Herpes simplex physical examination: Difference between revisions

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{{Herpes simplex}}
{{Herpes simplex}}


{{CMG}}; {{AE}} {{CZ}}
{{CMG}}; {{AE}} {{CZ}}, {{JH}}, {{USAMA}}


==Overview==
==Overview==
On physical examination multiple, round, superficial oral ulcers accompanied by acute [[gingivitis]] can be seen. Also [[lymphadenopathy]], [[gingivitis]] and [[tonsillitis]] may accompany the primary lesions <ref name="pmid17939933">{{cite journal |author=Fatahzadeh M, Schwartz RA |title=Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management |journal=J. Am. Acad. Dermatol. |volume=57 |issue=5 |pages=737–63; quiz 764–6 |year=2007 |pmid=17939933 |doi=10.1016/j.jaad.2007.06.027}}</ref>.
On physical examination multiple, round, superficial [[oral ulcers]] accompanied by acute [[gingivitis]] can be seen. [[Lymphadenopathy]], [[gingivitis]], and [[tonsillitis]] may accompany the primary lesions.<ref name="pmid17939933">{{cite journal |author=Fatahzadeh M, Schwartz RA |title=Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management |journal=J. Am. Acad. Dermatol. |volume=57 |issue=5 |pages=737–63; quiz 764–6 |year=2007 |pmid=17939933 |doi=10.1016/j.jaad.2007.06.027}}</ref>


==Physical Examination==
==Physical Examination==
The physical examination of herpes infection may show:<ref>{{Cite journal
| author = [[Lucas Harless]], [[Nancy Jiang]], [[Frank Schneider]] & [[Megan Durr]]
| title = Herpes Simplex Virus Laryngitis Presenting as Airway Obstruction: A Case Report and Literature Review
| journal = [[The Annals of otology, rhinology, and laryngology]]
| volume = 126
| issue = 5
| pages = 424–428
| year = 2017
| month = May
| doi = 10.1177/0003489417699421
| pmid = 28397560
}}</ref>


1) Blisters or ulcers
1) [[Blisters]] or [[ulcers]]


* Site - In orofacial herpes/[[herpes simplex]] 1 the [[ulcer]]s are commonly found on [[lip]]s, gums, [[throat]], front of [[tongue]], inside of the cheeks and roof of the mouth. Whereas, these occur around genitalia in cases of [[genital herpes]]/herpes simplex 2.
* Site - In orofacial herpes/[[herpes simplex]] 1 the [[ulcer]]s are commonly found on [[lip]]s, gums, [[throat]], front of [[tongue]], inside of the cheeks, and roof of the mouth. These occur around genitalia in cases of [[genital herpes]]/herpes simplex 2.
* Size - Generally small (2-5 mm)
* Size - Generally small (2-5 mm)
* Shape - Round
* Shape - Round
* The lesions may occur in groups/crop
* The lesions may occur in groups/crops


2) [[Lymphadenopathy]] (cervical, Inguinal glands)
2) [[Lymphadenopathy]] (cervical, Inguinal glands)
Line 22: Line 34:
The following image is an example of how the Herpes simplex virus can cause nail disease.
The following image is an example of how the Herpes simplex virus can cause nail disease.


[http://www.peir.net Image shown below is courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
===Gallery===
 
====Skin====
*Blisters
 
'''Images'''
<gallery>
 
Image: Herpes_simplex_01.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_08.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_12.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_17.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
</gallery>
 
====Genitourinary System====
*Blisters
*Ulceration
 
'''Images'''
<gallery>
 
Image: Herpes_simplex_02.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_16.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_21.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_22.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_23.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_30.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_33.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_36.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
</gallery>
 
====Face====
*Blisters at the:
**Angle of the mouth
**Vermilion border
**Nostrils
**Nose
 
'''Images'''
<gallery>
 
Image: Herpes_simplex_03.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_04.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_05.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_06.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_07.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_09.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_10.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_18.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_19.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_25.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_26.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_31.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_32.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_37.png| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
</gallery>
 
====Extremities====
*Blisters can be seen at:
**Tip of the finger
**Skin of the hand
**Legs
 
'''Images'''
<gallery>
 
Image: Herpes_simplex_11.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_13.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_14.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_27.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_28.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_29.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_34.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_35.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
Image: Herpes_simplex_38.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
 
