Internal Medicine

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

Herpes Simplex Herpes Type 1/Type 2 703

differential diagnosis

■Impetigo

■Herpes zoster

■Eczema

management

What to Do First

■The disease is self-limited, and it is not clear that treatment with

either topically or systemically administered antiviral agents alters

the course.

■This is an infectious disease that can spread from person to person

by contact with viral particles that are shed most during vesiculation,

but can even be shed between episodes.

General Measures

■Prevention of spread may be possible with continuous oral antiviral

therapies.

■Recurrences can be prevented with continuous antiviral therapy.

specific therapy

■Famciclovir 125 mg bid, valacyclovir 1000 mg bid, acyclovir 200 mg

5X/d for 5 days for acute infection

■Famciclovir 250 mg bid, valacyclovir 1000 mg/d, acyclovir 400 mg

tid: effective suppressive therapies

follow-up

■None is generally needed.

complications and prognosis

■Secondary impetigo is possible.

■Rarely scarring may occur.

Herpes Type 1/Type 2.................................

CAROL A. GLASER, MD

history & physical

History

■DNA virus in herpes family (herpes 1 and 2)

■Occurs worldwide without seasonal variation

■Human only known reservoir