Herpes Simplex (Synonym: Fever Blisters.)
What is herpes simplex?
An acute inflammatory disease, characterized by the formation of pin-head to pea-sized vesicles, arranged in groups, and occurring for the most part about the face and genitalia.
Describe the symptoms of herpes simplex.
In severe cases, malaise and pyrexia may precede the eruption, but usually it appears without any precursory or constitutional symptoms. A feeling of heat and burning in the parts is often complained of. The vesicles, which are commonly pin-head in size, are usually upon a hyperæmic or inflammatory base, and tend to occur in groups or clusters. Their contents are usually clear, subsequently becoming more or less milky or puriform. There is no tendency to spontaneous rupture, but should they be broken a superficial excoriation results. In a short time they dry to crusts which soon fall off, leaving no permanent trace.
Is the eruption in herpes simplex abundant?
No. As a rule not more than one or two clusters or groups are observed.
Upon what parts does the eruption occur?
Usually about the face (herpes facialis), and most frequently about the lips (herpes labialis); on the genitalia (herpes progenitalis), the lesions are commonly found on the prepuce (herpes præputialis) in the male, and on the labia minora and labia majora in the female.
State the causes of herpes simplex.
Herpes facialis is often observed in association with colds and febrile and lung diseases. Malaria, digestive disturbance, and nervous disorders are not infrequently predisposing factors. Herpes progenitalis is said to occur more frequently in those who have previously had some venereal disease, especially gonorrhœa, but this is questionable. It is probably often purely neurotic.
What are the diagnostic points?
The appearance of one or several vesicular groups or clusters about the face, and especially about the lips, is usually sufficiently characteristic. The same holds true ordinarily when the eruption is seen on the prepuce or other parts of the genitalia; it is only when the vesicles become rubbed or abraded and irritated that it might be mistaken for a venereal sore, but the history, course and duration will usually serve to differentiate.
Give the prognosis.
The eruption will usually disappear in several days or one or two weeks without treatment. Remedial applications, however, exert a favorable influence. Herpes progenitalis exhibits a strong disposition to recurrence.
What is the treatment of herpes facialis?
Anointing the parts with camphorated cold cream, with spirits of camphor or similar evaporating and stimulating applications will at times afford relief to the burning, and shorten the course.
What is the treatment of herpes progenitalis?
In herpes about the genitalia cleanliness is of first importance. A saturated solution of boric acid, a dusting-powder of calomel or oxide of zinc, and the following lotion, containing calamine and oxide of zinc, are valuable:—
℞ Zinci oxidi,
Calaminæ, ..............āā........................ gr. v
Glycerinæ,
Alcoholis, .............āā........................ ♏vj
Aquæ, ............................................ ℥j M.
In obstinate recurrent cases, frequent applications of a mild galvanic current will have a favorable influence.