Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

Hernia Herpes Labialis 701

differential diagnosis

n/a

management

n/a

specific therapy

■surgery in most cases

■support or binder for non-surgical cases

follow-up

n/a

complications and prognosis

n/a

Herpes Labialis......................................

SOL SILVERMAN JR, DDS

history & physical

■recurrent lip ulcers

■vary in size, frequency, duration

■due to reactivation of herpes simplex virus I (rarely HSV 2)

■spontaneous; aggravated by sunlight, cold, irritation/trauma

tests

■characteristic recurrent, crusted lesion on vermilion border of the

lip

■biopsy or culture if in doubt; virus sheds for first 3–5 days

differential diagnosis

■benign cheilitis; actinic cheilitis

■squamous cell carcinoma (biopsy if persists more than 3 weeks)

management

■palliative

specific therapy

■antiviral drugs if severe, e.g. acyclovir

■topical antivirals, e.g. penciclovir 1% cream

■antiinflammatory topical steroids after 5 days (avoid eye contact)

follow-up

■as needed