HSV 1, often referred to as being your sore
or cold sore that you see
here in this patient.
HSV 2 is associated with
genital type of herpes.
Remember that HSV1 if it
ever affects the brain,
may result in damage or influences and
affects the frontal and temporal lobe
whereas if it’s HSV 2 and
it affects the brain,
think of TORCHES and you’re thinking
about diffuse involvement of the brain.
Overlap can occur between
the two viruses.
Small, fluid-filled vesicles as you can
imagine with an erythematous type of base.
HSV 2, genital.
HSV 1, more commonly oral.
Morphology: Dew drops
on a rose petal,
same description that we’ve
seen earlier with chicken pox.
Both of these organism come
under the family of herpes.
So therefore, the vesicles remain, well,
in description-wise, pretty similar.
with an erythematous base
tend to occur in the same
area during stress or illness
and often painful
when actually active.
Demographics: Up to 1 in 6.
Some would say 1 in 4 nowadays with
the genital herpes, which is HSV 2.
So it’s almost like if you don’t have
this, there’s something wrong with you.
It’s amazing that is it’s
as high as you see here.
An even higher number have oral herpes,
referring to your HSV 1 or cold sores.
As soon as you hear herpes,
what are you thinking about?
And if you’re thinking about the
skin, what are you going to find?
What we saw earlier,
and we have identical to that seen
with zoster, which is what, please?
Reactivation of your VSV from
the dorsal root ganglion,
and therefore, following a dermatome type
of appearance causing pain, pain, pain.
Keep things simple.
If it’s Tzanck and
if it’s the skin,
you can expect there to be
as you see in this image,
multinucleated giant cells
here in the keratinocytes.
Oral acyclovir to shorten
the cycle of outbreaks,
but will not cure, obviously,
because it’s a virus.
Recurrence caused by reactivation of virus
lying dormant in the nervous tissue.
Just like it would for VZV.
Randomized trials have shown modest benefit
to the use of topical antiretrovirals
that are acyclovir based.
The studies have shown
some decrease in the time
to lesion healing,
the duration of pain during outbreaks,
and viral shedding.