Dermatology Power point slides Useful, Important & Easy Way To Understand The Chapter for the medical students aswell as others

1. Genital Herpes (GH)

2. Genital Herpes (GH)
 GH is a chronic sexually transmitted viral infection characterized
by recurring outbreaks of vesicles at the same site.
 Age of onset : Young sexually active adults.
 History :
 Incubation Period: 2 to 20 days. average 6)
 Symptoms: Only 10% of HSV-2 seropositive individuals are
symptomatic.
 Incidence :
 In the USA .60,000 new infections annually.
 30 million Americans are HSV infected.
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3. Etiology
 Herpes simples virus (HSV) 2 (70%),and
HSV1.(30%).
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4. Transmission :
Skin to skin contact.
Most transmission occurs during times
of asymptomatic HSV shedding.
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5. Pregnancy and GH
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Risk factor for neonatal HSV
infection;
Primary GH in mother at time of
delivery,
Absent maternal HSV antibody.

6. Pathogenesis :
Infection occurs via inoculation into mucosal
or skin surface.
HSV ascends peripheral sensory nerves
and enters sensory or autonomic nerve root
ganglion, where latency is established.
Latency can occur after both asymptomatic
and symptomatic infection
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7. Primary GH :
Most are asymptomatic.
Those with symptoms have fever,
headache, malaise, myalgia.
Pain itching, dysuria, vaginal and urethral
discharge are common
Grouped vesicles evolve to pustules which
break down to form erosions and ulcers.
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9. Recurrent GH :
Common symptoms are itch, burning,
eruption of vesicles, erosion
A 1 to 2cm erythmatous plaque on which
are vesicles which rupture forming erosions.
Heals in 1 to 2 weeks.
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11. Course and Prognosis
GH may be recurrent and has no cure.
70% of HSV 2 are asymptomatic.
HSV-2 GH recurs about 6 times/year
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12. Investigations :
 Identifications of virus :
 Tzanck smear : presence of multinucleated giant cells, low sensitivity
 Culture : ( confirmatory ) Isolation of HSV on tissue culture. Low
sensitivity
 Fluorescent antibody test : Identification of virus from lesions using
fluorescent antibody staning.
 PCR : Rapid, Specific, and Sensitive but expensive and used only as
a research tool
 Serology :
 Screening for IgM antibodies, elevated IgM doesn’t differentiate
present or past infection.
 Recent “ point of care tests “ – base on glycoprotein G have high
sensitivity & specificity

13. Treatment :
Oral Antiviral Therapy:
Provide control of symptoms and signs
only.
Do not eradicate latent virus nor affect
subsequent recurrences.
 Topical Antiviral therapy is of no use.
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14. Primary or Initial infection
Antiviral most effective when given within 48
hours of onset of symptoms.
Dosages:
 Acyclovir : 400mg TDS for 7 to 10 days.
 Famciclovir : 250 mg BD for 10 days
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15. Recurrent episodes :
Some benefit if treatment started within 24
hours.
Acyclovir : 400mg TDS for 5 days
Famciclovir : 250 mg BD for 5 days
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17. Complications :
 Secondary infections

18. Thank
you
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