Herpes simplex virus (HSV) infects the skin and mucous membranes, damaging keratinocytes and causing intense inflammation, seen as small blisters on a background of erythema. The primary infection may be obvious or subclinical; once latency is established in sensory ganglia, the virus may reactivate at variable intervals to produce visible lesions which often recur at the same location. In immunosuppression the disease can be chronic and antiviral resistance can develop. This chapter deals with HSV infection of the non-genital skin and mucosae; genital HSV infection is discussed in chapter 94.
Specific Investigations
- Electron microscopy of blister fluid
- PCR of blister fluid or biospy
- Viral culture from swab of lesion
- Immunocytology of blister floor cells
- Skin biopsy of atypical lesion
- Assessment of immune function
First- Line Therapy
- Topical aciclovir
- Oral aciclovir
- Topical idoxuridine
- Sunscreen
Second- Line Therapy
- Valaciclovir
- Famciclovir