Herpes simplex labialis B00.1

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 16.06.2023

Dieser Artikel auf Deutsch

Synonym(s)

cold sores; Herpes infection of the lips; labial herpes; lip herpes

Go to
This section has been translated automatically.

Definition
This section has been translated automatically.

Mostly contact infection, rarely droplet infection, caused by the herpes simplex virus -1. S.a.u. Herpes viruses, human (herpes from Greek herpein = to crawl). The viruses prefer the transition area between skin and mucous membranes. Small defects in the epithelium of the skin or mucous membranes serve as ports of entry. The frequent recurrences of the disease are caused by edogenic reactivation of the viruses. They often affect the same site(herpes simplex recidivans). Up to 40% of the population suffer from recurrent herpes simplex labialis.

S.a.u. Herpes viruses, human, Herpes simplex recidivans

Clinical features
This section has been translated automatically.

HSV primary infection (pathogen mostly HSV-1, rarely but increasingly: HSV-2):

  • Asymptomatic primary infection (>90% of cases): it is mostly not noticed.
  • Symptomatic primary infection: Uncharacteristic prodromal stage with tightness, itching or pain, rarely fever and swelling and painfulness of the draining lymph nodes (cervical lymph nodes). Solitary or grouped, 0.2-0.4 cm large, initially clear, tense vesicles appear on reddened and swollen lip skin. In the further course, clouding of the vesicle contents, erosions or ulcerations and yellowish crusts. Healing in uncomplicated courses usually after 5-10 days.
  • Complicative primary infection (<1% of primary infections): In a few cases, the initial manifestation leads to a clinically severe infection of the oral mucosa and the perioral region with the appearance of gingivostomatitis herpetica or its maximum variant, the aphthoid Pospischill-Feyrter.

Latent HSV infection:

  • In this infection phase, the patient is asymptomatic, but can excrete viruses and is therefore infectious.

Recurrent infection (HSV persists in the ganglion gasseri of the trigeminal nerve and is reactivated by various stimuli, see alsoherpes simplex virus):

  • S.u. Herpes simplex recidivans: Most frequent manifestation of a herpes simplex virus infection (usually recurrence) on skin or mucosa in the form of mostly chronic recurrent eruptions of grouped standing pinhead-sized vesicles.
  • Reactivation of the viruses usually occurs without any apparent reason, but also after various irritations (UV radiation). Irritations (UV irradiation = herpes simplex solaris; trauma (herpes simplex traumaticus) (physical or psychological stress; infections of other genesis).
  • A massive, extensive spread of a herpes simplex virus infection in atopic eczema is called eccema herpeticatum.
  • A dreaded infection of the eyes is herpes simplex corneae.

Differential diagnosis
This section has been translated automatically.

Physical trauma: Bite wounds usually lead to deeper injuries. Also missing is the typical medical history of recurrent herpes simplex infection.

Corner of the mouth rhagades: in children and adolescents with cheilitis simplex or atopic eczema. Elongated tears of the corners of the mouth with eczema. Long term (several weeks) continuous course.

Perlèche: rather long, continuous course with weeping and crust formation in the area of the corners of the mouth (rather untypical localization of the herpes simplex infection)

Syphilis: syphilitic papules occurring in the context of early syphilis. Miest appearing in the area of the corners of the mouth. Observe the overall constellation (exanthema, always positive syphilis serology)

Herpes zoster: rarely occurs as a circumscribed manifestation in red lips. Not recurrent. Segmental infestation.

Therapy
This section has been translated automatically.

Complementary medical therapy methods
This section has been translated automatically.

Systemically, the treatment with lysine, an amino acid, in the acute case has 3000 mg / day. The amino acid lysine in a dose of 3 x 500-1000 mg / day leads to faster relief until healing of acute herpes simplex. Commercial preparation for dietary treatment: Lyranda® chewable tablets. Besides L-lysine, they contain zinc, selenium, vitamins and bioflavonoids. Recommended dosage until healing is 3 chewable tablets / day. Furthermore, there are Lysine 500 and A Vitale L Lysine 750 Tbl.

Lysine probably displaces arginine, which is necessary for the growth of herpes viruses, from the binding site. It makes sense to avoid foods rich in arginine such as chocolate, nuts, wheat and oats in case of cold sores.

Local additional therapy with lemon balm leaves (Lomaherpan® cream), applied 4 x / day at the beginning, then 2-4 x daily. Also suitable for prophylaxis and care - here there is a combination of lemon balm leaves with additional sun protection factor 30 (Lomaprotect ®).

Furthermore, tannin drugs, sage leaves in combination with rhubarb root (Rhei radix) (Pyralvex ®) are used for brushing, In the study by Saller R. et al showed an equivalent effect to aciclovir with fewer study dropouts.

Furthermore, propolis (Propolisept®lip cream) and purple coneflower (Echinaceae purpureae herba) (Echinacin® Ointment Madaus, Echinacin® Lipstick care + sun) are used.

Note(s)
This section has been translated automatically.

Further information about Herpes simplex virus infections see there.

Literature
This section has been translated automatically.

  1. Griffith RS. et al. (1978) A multicentered study of lysine therapy in herpes simplex infection, Dermatologica;156:257-67.
  2. Saller R. et al (2001) Combined herbal preparation for topical treatment of Herpes labialis. Forschende Komplementärmedizin/Research in Complementary Medicine 8.6.: 373-382.
  3. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 459-462.
  4. Griffith RS et al. (1987) Success of L-lysine therapy in frequently recurrent herpes simplex infection. Treatment and prophylaxis. Dermatologica. 175:183-190

Incoming links (3)

Cold sores; Melissae folium; Sage echter;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 16.06.2023