RT Book, Section
A1 Cohen, Jeffrey I.
A2 Kang, Sewon
A2 Amagai, Masayuki
A2 Bruckner, Anna L.
A2 Enk, Alexander H.
A2 Margolis, David J.
A2 McMichael, Amy J.
A2 Orringer, Jeffrey S.
SR Print(0)
ID 1161340117
T1 Herpes Simplex
T2 Fitzpatrick's Dermatology, 9e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071837798
LK dermatology.mhmedical.com/content.aspx?aid=1161340117
RD 2024/04/19
AB AT-A-GLANCEHerpes  simplex  viruses  (HSVs)  are  common  human  DNA  viral  pathogens  that  intermittently  reactivate.  After  replication  in  the  skin  or  mucosa,  the  virus  infects  the  local  nerve  endings  and  ascends  to  the  ganglia  where  it  becomes  latent  until  reactivation.There  are  two  types  of  HSV:  HSV-1  and  HSV-2.  HSV-1  is  mostly  associated  with  orofacial  disease,  whereas  HSV-2  usually  causes  genital  infection,  but  both  can  infect  oral  and  genital  areas  and  cause  acute  and  recurrent  infections.Most  of  the  adult  population  is  seropositive  for  HSV-1,  and  the  majority  of  infections  are  acquired  in  childhood.  About  one-fourth  of  adults  are  infected  with  HSV-2  in  the  United  States.  Acquisition  of  HSV-2  correlates  with  sexual  behavior.Most  primary  HSV  infections  are  asymptomatic  or  not  recognized,  but  they  can  also  cause  severe  disease.  Most  recurrences  are  not  symptomatic  and  most  transmissions  occur  during  asymptomatic  shedding.Genital  herpes  is  the  most  prevalent  sexually  transmitted  disease  worldwide  and  is  the  most  common  cause  of  ulcerative  genital  disease;  it  is  an  important  risk  factor  for  acquisition  and  transmission  of  HIV.HSV  can  cause  diseases  involving  the  eye,  CNS,  and  neonatal  infection.  Cellular  immunity  defects  are  a  risk  factor  for  severe  and  disseminated  disease.Diagnosis  is  made  by  polymerase  chain  reaction,  viral  culture,  or  serology,  depending  on  the  clinical  presentation.Treatment  is  with  acyclovir,  valacyclovir,  or  famciclovir.  Regimens  and  dosages  vary  with  the  clinical  setting.  Resistance  is  rare,  other  than  in  immunocompromised  patients.