∎ Herpes gingivostomatitis: relatively common, mostly caused by HSV-1, most common in children aged 1 to 5 years old; characterized by blisters on the lips/buccal mucosa/palate, swelling, bleeding, erosion, and yellow gums membrane; the patient has salivation, bad breath, and pain when eating; accompanied by fever, malaise, and local lymph node enlargement; the natural course of the disease is 1 to 2 weeks

Neonatal herpes simplex: mostly caused by HSV-2 and infected through the birth canal; onset 5 to 7 days after birth, manifested by blisters and erosion on the skin/oral mucosa/conjunctiva, and in severe cases, systemic symptoms; divided into skin-eye-oral localization type, central nervous system type, disseminated type

Herpetic keratoconjunctivitis: more serious; manifests as potential corneal ulcer, accompanied by eyelid herpes, preauricular lymph node swelling and pain; in severe cases, corneal perforation may occur, leading to blindness

Herpetic eczema (eczema herpeticum)/Kaposi varicelliform eruption: refers to infection with HSV-1 or HSV-2 on the basis of original skin diseases (mostly infantile eczema, atopic dermatitis) A skin disease; manifested by sudden clusters of blisters on the original skin lesions, which quickly turn into pustules, with an umbilical depression at the top and red surrounding areas.

Fainting; the scabs dry and fall off after 1 to 2 weeks, leaving some superficial scars and pigmentation; may be accompanied by systemic symptoms such as high fever and local lymph node enlargement; most prognosis is good

Incubation herpes: The skin lesions are limited to the contact area and appear as clusters of blisters

Genital herpes: see later

The incubation period is generally 14 to 17 days; systemic symptoms may occur; the rash is centripetally distributed, starting as pinpoint-sized macules/papules, gradually turning into mung bean-sized blisters, oval in shape, with an umbilical depression in the center, and surrounding redness; 2 to 4 days The rash occurs in batches one after another, and erythema, papules, blisters and scabs can be seen at the same time ("four generations under one roof"); no scars are left after healing, and the course of the disease is about 2 weeks.

Bullous chickenpox: It is more common in children <2 years old and manifests as bullae of 2 to 7 cm that quickly turn into erosion without leaving scars.

Hemorrhagic chickenpox: more common in patients with malnutrition and immunosuppressive treatment

Neonatal chickenpox: rare, usually transmitted from mother during delivery

Chickenpox in adults: It is more obvious than chickenpox in children, and the rash is more severe. It is often accompanied by fever and obvious itching.

Varicella pneumonia, varicella encephalitis, Reye syndrome, thrombocytopenic purpura, secondary infection, erythema multiforme

Prodromal symptoms: Low-grade fever, fatigue, and local lymph node swelling and pain in the first few days of onset; the affected area may show hypersensitivity/pain.

Skin lesions

accompanying symptoms

trigeminal herpes zoster

Herpes zoster oticus: The virus invades the facial nerve and auditory nerve; manifests as ear canal/tympanic membrane herpes; Ramsay-Hunt syndrome (facial paralysis and earache) may occur when the geniculate ganglion is involved and the motor and sensory fibers of the facial nerve are also affected. External auditory canal herpes)

Disseminated herpes zoster: refers to the appearance of more than 20 skin lesions outside the affected dermatomes. It is mainly seen in people with severely low body resistance.

Complicated by HIV infection: The condition is severe or manifests as deep impetigo-like skin lesions, which can easily cause eye and nervous system complications and may recur.

Antiviral: early stage (starting 48 to 72 hours after the onset of rash), sufficient dose; oral or intravenous administration of acyclovir

Pain relief: Acute pain→TCAs; Subacute/chronic pain→Gabapentin/pregabalin/NSAIDs

Glucocorticoids: It is believed that early and reasonable application can inhibit the inflammatory process and shorten the course of ZAP in the acute phase, but it has no definite preventive effect on PHN; it is mainly used to improve immunity in elderly patients without contraindications within 7 days of the disease: transfer factor, thymosin

External use: unbroken blisters → calamine lotion, acyclovir cream; blisters broken → 3% boric acid solution, 0.5% neomycin ointment; if combined with eye damage, please consult an ophthalmologist

Physiotherapy: such as spectrum, audio, ultraviolet, helium-neon laser

It usually occurs on the dorsum of the hands and feet and around the nails. It has a long course but can subside naturally. It initially appears as a papule the size of a pin, and then gradually enlarges to a hemispheric shape the size of a mung bean. The surface is rough and becomes keratinized spines, which are hard and gray-brown in texture. There are no symptoms, but there may be pain when the wart is squeezed from both sides to the center.

Periungual wart: occurs in the periungual area. Subungual wart: occurs in the nail bed.

Filiform warts: single soft filamentous protrusions, height <1cm, with dry keratinization at the top; common on the neck, forehead, and eyelids. Filiform warts: clusters of multiple finger-like protrusions on the same soft base. Apical keratosis; common on scalp and between toes