There are two types of herpes simplex virus:
  • Type I – usually causes oral lesions, but can also cause genital lesions if transferred from coldsores.
  • Type II – sexually transmitted, can cause genital lesions

Presentation

  • In contrast to HPV, will cause ulcerated, painful lesions
  • May co-exist with urinary retention

Course of the disease

You can never eradicate the infection completely.
  • Usually the first attack is the longest and most severe
  • Subsequent attacks may be interpreted with prodromal symptoms such as:
    • Tingling / soresness at the site of a subsequent ulcer.

Treatment

Managing acute attack

Aciclovir – can be topical or oral. Shortens duration of symptoms.

  • If given in the presence of prodromal symptoms, can prevent a full blown attack.
  • Dose – e.g. 400mg 4x day for 5 days. Consider longer treatment if symptoms have not yet resolved
  • Often, acyclovir cream can be prescribed for patients inbetween attacks, to be used as soon a symptoms of an attack develop.

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