Herpes and shingles

 

Cutaneous herpes

Recurrent viral infection of the skin and mucous membranes due to the herpes simplex virus.

The clinical expression is different in the case of a primary infection.

Clinical signs:

– Recurrent herpes labialis: sensation of irritation and eruption of vesicles on an erythematous base, on the lips (“cold sores”) around the mouth, with a possible extension to the face. It corresponds to a reactivation of the virus after a primary infection. No discomfort, no lymphadenopathy or fever.

– Carefully consider other sites: oral, genital, eye, and bacterial infections.

Treatment:

– Clean with soap and water 2 times / day until healing of lesions.

– In case of bacterial infection: antibiotic treatment as for impetigo.

Shingles

Acute viral infection caused by varicella zoster virus. Chickenpox is the primary infection and herpes zoster virus reactivation.

Clinical signs:

– Unilateral neuralgic pains and onset of lupus closet coated vesicles grouped in clusters, located on the territory of a nerve root.

– The location of the injury is usually the chest but shingles can develop on the face with risk of eye complications.

– More common in adults.

Treatment:

– Similar to that of herpes, with the addition of systematic analgesics: paracetamol PO.

– The aciclovir PO given within 48 hours after the onset of lesions is only indicated for severe forms: necrotic lesions, extensive or localized to the face with a risk of eye damage. See HIV infection and AIDS.

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