Herpes Simplex: A Photo Essay

November 20, 2012

Grouped vesicles filled with straw colored liquid on an inflamed base that are accompanied by complaints of a tingling sensation and then pain are classic signs and symptoms of a herpes outbreak.

This itchy, vesicular lesion on a young woman’s neck had reappeared, at the same site, after being cleared 1 year earlier. An empirical diagnosis was made of herpes simplex virus (HSV) infection. A culture was positive for HSV type 1.

Photo courtesy of David L. Kaplan, MD.

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The grouped vesicles on an inflamed base, along with this patient’s complaint of pain and history of recurrence, is classic for an outbreak of HSV-1 infection.

Photo courtesy of Ted Rosen, MD.

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This widespread pruritic eruption on the buttocks of an elderly woman is an example of herpes simplex virus (HSV) type 2 infection. Genital herpes in women is seen most often on the outer vaginal lips (labia), vagina, cervix, around the anus, and on the thighs (see next image) or buttocks.

Photo courtesy of David L. Kaplan, MD.

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A tender blister on the posterior thigh of a 28-year-old woman is characteristic of HSV-2 infection.

Photo courtesy of David L. Kaplan, MD.

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This young patient described a “tingling” sensation of several days’ duration before this painful lesion erupted. A positive Tzanck test confirmed the clinical suspicion of herpes labialis (orolabial herpes).

Photo courtesy of Ted Rosen, MD.

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These painful vesicles that erupted suddenly and were accompanied by low-grade fever and a sore throat are characteristic of herpes labialis.

Photo courtesy of David L. Kaplan, MD.

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Tongue lesions associated with primary HSV-1 infection.

Photo courtesy of Dr Federico Brugnami.

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