Herpes labialis

Herpes labialis is infection of the lips, mouth, or gums with the herpes simplex virus. It leads to the development of small, painful blisterscommonly called cold sores or fever blisters.

Causes, incidence, and risk factors:

Herpes labialis is a common disease caused by infection of the mouth area with herpes simplex virus type 1. The initial infection may cause no symptoms or mouth ulcers. The virus then remains dormant (asleep) in the nerve tissue of the face. Herpes virus type 2, which usually causes genital herpes and can infect babies during birth to infected mothers, can also cause herpes labialis.

Herpes viruses are contagious. Spread may occur through intimate and personal contact, or through contact with infected razors, towels, dishes, and other shared articles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa).

Symptoms:

The first episode may be mild or severe. It usually occurs in children between 1 and 5 years old.

·         First symptoms usually appear within 1 or 2 weeks, and as long as 3 weeks, after contact with the virus. Sore throat and fever that can last up to 5 days may occur before the blisters appear. There may also be swollen glands in the neck.

·         First episode may last 2 to 3 weeks. The lesions may be on the gums, in the mouth and throat, or on the face. It may hurt to swallow.

An outbreak usually involves:

·         Skin lesions or rash around the lips, mouth, and gums

·         Small blisters (vesicles) filled with clear yellowish fluid

o    Blisters on a raised, red, painful skin area

o    Blisters that form, break, and ooze

o    Yellow crusts that slough to reveal pink, healing skin

o    Several smaller blisters that merge to form a larger blister

Signs and tests:

Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.

Treatment:

Untreated, the symptoms will generally go away in 1 to 2 weeks. Antiviral medications taken by mouth may help the symptoms go away sooner and decrease pain. Acyclovir, famciclovir, and valacyclovir are the three oral treatments currently available.

Expectations (prognosis):

Herpes labialis usually goes away by itself in 1 to 2 weeks. It may come back. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.

Complications:

·         Recurrence of herpes labialis

·         Spread of herpes to other skin areas

·         Secondary bacterial skin infections

·         Generalized infection -- may be life-threatening in immunosuppressed people, including those with atopic dermatitis,cancer, or HIV infections

Avoid direct contact with herpes sores. Minimize the risk of indirect spread by thoroughly washing items such as towels in hot (preferably boiling) water before reuse. Do not share items with an infected person, especially when they have herpes lesionsAvoid performing oral sex when you have active herpes lesions on or near your mouth and avoid receiving oral sex from someone who has oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of catching herpes from oral or genital sex with an infected person.

Herpes Zoster

Herpes Zoster

Anyone who has had chicken pox can develop herpes zoster. Also known as shingles or zoster, herpes zoster is caused by the same virus as chicken pox. After the chicken pox clear, the virus remains dormant (inactive) within certain nerve cells of the body. When the virus reactivates, zoster, which can be quite painful, develops.

CAUSES OF HERPES ZOSTER

It is not clear what reactivates or "awakens" the virus. A temporary weakness in immunity
(the body's ability to fight infection) may cause the virus to multiply and move along nerve
fibers toward the skin. Although children can get zoster, it is more common in people over the
age of 50. Illness, trauma, and stress also may trigger zoster.

SIGNS AND SYMPTOMS OF HERPES ZOSTER

        

Zoster typically causes more pain and less itching than chicken pox. A person may feel burning, itching, tingling, or extreme sensitivity on the skin (usually limited to an area on one side of the body). These symptoms are typically present for one to three days, sometimes more, before a red rash appears in the same area. A zoster rash usually occurs on only one side of the body. A fever or headache also may develop.

TREATMENT OF HERPES ZOSTER

Zoster usually clears on its own in a few weeks and seldom recurs. While zoster is clearing, pain relievers can help ease the discomfort, and cool compresses may provide soothing relief.

When diagnosed early (within 72 hours), oral anti-viral medication can be prescribed. This medication is often prescribed when the zoster is severe or affects an eye. Patients who have decreased immunity also are routinely prescribed an anti-viral medication. In addition to treating the zoster, an anti-viral medication can prevent post-herpetic neuralgia (pain, numbness, itching, and tingling that last long after the rash clears). 

Molluscum

A common skin disease, molluscum contagiosum is caused by a poxvirus that infects only the skin. This virus enters the skin through small breaks in the skin barrier. After an incubation period, growths appear. These growths can develop anywhere on the skin. Like warts, which are caused by a different virus, molluscum contagiosum is considered benign. Molluscum contagiosum does not affect any internal organs and rarely causes symptoms. As the name implies, molluscum contagiosum is contagious.

WHAT MOLLUSCUM CONTAGIOSUM LOOKS LIKE

Mollusca are usually small flesh-colored or pink dome-shaped growths that often become red or inflamed. They may appear shiny and have a small central indentation or white core. Because they can spread by skin-to-skin contact, mollusca are usually found in areas of skin that touch each other such as the folds in the arm or groin. They also are found in clusters on the chest, abdomen, and buttocks and can appear on the face and eyelids.

In people who have a disease that weakens the immune system, the mollusca may be very large in size and number, especially on the face.

HOW MOLLUSCUM CONTAGIOSUM SPREADS

The virus spreads in three ways. As described above, a person who has molluscum contagiosum can spread the virus to other parts of the body. This may happen by rubbing or scratching a growth and then touching unaffected skin.
Molluscum contagiosum also spreads from person to person through direct skin-to-skin contact. And it is possible to get the disease by coming into contact with an object that has touched infected skin such as a towel, toy, or clothing. There have been reports of people contracting molluscum contagiosum from a swimming pool or gymnastic mat.

THOSE MOST AT RISK

Children tend to get molluscum more often than adults. It is common in young children who have not yet developed immunity to the virus. Children also tend to have more direct skin-to-skin contact with others.
Anyone who is exposed to the virus through skin-to-skin contact has an increased risk of developing molluscum contagiosum. This may happen by participating in a close contact sport such as wrestling or having sexual contact with an infected person. Living in a tropical area also increases the risk. The virus thrives in areas that are warm and humid. Certain medical conditions also make a person more susceptible. People who have atopic dermatitis or a disease that weakens the immune system are more likely to develop molluscum contagiosum.

TREATMENT

While molluscum contagiosum will eventually go away on its own without leaving a scar, many dermatologists advise treating. Treatment can prevent the growths from spreading to other areas of a patient's body and to other people.

Treatment for mollusca is similar to that for warts. Growths can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, or treated with an electric needle (electrocautery) and scraped off with a sharp instrument (curette). Laser therapy also has been effective in treating mollusca.