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Urticaria, commonly known as hives, is a condition where there is red, itchy swellings on the skin (wheals or welts) that appears and disappears often for no known reason. Urticaria occurs when certain chemicals that cause inflammation are released in large amounts for no obvious reason.
Sometimes the immune system itself triggers this release of these chemicals and it is therefore said to be an immune-mediated activation. Angioedema is the swelling that occurs in the lower layers of the skin or the mucosal lining of cavities, often as a result of an allergic reaction.
There are several different subtypes of urticaria that may be classified by the causes or triggers. Physical urticarias triggered by physical triggers like mechanical force, temperature, water and sun. The causes behind urticaria is not always known although the disease process is fairly well understood. Contact with latex, animal hair, pollen, dust and other allergens similar to allergic contact dermatitis.
Autoimmune diseases like systemic lupus erythematosus (SLE), Sjogren’s syndrome and autoimmune thyroiditis. Apart from skin symptoms, urticaria can also present with various other symptoms some of which can be very serious and potentially life threatening. Picture of the angioedema of the lip from Dermatology Atlas courtesy of Samuel Freire da Silva, M.D. Various other symptoms may be present which are systemic meaning it involves different sites and systems throughout the body. Some of the following tests may be helpful to identify the underlying cause of chronic urticaria in particular. Corticosteroids are rarely used but may be needed for short period during a severe episode of urticaria. Tricyclic antidepressants may be useful to relieve itching particularly in chronic urticaria. Epinephrine may be administered for angioedema particularly when it causes airway obstruction.
Avoid becoming overheated or cold by dressing appropriately especially in environments with extremes of temperature. Take note of acute medication that may trigger urticaria or speak to a doctor about the possibility of chronic medication triggering the condition. Ask a Doctor Online Now!Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis.
Last week Wizards of Waverly Place actress, pop singer, and current Justin Bieber girlfriend, Selena Gomez was hospitalized after her appearance on the Tonight show.
Iron-deficiency anemia usually develops over time if your body doesn’t have enough iron to build healthy red blood cells. Iron-deficiency anemia can cause fatigue (tiredness), shortness of breath, chest pain, and other symptoms.Severe iron-deficiency anemia can lead to heart problems, infections, problems with growth and development in children, and other complications.
In women, low iron levels may be due to blood loss from long or heavy menstrual periods or bleeding fibroids in the uterus. Blood loss from severe injuries, surgery, or frequent blood drawings also can cause iron-deficiency anemia. The best sources of iron are meat, poultry, fish, eggs, and iron-fortified foods (foods that have iron added).
During some stages of life, such as pregnancy and childhood, it may be hard to get enough iron in your diet.
Women of childbearing age are at increased risk for iron-deficiency anemia because of blood loss during their monthly periods.
Treatment for iron-deficiency anemia will depend on the cause and severity of the condition.
Eating a well-balanced diet that includes foods that are good sources of iron may help you prevent iron-deficiency anemia.
For more information about iron deficiency anemia, click here to go to the Resounding Health Casebook on the topic. AboutWe are a wife & husband team of physicians who have trained and taught at some of the top medical schools in the country including Harvard, Johns Hopkins and Washington University in St. Our mission is both a journalistic and educational one: by reporting on common diseases affecting uncommon people, and including the medical facts behind the headlines, we provide a dynamic collection of Teachable Moments in Medicine™ to increase health awareness and medical knowledge.
We give you the medical facts behind Hollywood's health headlines plus information that empowers you to achieve your health and wellness goals. Nuestro curso de naturopatia, reconocido por el estado, lo podra realizar en un ano, en comodos plazos y con los mejores profesionales del campo de la medicina natural.?Ahora por 50€ al mes y sin intereses ni gastos de matriculacion!
La presion sanguinea es la fuerza que ejerce la sangre al circular, sobre las paredes de los vasos sanguineos. La causa de la Gonorrea es la bacteria Neisseria gonorrhoeae, que puede crecer y multiplicarse en areas humedas y calidas del aparato reproductor femenino, incluyendo el cuello del utero, el utero, las trompas de Falopio y en la uretra. Mantener relaciones con diferentes personas a las cuales no conoce en profundidad y por lo tanto no esta seguro de que no sean portadores de la enfermedad. Dolor en la parte inferior del abdomen, sobre todo si la infeccion se disemina a las trompas de Falopio y al area del estomago. Salpingitis (cicatrizacion de las trompas de Falopio) que puede llevar a tener problemas para quedar en embarazo o a embarazo ectopico. Las mujeres embarazadas que tengan gonorrea grave le pueden transmitir la enfermedad a su bebe mientras esta en el utero o durante el parto. En el varon: Aparecen los primeros sintomas a los 2 o 3 dias de haber contraido la infeccion y si no se trata a tiempo puede ocasionar esterilidad.
