SKIN DISEASES PERTAINING TO VIRAL INFECTIONS
a. Herpes Simplex (Fever Blister).
(1) Description/characteristics. Herpes simplex is a recurrent acute viral
infection characterized by the appearance on the skin or mucous membranes of single
or multiple clusters of small vesicles. These vesicles are filled with clear fluid, and the
vesicle base is slightly raised. The infectious agent is a relatively large virus which
frequently accompanies febrile (fever causing) illnesses: colds, cases of overexposure,
exhaustion, nervous tension, and menstruation. Herpes simplex is a benign disease
and occurs in almost everyone at one time or another. It may appear anywhere on the
skin or mucous membranes, but it most commonly appears on the face (especially
around the mouth), conjunctiva, cornea, or genitals. At times, there is an associated
stomatitis (inflammation of the mucous membrane of the mouth). Vesicles usually
appear after a period of tingling discomfort or itching. The principle symptoms are
burning and stinging. Neuralgia may precede and accompany attacks. Single vesicles
or small groups may come together to form large lesions. The vesicles usually persist
for a few days. Then, they begin to dry and form a yellow crust. Vesicles on the nose,
ears, or fingers may be painful. Self-limiting healing usually occurs within seven to ten
days. Vesicles usually recur in the same areas. The time between episodes varies
from weeks to months. Do not confuse herpes simplex with herpes zoster or impetigo.
Examine lesions in the genital area carefully to be sure the lesion diagnosed as herpes
simplex is not syphilis, lymphogranuloma venereum (LGV), or chancroid.
(2) Treatment. There is no specific medication for herpes simplex, but there
is a course of treatment to follow. Apply topical lotions. Drying lotions and liquids help;
however, moisture aggravates the condition and delays healing. Treat stomatitis, if it
occurs, with mild saline mouthwashes. Medications which can be applied to the skin
lesion include vioform three percent; tincture of benzoin, ten percent spirits of camphor,
and the commercial product Campho-Phenique. To abort lesions, apply a moistened
styptic pencil several times daily. For herpes of the eye, DO NOT use corticosteroids,
systemic or local. Costicosteroids may cause the problem to progress to dendritic ulcer
of the cornea (cornea ulcer that spreads in all directions).
b. Herpes Zoster (Shingles).
(1) Description/characteristics. These skin lesions are an infection of the
central nervous system primarily involving the dorsal root ganglia (a collection of nerve
cell bodies on the dorsal root of each spinal nerve). The lesions are characterized by a
blister and pain in the affected areas. Shingles is most common after the age of fifty.
With rare exceptions, one attack of zoster gives a person lifelong immunity. Early
symptoms include chills, fever, malaise, and gastrointestinal disturbances. These
symptoms may be present from three to five days before the skin lesions appear. Pain
usually precedes the appearance of skin lesions by about 48 hours or more. Severe
pain and burning are common but may not be present.