Recently, many patients with frequent recurrences of genital herpes have come to the doctor, stating that the frequent recurrences of genital herpes have seriously affected their lives, but there is no good solution. Now we will share the relevant knowledge with you.
Genital herpes is a sexually transmitted disease caused mainly by herpes simplex virus II (HSV II). It belongs to the range of “hot sores” in Chinese medicine.
Etiology and pathogenesis
Most of the pathogens of this disease are HSV II, which is mainly transmitted through sexual intercourse, causing primary genital herpes, and the virus is latent in the sacral ganglion after receding, and recurs when it encounters a decrease in resistance, menstruation, colds, cold or exertion and other triggers. A few patients are infected by HSVI through close contact with respiratory tract and skin mucosa, causing genital infection.
Clinical manifestations
(A) lesion characteristics: for local skin mucous membrane burning sensation after the occurrence of clusters of papules, followed by becoming blisters, a cluster or more clusters, can develop into pus rupture to form vesicles, shallow ulcers, and finally crust self-healing.
(b) Preferred sites: foreskin, glans, coronal sulcus, penis or occasionally in the male urethra, female labia majora and minora, clitoris, mons pubis, cervix or urethral orifice, etc. Occasionally, it occurs in the anorectum.
(c) The incubation period is 2 to 10 days, with an average of 6 days, and the duration of the disease is about 2 to 3 weeks, with frequent recurrence, lighter symptoms and less damage than the original, often without general discomfort, low fever, headache, swollen lymph nodes, and less self-induced pain than the original.
If it occurs in the muscular rectum, the affected area is painful, constipation, increased secretion, urgency, perianal herpetic ulcers, mucosal congestion and bleeding in the lower rectum, and small ulcer foci.
Diagnosis and differential diagnosis
It is not difficult to diagnose based on the characteristics of clustered blisters in the genital area, local burning pain, combined with the history of unclean sexual intercourse and short course of recurrence, etc. Laboratory PCR can easily detect and distinguish the virus type. It is easy to detect and distinguish the type of virus by laboratory PCR. However, it should be differentiated from soft chancre, acute female vaginal ulcer, leukodystrophy and solid-form drug rash.
（The lesions are round or oval in shape, with irregular margins and a yellow-white, lipid-like moss at the base, and smear with Haemophilus ducreyi.
(b) Acute female genital ulcers and leukoplakia: both not directly related to sexual intercourse, showing multiple small ulcers, the latter may be accompanied by oral ulcers, ocular lesions and other manifestations.
(iii) Fixed drug rash: blisters, erosions, and ulcers in the genital area, usually solitary, with a history of drug use and no history of unclean intercourse.
【Treatment
(B) Western medicine treatment
⒈ general treatment: to prevent secondary bacterial infection, keep the herpes wall intact, clean and dry; and bacterial infection when the application of antibiotic therapy.
⒉ systemic treatment: can use anti-viral, enhance the immune function of drugs. Such as acyclic guanosine, vancomycin. In addition, thymidine can be used
Transfer factor, human immune ribonucleic acid and interferon can be used as adjuvant therapy.
Topical treatment: The main purpose is to prevent secondary infection and promote the healing of skin lesions as soon as possible.
(1) 1/5000 potassium permanganate solution or 1/20 povidone-iodine solution for external washing of the affected area.
(2) Acyclovir (acyclovir) ointment is applied externally, or 0.1% herpes net solution or phthalbutamide solution is applied externally.
(3) Local pain symptoms can be obvious with topical application of 1% dacrynic solution or 5% lidocaine ointment to relieve pain.
4. for more than 6 times a year, often affecting the harmony of the patient’s life, we call the frequent recurrence of genital herpes, treatment is more difficult, now advocate long-term antiviral drugs, more than six months, it is best to go to the dermatologic venereal disease specialist, so that the specialist doctor according to the specific situation to develop a treatment plan.
Prevention and care]
(a) Try to remove the triggering factors, avoid unclean sexual intercourse.
(2) Maintain local hygiene, eat a light diet and avoid alcohol.
(3) Pregnant patients can have a cesarean section.
It is worth noting that some patients often say when they visit the clinic that I have worn a condom, but how come they still have the disease? It is because the virus of genital herpes is smaller than the condom, so some of it can be transmitted through the condom during sexual contact, and there is also the transmission caused by a broken condom or a poor quality condom, so the best way to prevent it is to be clean and avoid impure sexual behavior.