Page 39 - LECTURE NOTES

3.8.8. Genital Herpes (herpes progenitalis)

Usually due to HSV - 2 causing 85% ( >15% can be caused by HSV -1) of initial

infections and up to 98% of recurrent lesions
In the mid 1980’s because of the change in the sexual behavior, the prevalence of

HSV – 1 began to increase. In developed countries up to 40% of the anogenital herpes
in women is caused by HSV – 1

HSV – 1 is associated with less recurrence rate than HSV – 2

Genital herpes → transmitted by skin-to-skin contact

Incubation Period: 5 days

Asymptomatic shading occurs in all sites (vagina, cervix, and mucous membranes)
even through normal appearing skin and mucous membranes.

Grouped blisters and erosions in the vagina, vulva, penis … continues to develop in 7
– 14 days. Lesions are bilateral and symmetrical, inguinal lymph nodes may be

enlarged, fever and flu like symptom may be there. Pain, dysuria, and dysparunia may
also be observed.

Previous HSV – 1 lessens the severity resembling recurrent genital herpes.

Most HSV – 2 will have recurrence even if the initial infection was asymptomatic which
is estimated to be 6 times more frequent than HSV – 1

Recurrence:

Nature: 24 hrs prodromal symptoms → 24 hrs vesicles appear → 24 – 36 hrs

ulceration → 2 – 3 days healing: TOTAL: 7 days recurrence

Sites and clinical presentation:
9 Genitalia and upper buttocks are the common sites for occurrence

9 Healing without scar

9 Social stigma – the emotion from recurrent lifelong disease
9 Guilt

9 Blamefulness of the presumed source (i.e. partner)

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