Herpes labialis is the term given to recurrent episodes of oral labial herpes. The episodes are milder than the primary infection and often start with a prodrome. Most patients complain of a tingling or painful sensation hours to a day before the appearance of herpes labialis. Patients can use this knowledge to their advantage and begin antiviral therapy at the first indication of recurrence to decrease the severity of the episode or abort it all together. Herpes labialis, also known as a cold sore, appears as a vesicle or bulla that quickly breaks down and forms an erosion and crusted papule or plaque. The lesions last for a few days to 1 week and can cause significant psychological issues.
Herpes infection of the genital region is spread by sexual contact and is one of the most common of all sexually transmitted diseases. Initial episodes of genital herpes infection manifest with fever, adenopathy, and painful ulcerations and blistering of the affected region. The primary episode is always more severe than subsequent reactivations of the virus. The ulcerations are grouped vesciulopustules on an erythematous base. They are extremely tender and easily rupture to form shallow ulcerations that appear “punched out” with an overlying serous crust. The cervix is often involved, and scarring can occur. Genital herpes infection almost universally causes dysuria and inguinal adenopathy that is tender.
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