Herpes simplex (HSV)

Herpes simplex is a viral infection which is caused by the Herpes Simplex Virus (HSV-1) with marked tropism in the oral-facial area, eyes and upper cutaneous diaphragm. It can remain in a latent state in the trigeminal nerve, persisting throughout the patient’s life. It can be reactivated – with clinical signs – following: psycho-physical stress, fever, exposure to UV, thermal shock, allergies, orthodontic procedures, systemic pathologies and the menstrual cycle. Infection occurs by the patient coming into contact with saliva or other biological fluids. The first contact usually occurs in childhood/early adolescence and it is often unaccompanied by clinical symptoms. In 10% of cases the first contacts occur as primary herpetic gingivostomatitis, which is characterised by: fever, anorexia, cervical lymphadenopathy and the ulceration of keratinised or non-keratinised mucosa. It will heal spontaneously after 1-2 weeks. In adults there is a primary occurrence in the form of vesicular pharyngotonsillitis. Recurring types also include herpes labialis (cold sores) or other preferred keratinised sites (the hard palate, gingival or dorsum of the tongue). Herpes simplex always returns to the same point, presenting a prodromal stage, followed by the formation of vesicles and then scabs. Cutaneous types also exist. The management of Herpes simplex involves identifying the lesions and offering symptomatic treatment. In some cases treatment with anti-viral, systemic medication is required (Aciclovir). Topical, anti-viral formulations (Penciclovir, Aciclovir) are used in the prodromal stages of recurring cases.