Viral skin infections – herpes simplex, herpes zoster, papilloma virus.
HERPES SIMPLEX
Herpes simplex is caused by the herpes simplex virus(HSV), also known as herpesvirus hominis. There are two major types: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). HSV-1 is traditionally associated with the orofacial infection, while HSV-2 is associated with genital infection.
- Etiology:
Both HSV-1 and HSV-2 are acquired by direct contact with, or via droplet form, infected secretions entering via the skin or mucous membranes. In 80% of cases the primary infection is asymptomatic.
- Clinical findings: -HSV has many different presentations; the severity of which depends on the age, the immune status of the individual, and whether it is a primary or recurrent infection - primary HSV infections are accompanied by systemic signs, longer duration of symptoms, and higher rate of complications. Recurrent episodes are milder and shorter.
IV. Herpetic gingivostomatitis
This is the most common primary presentation of HSV-1 infection. Most cases arise between the ages of six months to five years. Clinical features include:
- systemic upset,
- lymphadenopathy,
- gingivitis,
- painful, white vesicles on the tongue, buccal mucosa, palate, pharynx and lips
The main symptoms persist for 5-7 days, and are fully resolved within two weeks
Adults may also develop acute gingivostomatitis, but it is less severe and is associated more often with a posterior pharyngitis
V. Herpes labialis (syn. cold sore)
Recurrent infections of orofacial herpes simplex normally present as cold sores. Triggers include UV-radiation, minor trauma and stress. The clinical presentation of a cold sore is:
- grouped vesicles, especially of the lips and perioral skin.
The eruption is often preceded by a tingling, itching or burning sensation. Over a few days the vesicles form a crust, and the eruption resolves within 7-10 days
VI. Herpes genitalis
Can be caused by both HSV-1 and HSV-2, and is usually sexually transmitted. The clinical features and course of primary genital herpes caused by both HSV-1 and HSV-2 are indistinguishable, but recurrences are more common with HSV-2.
Systemic symptoms may precede the development of painful ulcers in both men and women. In women, ulcers can affect the external genitalia, as well as the vagina and cervix, which is involved in 70%-90% of cases. Dysuria may be severe and can