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The Herpes virus has always been a notorious one when causing infection, primarily because of how difficult it is to treat. Herpes Labialis is caused by Herpes Simplex Virus 1 and 2, more often though by the former. Herpes labialis is caused by HSV-1 primarily, though in the recent years HSV-2 has also been identified as a common cause.
However, in the recent past, improvement in socio-economic conditions has led to a shift in the time of onset of the disease, and these days patients are usually affected during adolescence rather than at childhood. When infected by HSV-1 and 2, the virus enters the sensory nerves and migrates up to the sensory ganglion, where it remains dormant for long periods of time. The ganglion that is commonly affected is the trigeminal ganglion, and as a result infection is most often seen on the lip, though they can occur on the hard palate as well. Shortly after, patients will notice a 4-stage process of transformation of the lesion, characterised by vesicle formation, postulation, ulceration on the surface and eventually ending with scab formation. In children, infection can sometimes be a bit more severe, with multiple blister formation around the mouth and on the tongue.
Other more advanced techniques such as polymerase chain reaction and Tzank smears may also be performed to confirm the diagnosis.
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Penciclovir is an antiviral drug that can be used either as topical cream or intravenously to treat herpes simplex virus (HSV-1, HSV-2) infections. Penciclovir is a nucleoside deoxyguanosine analog that inhibits the DNA synthesis of herpesviruses. Denavir© is a 1% topical cream used for the recurrent infection of HSV-1, herpes labilias, otherwise known as cold sores. In randomized, double-blind, placebo-controlled, patient-initiated trials of Denavir©, the penciclovir-treated patients has shorter lesion-healing times, reduced symptoms, and shorter periods of viral shedding. For therapy of HSV-1 and HSV-2 in immunocompromised patients, penciclovir is equal in efficacy to acyclovir, but can be administered less frequently because of its extended half-life in the cell. Denavir© is to be administered every two hours during the day for four days beginning in the prodrome or initial lesion period. Intravenous penciclovir is not currently licensed as a treatment, but in clinical trials it was found that doses of 5mg per kg every twelve hours was as effective as acyclovir in treating HSV infections.


Denavir© is not recommended for children under 18 years of age, pregnant or nursing mothers, and its effects have not been studied in immunocompromised patients (although intravenous penciclovir produced no harmful effects). Side effects of intravenous penciclovir (seen in comparable rates in placebo) may be headache, abdominal pain, increased serum lipase, nausea, dyspepsia, dizziness, and hyperbilirubinemia.
The virus causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. Herpes simplex virus 1 (HSV-1) is the main cause of herpes infections that occur on the mouth and lips. Rare reinfections occur inside the mouth (intraoral HSV stomatitis) affecting the gums, alveolar ridge, hard palate, and the back of the tongue, possibly accompanied by herpes labialis.
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Herpes simplex in particular is rather stubborn, with a majority of the population having suffered from it at one point in their life. It is considered cosmetically unpleasant but usually resolves itself in around a week to 10 days.
Studies have shown a higher prevalence of the HSV virus in developing countries when compared to the developed part of the world. It is usually acquired in childhood or during adolescence through non-sexual contact, such as drinking from the same water bottle as someone who already suffers from herpes labialis. Clinical features include a prodromal phase, where patients can experience burning and itching sensations on the lip or hard palate associated with development of erythema and papules along the vermilion border. However, in adults, features are as described above, and may be associated with cervical lymphadenopathy and a sore throat.
In order to post comments, please make sure JavaScript and Cookies are enabled, and reload the page. Om het te downloaden, raad, alsjeblieft, deze presentatie aan je vrienden in de sociale netwerken. Het tijdig smeren van Zovirax heeft onvoldoende resultaat en de patiente krijgt regelmatig een antivirale kuur. Onderzoeksstrategie PICO therapie: -Population Bij kinderen met koortsstuipen -Intervention kunnen antipyretica -Comparison.
It is currently licensed as Denavir© to treat herpes labialis, otherwise known as cold sores. Because it is very poorly absorbed orally, famiclovir was developed to orally treat herpesvirus infections. Penciclovir has also been studied in its ability for acute intravenous therapy of herpes simplex virus disease in immunocompromised patients. Herpes simplex virus, type 1 or herpes-1, which causes 80 of cases of oral herpes infections. Recurrent herpes simplex labialis, also known as oral or orolabial herpes, is an infection of the mouth area caused by the herpes simplex virus.
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Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. In experimental stages currently, intravenous penciclovir could be used to treat HSV-1 and HSV-2 in immunocompromised hosts.
Also from these studies came the hypothesis that penciclovir may keep lesions from becoming severe and therefore prevent severe attacks.


Blisters in the mouth, often on the tongue, cheeks, roof of the mouth, gums, and on the border between the inside of the lip and the skin next to it.
However, in some cases, further confirmation of the diagnosis may be required (such as in immunocompromised patients). Binnen 2 weken ontstond een herpes labialis en genitalis, waarop een stuutkuur werd gegeven van valacyclovir van 2dd500mg gedurende 10 dagen.
A drug called famciclovir is the oral prodrug of penciclovir and is used to treat HSV-1, HSV-2, and VZV. In the virus-infected cells only, penciclovir is phosphorylated to its active form first by the viral thymidine kinase which adds the first phosphate and then by a cellular enzyme which completes the activation.
Because of these positive effects, Denavir© became the first treatment for episodic use of herpes labialis in the United States. Mouth sores most commonly occur in children aged 1-2 years, but they can affect people at any age and any time of the year.
HSV-1 is typically spread by contact with infected saliva, while HSV-2 is usually spread sexually or via the mother’s genital tract to her newborn baby. If you have oral herpes on your lip, mouth or tongue, a topical anesthetic medication such as viscous lidocaine (Dilocaine, Nervocaine, Xylocaine, Zilactin-L) may be prescribed to relieve pain. In such cases, tissue culture may be required, which on microscopy can show ballooning of the cells and apoptosis. De patiente startte hierna weer met profylaxe en heeft momenteel nog geen last gehad van recidieven.
In this way, penciclovir in its active triphosphate state is confined to the virus-infected cells. The sores may occur on the lips, the gums, the front of the tongue, the inside of the cheeks, the throat and the roof of the mouth.
Once formed, penciclovir triphosphate has a very long intracellular half-life when compared with acyclovir triphosphate.
HSV-1 is most often associated with infections of the oral cavity, with up to 90 percent of people in the US exposed to this virus.
Canker sores appear in the mouth area (tongue, gums, lip) and are small, shallow ulcers that make talking and eating uncomfortable.
Penciclovir triphosphate is now free to insert in the viral DNA as it is being formed in place of the nucleotide guanine and terminate the sequence, thus inhibiting replication of the virus.
In addition, herpes simplex type 1 is responsible for 80 of herpes in the mouth infections, and herpes simplex type 2 causes the rest. Genital herpes can be transmitted to other parts of the body, including the lips, tongue, gums, eyes, and fingers. The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history. The mouth lesions (herpetic gingivostomatitis) consist of painful vesicles on a red, swollen base that occur on the lips, gingiva, oral palate, or tongue.
Canker sores, however, occur only inside the mouth-on the tongue and the inside linings of the cheeks, lips and throat.
Most people infected with the type 1 herpes simplex virus became infected before they were 10 years old. They occur only inside the mouth, on the tongue or the insides of the cheeks, lips or throat.
Herpes simplex virus type 1 usually causes cold sores, and herpes simplex virus type 2 usually causes genital herpes, though either can cause sores in the facial or genital area.



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