De no tratarse, puede producir epididimitis, que afecta los testiculos y puede causar infertilidad.
TweetThe human skin is not just a protective layer but also a highly sensitive sensory instrument which may be afflicted with a number of sensations that can cause discomfort.
Ask a Doctor Online Now!Itching of the legs is a common ailment that may arise without any underlying disease or obvious skin rash and often no cause can be found. The itch receptors are intended to serve as a means of warning a person of some irritation on the skin. Proper hygiene ensures that sweat, sebum (oil) and dead skin cells that have not fallen off as yet, do not collect on the skin surfaces.
In keratosis pilaris (link : pictures) thickening of the hair follicles result in small, skin-colored, red, or brown bumps (goose bumps, chicken skin, leg acne) on the thighs, arms or other parts of the body.
In staphylococcal folliculitis (link : pictures and treatment), there is an infection of the hair follicles with Staphylococcus aureus (bacteria). A person who starts vigorous exercise like running after a prolonged period of inactivity can experience intense itch a short while into the activity. Cholinergic urticaria (hives) are red, swollen bumps or patches appearing on the skin as an allergic reaction to physical stimuli, like pressure of the clothes, exercise, heat, sunlight, cold, vibration, water, spicy food, or emotional stress.
Some people experience intense leg itch during walking, running, after a hot shower or in a hot environment in general (3).
Tendency of the skin to develop an urticaria-like rash, when stroked, is called dermatographism. Anaphylaxis (Gk ana = against, phylaxis = protection) is a severe allergic reaction to certain, very specific allergens (allergy-triggering substances). Treatment of severe allergic reaction in EIA is by an intramuscular injection of adrenaline (epinephrine) as soon as possible (3). Prevention of EIA is by determining trigger foods and medication with skin patch tests and avoiding these triggers on the day of and immediately before the scheduled exercise program. Wearing new pants or ones made by synthetic material may irritate the skin and cause contact or allergic dermatitis.
Frequent use of very hot water and certain soaps like antibacterial and strongly scented soaps, removes the protective oily layer lining the skin thereby making the skin dry and itchy. In deep vein thrombosis or in varicose veins, blood can not be pumped efficiently from the leg veins back to the heart. Leg itch may be a part of generalized itch caused by different disorders, such as xerotic eczema, senile pruritis, atopic dermatitis, contact dermatitis, parasites, infections, obstructive biliary disease, chronic renal failure, malignancy, medications, neurodermatitis, diabetes, peripheral nerve damage, emotional stress or psychological disorders. When I stand for a short period of time less than 2 minutes, my lower legs from about the top of my feet to mid lower leg itch and tingle uncontrollably. Hi For about 6-7 years in every summer atleast 2 months I suffer from itching on my lower legs accompanied by small red coloured spots.
These chemicals include histamine, bradykinin, kallikrein and other vasoactive substancs which are stored in certain immune cells in the skin known as mast cells and basophils. It may appear as deep welts on the skin or a swollen red area like when it affects the eyelids or lips. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. If you don’t have enough iron stored in your body to make up for the iron loss, you’ll develop iron-deficiency anemia. If you don’t eat these foods regularly, or if you don’t take an iron supplement, you’re more likely to get iron-deficiency anemia.
For example, good non-meat sources of iron include spinach and other dark green leafy vegetables, certain types of beans, dried fruits, and iron-fortified breads and cereals. This may be due to intestinal surgery or diseases of the intestine, such as inflammatory bowel disease or celiac disease.Prescription medicines that reduce acid in the stomach also can interfere with iron absorption. Taking iron supplements (as your doctor prescribes) also may lower your risk for the condition if you’re not able to get enough iron from food. Tambien se pueden transmitir con el uso compartido de jeringuillas y sangre contaminadas, asi como en el embarazo de madre a hijo.
It can nevertheless cause great discomfort and even affect a person’s daily functioning or sleep. It usually elicits the scratching action which not only provides some relief from itching but is also intended to remove the surface irritant. On the other hand, excessive cleaning can cause the skin to dry and therefore cause itching.
It presents as small red bumps sometimes with white centers which resembles acne, and tends to appear on the thighs, upper trunk, face or other body parts.
Jock itch is a red or brown papular rash on the inner thighs, genitals, and buttocks, caused by dermatophytes (tinea fungi), commonly affecting athletes and others who perspire excessively in the groin region. It can be treated with antifungal medication.
In a fit runner, the small arteries in the muscles usually open rapidly in response to high demand to blood, but in an unfit runner arteries may not open properly leading to a low oxygen state.
