4

PRSC extra notes

Answer 4

Virus earlier you treat the better.