</gallery>
 
====Neck====
*Blisters
 
'''Images'''
<gallery>
 
Image: Herpes_simplex_15.jpeg| Herpes simplex. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=182>
</gallery>
 
==Gallery==
 
<gallery>
 
Image: Human herpesvirus01.jpeg| Image depicts the right foot of an infant born with a herpes simplex infection, known as neonatal herpes, or herpes simplex neonatorum, which had manifested itself through the development of maculopapular lesions of the foot’s heal and sole. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Human herpesvirus02.png| Photograph depicts a 70 year-old Cardiff, Wales female is a chronic lymphocytic leukemia patient. Patient exhibiting an indolent chronic oral herpes simplex ulcer. This patient had been vaccinated for “therapy” of this ulcer, and subsequently developed vaccinia necrosum, also known as progressive vaccinia. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>


<div align="left">
<gallery heights="175" widths="175">
image:Whitlow.Herpetic disease.Nail.jpg|Herpes simplex caused nail disease.
</gallery>
</gallery>
</div>


==References==
==References==
Line 35: Line 170:
{{WS}}
{{WS}}


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Latest revision as of 22:09, 29 July 2020

Sexually transmitted diseases Main Page

Herpes simplex Microchapters

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Genital Herpes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Jesus Rosario Hernandez, M.D. [3], Usama Talib, BSc, MD [4]

Overview

On physical examination multiple, round, superficial oral ulcers accompanied by acute gingivitis can be seen. Lymphadenopathy, gingivitis, and tonsillitis may accompany the primary lesions.[1]

Physical Examination

The physical examination of herpes infection may show:[2]

1) Blisters or ulcers

  • Site - In orofacial herpes/herpes simplex 1 the ulcers are commonly found on lips, gums, throat, front of tongue, inside of the cheeks, and roof of the mouth. These occur around genitalia in cases of genital herpes/herpes simplex 2.
  • Size - Generally small (2-5 mm)
  • Shape - Round
  • The lesions may occur in groups/crops

2) Lymphadenopathy (cervical, Inguinal glands)

3) Gingivitis and tonsillitis in herpes simplex 1

The following image is an example of how the Herpes simplex virus can cause nail disease.

Gallery

Skin

  • Blisters

Images

Genitourinary System

  • Blisters
  • Ulceration

Images

Face

  • Blisters at the:
    • Angle of the mouth
    • Vermilion border
    • Nostrils
    • Nose

Images

Extremities

  • Blisters can be seen at:
    • Tip of the finger
    • Skin of the hand
    • Legs

Images

Neck

  • Blisters

Images

Gallery

  • Image depicts the right foot of an infant born with a herpes simplex infection, known as neonatal herpes, or herpes simplex neonatorum, which had manifested itself through the development of maculopapular lesions of the foot’s heal and sole. From Public Health Image Library (PHIL). [3]

    Image depicts the right foot of an infant born with a herpes simplex infection, known as neonatal herpes, or herpes simplex neonatorum, which had manifested itself through the development of maculopapular lesions of the foot’s heal and sole. From Public Health Image Library (PHIL). [3]

  • Photograph depicts a 70 year-old Cardiff, Wales female is a chronic lymphocytic leukemia patient. Patient exhibiting an indolent chronic oral herpes simplex ulcer. This patient had been vaccinated for “therapy” of this ulcer, and subsequently developed vaccinia necrosum, also known as progressive vaccinia. From Public Health Image Library (PHIL). [3]

    Photograph depicts a 70 year-old Cardiff, Wales female is a chronic lymphocytic leukemia patient. Patient exhibiting an indolent chronic oral herpes simplex ulcer. This patient had been vaccinated for “therapy” of this ulcer, and subsequently developed vaccinia necrosum, also known as progressive vaccinia. From Public Health Image Library (PHIL). [3]

References

  1. ↑ Fatahzadeh M, Schwartz RA (2007). "Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management". J. Am. Acad. Dermatol. 57 (5): 737–63, quiz 764–6. doi:10.1016/j.jaad.2007.06.027. PMID 17939933.
  2. ↑ Lucas Harless, Nancy Jiang, Frank Schneider & Megan Durr (2017). "Herpes Simplex Virus Laryngitis Presenting as Airway Obstruction: A Case Report and Literature Review". The Annals of otology, rhinology, and laryngology. 126 (5): 424–428. doi:10.1177/0003489417699421. PMID 28397560. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 "Public Health Image Library (PHIL)".

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