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