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Bullous Viral Eruptions

»What do herpes simplex (HSV) virus and varicella-zoster virus (VZV) have in common?
»What happens during primary HSV infection?
»What about recurrent infection?
»What is the difference between a primary and an initial HSV infection?
»How is HSV transmitted?
»How long is incubation period for HSV (i.e., the time from initial infection to appearance of vesicles)?
»Define asymptomatic shedding.
»Can you be infected with HSV and not know it?
»How do HSV-1 and -2 differ?
»How do you diagnose HSV infection?
»How is a Tzanck smear performed?
»What are the drugs of choice for treatment of HSV?
»When is chronic suppressive therapy indicated?
»Are patients with genital herpes at greater risk for becoming infected with the human immunodeficiency virus (HIV)?
»What recommendations can you make to a patient with genital herpes to reduce the risk of transmission to his or her partner?
»Can HSV infect the skin in areas other than around the mouth or anogenital areas?
»How does a baby get herpes? Is it a serious problem?
»Describe the natural history of varicella.
»What is shingles?
»Can herpes zoster be recurrent?
»What is disseminated zoster?
»Is herpes zoster contagious?
»What is postherpetic neuralgia?
»How do you diagnose VZV infection?
»What is the treatment for varicella?
»How about herpes zoster?
»Should I be concerned about the patient with herpes zoster involving the tip of the nose?
»Who should get the herpes zoster vaccine?
»What is hand, foot, and mouth disease?
»What is orf?

 
 
 

How do HSV-1 and -2 differ?

HSV types 1 and 2 are very closely related, sharing approximately 50% homology in their genetic composition. As expected, many of their viral proteins are also similar (known as type-common), although each type also produces unique proteins (type-specific). Immunohistologic techniques can be used to distinguish these type-specific proteins and differentiate HSV-1 from HSV-2 in clinical situations. Serologic testing that can accurately identify and differentiate antibodies to HSV-1 versus antibodies to HSV-2 is now also available (glycoprotein G type-specific assays). HSV-1 is usually associated with oral herpes and HSV-2 with genital herpes, although each virus can affect both sites. HSV-1 cannot be differentiated from HSV-2 based on the appearance of the skin lesions alone.