Injection with acetylcholine tends to provide rapid relief of symptoms, hence the term cholinergic. In severe itching, discontinuing exercise and removing tight clothing around the legs is advisable.
Symptoms of EIA do not appear after eating alone or exercising on its own, but only after a combination of eating certain foods followed by exercising. This results in blood pooling within the lower limbs.  The lower legs may be red, swollen, itchy, and cracks and scaling may appear. I used to think I only got it when I had an uti or bv infection but now M6 husband has itchy legs too. I don’t know why but I drank about 4 days ago then the next morning i felt fine so i excersised. There are many possible causes of leg itching but if both you and your husband are experiencing it then it is most likely due to a common factor within the home. A side effect of taxol that I had is neuropathy, which I am Experiencing In feet and lower legs and itchiness in lower legs and thighs. It drives my fiance crazy I itch so bad to the point where it starts to bleed and I can’t fall asleep what can I do to help this it’s bugging me?!?!?!? There are many possible causes but given that this is more common in summer, it is most likely due to environmental or climatic factors. I thought it was something to do with my blood, but infact it’s just my Keratosis Pilaris. Sometimes the swelling is of the airways and can lead to difficulty breathing, suffocation and even death.
Normally these chemical are only released when necessary, like if the skin is injured or there is an infection. Chronic urticaria is more likely with autoimmune diseases which are usually chronic conditions. Swelling of the lips and tongue can cause slurred speech and the tongue or larynx may be responsible for a change in the tone and volume of the voice.
Testing is advised when other skin diseases need to be excluded or in chronic urticaria to identify any underlying diseases. Using cool water to bathe the area and topical applications (creams or lotions) like menthol 1% may provide some relief. HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes. After running some tests, the 18-year-old was back  on stage Monday for a Santa Monica Place show she had cancelled because of her illness.
Severe iron-deficiency anemia may require treatment in a hospital, blood transfusions, iron injections, or intravenous iron therapy.
I actually like what you have acquired here, certainly like what you’re saying and the way in which in which you are saying it.


It can vary in intensity and duration, from a mild itch of a few minutes to the severe itch that can last for weeks.
Itching of the legs must be clearly differentiated from other sensations like leg pain or leg tingling.  Pain may be due to actual injury to the skin and underlying tissue, while tingling may be a sign of neurological conditions.
However, itching may occur without any irritant triggering these receptors on the surface of the skin.
Bumps in this harmless, genetically predisposed condition can be rubbed off but tend to recur. Sweat triggers the release of histamine causing itchiness in the legs or other parts of the body. The condition can last for several months and continuous treatment with non-sedative antihistamines is usually effective.
It can be prevented to some extent by using natural textiles like cotton and washing new clothing before first use.
Use lukewarm water, avoid strongly scented and antibacterial soaps and use a moisturizing cream immediately after bathing. The itching may be associated with early stages of blood circulation disorders in the legs. Lately in gym, it seems that when I have to run for more than about a quarter of a mile, I develop rashes on my thighs. Sometimes hives (urticaria) is triggered by certain activities although it may not be so much the physical exertion but the sweating that arises with physical activity. Rubbing alcohol may give momentary relief for some people but it also causes drying of the skin. Two other possibilities that could account for it is a circulatory problem in the lower leg, or possibly nerve root compression which involves the lower leg.Disturbances in blood flow can cause itching as can irritation of the nerves. Yes, a deficiency of certain B-vitamins can cause a range of symptoms as mentioned by the user above. Sometimes it may related to allergies with triggers being localized to the mattress or bedroom, for example house dust mite. When urticaria arises by some other trigger like drug usage, physical stimuli and psychological stress then it is known to be non-immune mediated activation. It also arises for no known reason in the majority of cases (idiopathic urticaria) and the triggers are almost never identified. More seriously though, swelling of the airways can cause difficulty breathing and in severe cases this is potentially life threatening. Oxygen may be administered as supportive treatment when there is airway narrowing with angioedema. Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1.
The condition tends to ease after a few days to weeks of activity as the body adapts to the increased demands. It may also present with warm skin and small (up to 2-3 mm) bumps, which usually persist from 30 minutes to 2 hours. If the itching does not stop, antihistamines like oral hydroxyzine may help with symptomatic relief.
Exercising in cold weather or during menstruation can also trigger exercise-induced anaphylaxis in some individuals. However, if you have used it just once off or a few times then it may not cause much drying. However, you should speak to your doctor again and possibly get a referral to a specialist physician who may be in a better position to isolate other causes. However, the other possibility could be a circulatory disturbance which is more likely to occur in people who are on their feet all the day. Looking up this problem on the net reveals that there are many causes which does not help when you are being driven mad. Within minutes it causes more blood to flow through the skin and for fluid to leak out of blood vessels into the skin thereby causing swelling of the skin. In most cases a trigger can be found such as certain drugs, foods, an infection or insect bite.
