Centro Studi GISED

Herpes simplex

Infections of herpes simplex (HSV) is very common. It is characterised by the appearance of groups of vesicles with reddened bases on the skin or mucous membranes. After the first infection periodic relapses can occur.

Dear Doctor, I hope very much to receive a response to my problem. I’m a 31 year-old woman and four and a half months ago I had unprotected sex with a man that I have known for years and who has never seemed ill to me, but continued to develop acute cystitis 2 days later, I used a vaginal tampon and all was as normal. But, suddenly, a very itchy, acrid smelling spot appeared on my left buttock that has rapidly grown bigger followed by the formation of other smaller ones, which are, in turn, full of little blisters. I ran to a dermatologist and explained my anxieties. The diagnosis, based only on a visual examination was that of herpes zoster. He told me not to worry, that it wasn’t a sexually transmitted disease and that it had only been provoked by chickenpox due to stress. Ok, but I think I should have had a test, or a blood test, instead nothing. Today I’ve noticed that I’ve got a small lesion on the inside of the small lip on the left side of my vulva, it’s large, about 5mm and seems full of little blisters, although I can’t see very well, it’s clearly full of a clear liquid. I’m worried that I’ve caught genital herpes, even if it doesn’t feel uncomfortable anymore in that area; there’s a light general itchiness on my legs and buttocks but without other visible indications. I had a haematocrit count and everything seems normal. If it were HSV2 shouldn’t there be some anomalous results from the test? And if it was HSV1 instead (periodically I suffer from labial herpes)? I don’t know what to do, I’ve had two visits to a gynaecologist and an internal ultrasound scan within the last 4 months and both times the outcome was : “no active gynaecological pathology.” Should I see a new dermatologist straight away? Please respond to me on the FAQ part of the website and not privately as I would like to keep my privacy and I’m not the only person who uses this PC. Thank you very much in anticipation.

Dear Madam, the diagnosis of herpes zoster and herpes simplex is usually diagnosed in clinic (i.e. based on direct observation by the doctor) and doesn’t normally require any particular laboratory examinations. A blood test (checking for anti-herpes simplex antibodies type 1 and 2) can be carried out in cases of uncertainty but it’s not used an awful lot in practice (false positives are possible in cases of the presence of rheumatoid factors, moreover the neutralised antibodies remain present for your whole life even after only one brief contact with the virus). I would advise you not to alarm yourself too much, infact you were correct to undergo a visit to both a gynaecologist and a dermatologist for further reassurance. Obviously, if the problem persists you can consult your dermatologist again as a precautionary measure (and in the case of recurrent herpes it’s possible to use acyclovir as a preventative treatment). Best regards, Dr Lorenzo Peli – GISED.

I have been affected by labial herpes since I was born. It come, more-or-less every month, more, or less prevalently. Now I’ve got 5 together and I don’t know what to do. I’ve tried... but by now I must have become acclimatised to these treatments, I think, if it’s possible. I’ve have many analyses and it’s turned out that I do have the antibodies against the herpes, but it’s not known why it always comes every month. I have heard about tablets and vaccinations but my doctor says that they’re only for treatment against Saint Anthony’s Fire. What do I do? I hope you will respond to my problem. Thank you.

Dear Madam, recurrent labial herpes is due to the re-activation of the virus herpes simplex that persists in nerve ganglions of sensory nerves after the first infection. Humoral immunity (antibodies) and that which is cell-mediated don’t give protection against recurrent episodes. A few factors, like exposure to intense sunlight or psyco-physical stress can provoke such episodes. Best regards. Dr Luigi Naldi coordinatore Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).