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Verruca vulgaris, also known as the common wart, is a manifestation of cutaneous infection with human papillomavirus (HPV) and presents as solitary papules with an irregular, rough surface.
Molluscum contagiosum is a self-limited epidermal poxvirus infection that presents as skin-colored, shiny papules that are often umbilicated. Herpes simplex virus (HSV) infections present as grouped vesicles on an erythematous base, but occasionally only nonspecific crusted erosions are seen.
Varicella (aka the chickenpox) is a contagious primary infection caused by varicella-zoster virus (VZV). Measles, aka rubeola, is a contagious childhood viral infection characterized by fever, coryza (acute rhinitis), cough, conjunctivitis, and cutaneous and mucosal lesions. Rubella, aka German measles, is a common benign childhood illness manifested by lymphadenopathy and an exanthem that begins as pink macules and papules on the forehead and spreads inferiorly to the face, trunk, and extremities during the first day. Hand-foot-and-mouth, disease also known as vesicular stomatitis with exanthema, can be seen in children and infants. Classic roseola, also known as exanthema subitum, is characterized by high fever (~104 degrees F) which suddenly disappears after 3 days only to be followed by eruption of the exanthem.
Herpes simplex infection of the mouth and face, known as orofacial herpes simplex, herpes labialis, cold sores, or fever blisters, is a common, recurrent skin condition associated with infection by the herpes simplex virus (HSV). HSV infections occur in people of all races, of all ages, and of both sexes.Increasing age is associated with increased likelihood of infection.
The most common locations for HSV-1 infections include: Lips Mouth (including gums, tongue, roof of mouth, and inside the cheeks) Nose Chin Cheeks Shortly after exposure to the virus, a newly infected person may develop fluid-filled blisters, occurring singly or in a cluster of several blisters. Acetaminophen or ibuprofen may help reduce fever, muscle aches, and pain caused by cold sores. This Site and third parties who place advertisements on this Site may collect and use information about your visits to this Site and other websites in order to provide advertisements about goods and services of interest to you.
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They are usually found on the extremities, but they may be found anywhere on the skin, including the scalp and oral and genital mucosa.
Once an individual is infected, HSV persists in sensory ganglia for the life of the patient, recurring with lessening immunity. The cutaneous exanthem develops around the 4th febrile day and begins on the forehead and progresses to involve the face, trunk, and then extremities. On the second day, the facial exanthem fades; and by the third day the exanthem fades completely. Orofacial HSV usually appears as small blisters or sores around the mouth, nose, genitals, and buttocks, though infections can develop almost anywhere on the skin.
Up to 80% of Americans are infected with HSV-1 by the time they are 30 years old.Only 20% of people who are infected with HSV actually develop visible blisters or sores. These blisters may be yellow to gray and are fragile, so that many people never notice blisters but instead see tiny open sores (ulcers).


Seek medical advice as soon as possible, especially if you are at risk for more serious complications. On occasion, however, a swab from the infected skin may be sent to the laboratory for viral culture, which takes a few days to grow. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.
Studies have shown that bacteria and viruses activate the complement system via antigen or antibody-antigen complexes.
Mucocutaneous features of Chikungunya fever: A study from an outbreak in West Bengal, India.
Chronic urticaria associated with recurrent genital herpes simplex infection and success of antiviral therapy: A report of two cases. The Immunocompromised district: A unifying concept for lymphoedematous, herpes-infected and otherwise damaged sites.
Sabroe Immunology and Allergy Clinics of North America.
It is characterized by unilateral nerve pain and a vesicular or bullous eruption limited to one or two dermatomes innervated by a corresponding sensory ganglia. It is a morbilliform eruption which means it presents as generalized, discrete, red to pink macules. Rubella infecting a pregnant female produces a benign illness in the mother but results in congenital rubella syndrome with serious chronic fetal infection and malformation. Furthermore, these cold sores may periodically come back in the same sites.Infections with HSV are very contagious and are spread by direct contact with the skin lesions.
That means that approximately 80% of people with HSV infections have not been diagnosed and are unaware of their condition.
Blood tests may also be performed.Untreated HSV infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. HSV-1 tends to infect the orofacial areas more often, whereas HSV-2 tends to infect the anogenital regions more often, although either one can affect either site. The mucosal enanthem is known as Koplik's spots and are characterized as tiny bluish-white papules with an erythematous base on the buccal mucosa opposite premolar teeth. There are 2 types of HSV: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 infections usually occur around the mouth, lips, nose, or face, while HSV-2 infections usually involve the genitals or buttocks.
Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus. In severe cases of HSV infection, cold sores may involve the entire lining of the mouth and both lips.
In children, it is frequent due to respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, adenovirus, CMV, entrovirus, Epstein-Barr virus, Parvovirus. However, only about 20% of people who are infected with HSV actually develop visible blisters or sores.


These severe infections may be accompanied by fever, sore throat, foul breath, and difficulty eating.Repeat (recurrent) HSV infections are often milder than the primary infection, though they look alike.
However, some people never develop the symptoms of a primary HSV infection and may mistake a recurrent infection for a primary infection.
Nevertheless, the virus remains in the body, hibernating in nerve cells.Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent HSV infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.Most people get cold sores as children, through contact with a friend or family member who is already infected with HSV. There was no antecedent history of fever and drug intake but she travelled for few hours in sunlight for few hours and had a lot of physical and mental stress during that period.
It can be spread (transmitted) by kissing, sharing eating utensils or drinking vessels, or by using the same towel. There was no history of urticaria, asthma and drug eruptions or contact dermatitis or food allergy in her past or family. She attained menopause 6 years ago and was not receiving any drugs including hormone replacement therapy. Her investigations including blood sugar, complete blood counts, and urinalysis were normal. Two months later, she again came with the similar presentation but her major concern this time was painful eruptions on upper lips at the same location as that in the past.
She was again investigated for her blood counts, blood sugar, thyroid function tests, antinuclear antibodies, and HIV antibodies, which turned out to be normal.
We prescribed her with oral roxithromycin 150 mg bid, paracetamol 500 md tid, desloratidine 5 mg od, and acyclovir 200 mg 5 hourly and asked her to follow after 5 days. On telephonic inquiry, she told that there was dramatic resolution in herpetic lesion on lips as well as the urticaria just within 3 days and she did not complete the course of medications.
We requested her to report as soon as she gets any of similar complains in future.Again after 2 months, she came with the similar presentation.
Herpes simplex labialis of 5 days duration on upper lips had started forming crusts and acute urticaria consisting of 1-4 cm erythematous plaques on right side of face since 1 day [Figure 1]. The individual weals of urticaria did not last more than a few hours, even without medications, as per the history narrated by the patient. She did not consent for a skin biopsy of urticarial weal.We started oral acyclovir 200 mg 5 hourly for 7 days, desloratidine 5 mg daily and topical mupirocin ointment for lip lesions. She remained healthy and there were no recurrences, either of urticaria or herpes simplex labialis.



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