skin infections

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Herpes simplex

Diagnosis

In this the vesicles are single, flaccid, rapidly increase in size and rupture, leaving an oozing surface which soon becomes covered with a yellow crust. Fresh lesions are constantly appearing on different parts of the face and the outline of each lesion is a smooth curve.When this occurs on the face, it is generally in the distribution of one of the branches of the fifth cranial nerve, usually the supra-orbital. In any case it is unilateral whereas herpes simplex is often bilateral. Herpes zoster is generally preceded for a day or two by pain and is accompanied by swelling of the lymphatic glands in the neighbourhood. Previous attacks are very rare. In herpes zoster, especially supra orbital, the vesicles are often haemorrhagic and considerable scarring is left. Herpes genitalis from ehanuoid  (soft sore). In this the ulcer has an inflamed red margin, overhanging edges and a cribriform base covered with a yellow slough. One or more of the inguinal glands are usually inflamed, tender, adherent to skin and deep tissues, and may suppurate. Herpes genitalis bears little resemblance to a primary sore except when the ulcers are healing, when there is occasionally a good deal of induration immediately beneath and around them. Typically there is no induration. The incubation period may be of some assistance if all the dates of coitus for the previous month or five weeks are considered. Herpes usually appears one to two days after coitus and a primary sore from two to five weeks after. In a case of herpes genitalis there will very likely be a history of previous attacks.

Treatment

Treatment of herpes simplex. There is no specific treatment and all that can be done is to keep the ulcers clean and dry. Antibiotic ointments will prevent secondary infection. I.D.u. (iodo-deoxyuridine) appears to be helpful in ocular cases in the form of drops, but the ointment is less effective on the skin. Unfortunately also there is no known treatment which will certainly prevent the recurrence of herpes. If discovered before the vesicles have begun to appear, an attack can occasionally be aborted by superficial X-rays or by painting with spirit. Patients'suffering from either variety of herpes simplex should not come in contact with cases of atopic eczema, for fear of causing eczema herpeticum. Further, they should not kiss infants or young children, because they may transmit the disease to the eye. In this site it can cause scarring of the cornea and so lead to interference with vision or even blindness.