NATURAL-HISTORY, MANAGEMENT AND COMPLICATIONS OF HERPES LABIALIS

Infection with herpes simplex virus (HSV) is a common worldwide proble m. Primary infection with HSV-1 rarely causes significant problems alt hough widespread involvement in atopic eczema can be life-threatening as may associated encephalitis. Keratoconjunctivitis, pharyngitis and hepatitis can also complicate primary infection. Twenty to 40% of the population at some stage have recurrent orolabial infections with HSV although in only 1% of these cases is this recurrence severe. Recurren t erythema multiforme appears to be associated with HSV-65% of patient s are thought to have preceding herpes labialis. Many primary and recu rrent infections with HSV-1 require little more than topical antisepti c therapy to control secondary infection. Systemic acyclovir, however, is indicated in various situations including complicated primary infe ction, infection in neonates, eczema herpeticum, HSV infections in the immunocompromised, and recurrent erythema multiforme. In the latter, prophylactic treatment with 6 months acyclovir appears to be effective . (C) 1993 Wiley-Liss, Inc.