Herpes Simplex Virus

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This  is  a  viral  infection  commonly  affecting  the  lips  and  perioral  soft  tissues  presenting  as  papulovesicular lesions which ultimately ulcerate. The primary infection affects mainly the gingiva and palate. 

Clinical presentation 

  • A prodromal of tingling, warmth or itching at the site usually precedes the recurrence
  • About 12 hours later, redness appears followed by papules and then vesicles
  • These vesicles then burst, weep, dry, scab and then heal
  • The length of the cycle is variable 5–12days, mean time being 7days

Non-pharmacological Treatment 

  • Adequate hydration
  • Avoid salty and acidic drinks
  • Cover lesions on the lips with Petroleum jelly and control any underlying cause

Pharmacological Treatment 

This  is  an  otherwise  self-limiting  condition  but  if  persistent  for  10days  or  recurrent  infection  use  medication: 

For Herpes Labials 

B: acyclovir cream applies 4hourly for 5days 

For Herpes Stomatitis 

B: acyclovir (PO) 200mg 6hourly for 5days 

AND 

B: acyclovir cream 12hourly for 5days 

In immunocompromised patients 

B: acyclovir (PO) 400mg 6hourly for 5days 

For oral facial lesions of herpes zoster treat with 

B: acyclovir (PO) 400–800mg 6hourly for 5days 

Pain control by analgesics 

A: paracetamol (PO) 1g 8hourly for 3days 

OR 

C: diclofenac (PO) 50mg 8hourly for 3days 

OR 

A: ibuprofen (PO) 400mg 8hourly for 3days