Cold Sores Oral Herpes Causes, Signs & Symptoms, Treatment
Hey everyone and this listener talk about cold sores or herpes. So in this that’s where i talk about what causes cold sores what are some of the other manifestations. What we can do to make the diagnosis and what we can do to treat it.
So cold sores or herpes are chronic clusters of vesicular erosive lesions. Well what does that mean well as you can see they are. They’re basically groups of little skin lesions that become little vesicles that can erupt and become erosions.
They are due to infection by herpes simplex virus 1 or 2 so we used to learn that maybe one of these viruses causes oral herpes one of them causes genital herpes. But really they can both cause cold sores or oral herpes.
Now the primary infection involving herpes simplex virus one or two. There is a site of inoculation so if someone comes into contact with someone else that has is shedding the virus. And there’s maybe a break in the skin that is the site of an occupation.
There can be a sudden onset of multiple painful vesicles on an erythema to space. So you can get this very sudden very nasty painful area on the lip or wherever this site of inoculation is and it can be very red and very sore.
And the primary infection generally lasts for about ten to fourteen days and it may have systemic symptoms this can include fever or chills malaise. You just may feel very under the weather with this now the pathophysiology of cold sores and herpes virus.
In general is that after the resolution of the primary infection so after that 10 to 14 day period where your body eventually seems to resolve the infection. And you’re back to your normal self unfortunately the virus hangs around and it remains dormant within ganglion cell neurons so they basically stay there.
And what happens is so that hsv or herpes simplex virus hangs around and dangling cell neurons and really your immune system basically keeps them in check and suppresses them and keeps them within the neuron.
And you’re not gonna have any symptoms until you have something that causes a recurrent infection. It could be that your immunosuppressed. In some way you may have an illness or infection or sometimes when you get older or some kind of stressor can cause this to erupt.
And have another recurrent infection of cold sores and this is due to a reactivation of the herpes simplex virus from the ganglion cell neurons. And it recurs at the primary site of infection so wherever you had that site of inoculation the first time already had that eruption of painful vesicles.
You’re gonna have the same recurring a recurrent infection in the same place so right in the same site but what’s good news about the recurrent infection if there is any good news, is that the duration of the recurrent infection is shorter than the primary infection.
And generally can last around five days and a lot of times people will report that they have some program o symptoms and programable symptoms really mean. You start feeling something before you have an onset of the cold sore.
So you may feel that know with you know six to fifty three hours prior to eruption of the vesicles. You have this feeling of burning tingling maybe itchiness purity / itis or pain in that area. So you can just feel something coming on with your with your lip and b so once you have the prodromal symptoms.
You’re gonna have an eruption and that’s your recurrent infection even if you don’t have that eruption continuing perhaps. You’ve resolved the recurrent infection or resolved the primary infection you can have what is called subclinical shedding of the virus so even if you don’t feel like you have this infection or this cold sore.
You may be shedding the virus and passing it on to others without you even knowing it. So i just wanted to quickly mention that here so there is something we call subclinical shedding of the virus. Now i won’t also talk about other manifestations of herpes.
We can get what we call a herpetic whitlow and basically this is an infection of herpes simplex virus on a finger so perhaps you’ve maybe had it on your on a lip or had a cold sore and maybe had a break in the skin. Or something else that leads to an inoculation of a finger.
You’re gonna get these painful vesicles on your finger and that’s actually just a herpes virus infecting the finger causing what we call or petach whitlow again it’s inoculation again this will resolve .and again it will often recur because again that virus hang around in your neurons.
So another manifestation of cold sores or herpes can be herpes gladiatori so herpes gladiator ms basically in a herpes infection of the face the neck or the arms so again same thing. As before there’s an inoculation of a certain site not a lip not a finger but a face neck or arm. And again you get vesicles on an erythematous base just like we said before with oral herpes.
And in this case this herpes gladiatori is caused or occurs in wrestlers and rugby players so herpes gladiatorial ad8 er so you can think of gladiators people that are have physical contact with each other. So one person might have an eruption of herpes.
And they’re in physical contact with someone else they can actually pass it on to another individual in a different location perhaps they struck them in the face or they had a very close contact with someone with herpes up against an area of the face or neck or arm.
And that can lead to this what we call herpes gladiatori and again this is all due to skin-to-skin contact so people in physical sports like wrestling rugby can all get this condition and the last manifestation.
I want to just discuss quickly is your theme in malta for me erythema multiforme a is basically an acute immune system disorder that may be elicited during infection with herpes simplex virus so he if he you know infected on your lip.
You might get these odd kind of skin manifestations or mucosal manifestations on certain parts of your body some some of these can cause these manifestations on your hands and your oral mucosa or even your genitals so you may get this odd cutaneous manifestation here like in his picture.
And that’s actually your theme of melissa for me so how do we make the diagnosis of cold sores or herpes infection well we can do a viral culture or pcr. We can see evidence of the herpes simplex virus but in actuality almost always there’s probably going to be a clinical diagnosis.
So what can we do to to treat this condition. Well we can use acyclovir so acyclovir is an antiviral that’s been shown to help reduce the either onset if you use it prophylactically. Or we can reduce the duration of symptoms and the other related antiviral is the valley cycle here so either of these can be used to actually reduce the onset. Or eruption of herpes or reduce the duration of symptoms so both of these are great treatments for this condition so if you want to learn more about other dermatological conditions.
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