She was a medical internet pioneer having established one of the first medical practice websites in 1997. In cholinergic urticaria, an antihistamine like Benadryl by mouth taken 30 minutes before shower usually helps.
I pulled my shorts up a bit to see that I’d, once again, developed large, red patches on my thighs that soon covered the entirety of both of my thighs. Of course this is just one possibility and it is difficult to say for sure through an online platform.
The user above seems to be suffering with chronic itching and using it daily in her case would very likely lead to drying of the skin.
However, this itching could also be due to allergies and there may be a common allergen that both you and your husband are sensitive to.
The change in position once lying flat can alter the circulation and itching may be one of the symptoms that then arises.
The condition may affect 1 out of 6 people at least once in their lifetime but in most cases it is acute and never occurs again. In recent years, HSV-1 has become a significant cause in developed countries, including the United States. Skin patch tests may be able to identify topical causes like an allergy to specific soaps or shampoos. These symptoms would further support the possible diagnosis of circulatory disorders in the leg, particularly a problem with the veins.
Scratching them caused pain, and when we went inside the gym, I sat down, and noticed that the rash seemed to be radiating heat almost. The risk of infection is highest during outbreak periods when there are visible sores and lesions. Investigations like a doppler ultrasound can be useful in identifying circulatory disturbances. On awaking with cold limbs I covered up and in a short time I could feel the cursed itching returning. SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks. Although I could feel the underlying problem remained at least I got relief albeit with cold legs. Herpes, Pregnancy, and Newborn InfantsHerpes can pose serious risks for a pregnant woman and her baby. The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission. Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Herpes viruses include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox).
Like I said at the beginning there are all sorts of reasons for this ailment and so with this in mind it may not work for you. The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. The usual cause of oral herpes (herpes labialis), which are commonly called cold sores or fever blisters.
HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2). Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes.
It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites).
In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact.
To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. The risk for infection is highest with direct contact of blisters or sores during an outbreak. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate. The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time. However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again. During this time, the virus can infect other people if it is passed along in body fluids or secretions.
Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding). In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters.
Certain triggers can wake up the virus from its dormant state and cause it to become active again.
In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. In addition, because HSV-1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils. Transmission of Genital Herpes Genital herpes is transmitted through sexual activity. People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner. People with active symptoms of genital herpes are at very high risk for transmitting the infection. Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms.
Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex.
African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing.
Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak.
However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding). Although condoms may not provide 100% protection, they are proven to significantly reduce the risk of sexual disease transmission, including herpes.
Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them. Use a water-based lubricant.
Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. However, it is best not to use condoms pre-lubricated with spermicides. Do not use spermicides for protection against herpes. Nonoxynol-9 can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. Use a dental dam or condom for oral sex. If you have any symptoms of oral herpes, it is best not to perform oral sex on a partner until any visible sores or blisters have healed. Limit the number of sexual partners. The more sexual partners you have, the greater your chances of becoming infected or infecting others. It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery.
Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare.


Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery. Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery.
Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy.
A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple.
Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis.
Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir.
It is important to treat babies quickly, before the infection spreads to the brain and other organs. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.
Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light.
Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness.
It only affects the upper layer (epithelium) of the cornea and heals with scarring. Stromal Keratitis. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed.
Herpes Skin ComplicationsEczema Herpeticum A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system.
Untreated, this condition can be extremely serious and possibly fatal. Gingivostomatiti Oral herpes can cause multiple painful ulcers on the gums and mucus membranes of the mouth, a condition called gingivostomatitis. Children with gingivostomatitis commonly develop herpetic whitlow (herpes of the fingers). Herpetic Whitlow A herpetic whitlow is an infection of the herpes virus involving the finger, often around the fingernail.
In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms. In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes. The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge. Recurrent Genital Herpes Outbreak In general, recurrences are much milder than the initial outbreak.
The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks.
Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral HerpesOral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Primary Oral Herpes Infection If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in children. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing.
Recurrent Oral Herpes Infection A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu). The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction. Timing of Recurrences Recurrent outbreaks may occur at intervals of days, weeks, or years.
For most people, outbreaks recur with more frequency during the first year after an initial attack.
The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes.
People diagnosed with genital herpes should also be tested for other sexually transmitted diseases.
At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2. It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations.
Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur.
Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak. PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis.
PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected. However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions.
The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2. When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection. If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes). Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy). Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously.
Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity.
Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%. It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year). Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences. A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day. In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms.
However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later. Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin.
Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks. Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work.
Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.
Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008.
Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



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