A Quick Synopsis of AFP's "Nongenital Herpes Simplex Virus "

Nongenital Herpes Simplex Virus 
RICHARD P. USATINE, MD, and ROCHELLE TINITIGAN, MD, University of Texas Health Science Center, San Antonio, Texas
Am Fam Physician. 2010 Nov 1;82(9):1075-1082. 
http://www.aafp.org/afp/2010/1101/p1075.pdf

     It's really hot out up here in the Bronx, so i'm going to try and make this a brief, brief review. This article had some nice pictures so it is worth clicking the link above. HSV-1 is the "other" herpes virus. This is the one that is on the oral mucosa and lips. HSV-2 is the "genital herpes" disease. Its important to remember that type-2 can be found on the mouth and type-1 can be found on the genitals. The prevalence of HSV-1 is almost 60%. Transmission can occur through kissing, sharing a toothbrush or utensil, or sharing towels. It takes between two to 20 days for the infection to appear. The patient may have a fever, tingling, burning, paresthesia or itching before the lesions occur. Lymphadenopathy can appear in the cervical and submandibular area. The ulcers heal in about a week.
    HSV-1 can also spread to the eye. Look for pain, photophobia, and dendritic ulcers on fluorescein staining. Scarring can be permanent. If it appears on the fingers and hands it is called herpetic whitlow. It can also cause erythema multiforme. Diagnosis can be done my culture, PCR, serology, antibody testing, or the Tzanck test.
     As far as treatment is concerned, the topical treatments have not been shown to be effective,  by maybe resolving the features by about half of a day faster. Oral treatment has been more effective. It can decrease pain, shedding, and healing time by about 50% in each category. The different types of protease inhibitors (acyclovir, famciclovir, valacyclovir) have been equally effective. They are relatively safe.