Images (2)

Vulvovaginitis herpeticaA60

Author:Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 24.05.2022

Dieser Artikel auf Deutsch

Synonym(s)

vulvitis aphthosa

Requires free registration (medical professionals only)

Please login to access all articles, images, and functions.

Our content is available exclusively to medical professionals. If you have already registered, please login. If you haven't, you can register for free (medical professionals only).


Requires free registration (medical professionals only)

Please complete your registration to access all articles and images.

To gain access, you must complete your registration. You either haven't confirmed your e-mail address or we still need proof that you are a member of the medical profession.

Finish your registration now

DefinitionThis section has been translated automatically.

Primary infection by herpes simplex viruses in the vulva area.

ManifestationThis section has been translated automatically.

Mainly occurring in female adolescents and young women.

Clinical featuresThis section has been translated automatically.

Incubation period: 2-7 days. Acute illness with fever and disturbance of general condition. First clear, then cloudy, partly grouped standing vesicles, later ulcerating and encrusted vesicles in the area of the inflammatory swollen vulva. Severe itching. Involvement of the proximal vagina and the portio are possible. Formation of extensive erosions after bursting of the vesicles.

Differential diagnosisThis section has been translated automatically.

Primary stage of syphilis; ulcer molle; ulcer vulvae acutum.

Complication(s)This section has been translated automatically.

Secondary infection with Candida species or bacteria.

External therapyThis section has been translated automatically.

Disinfecting sitz baths with e.g. polyvidon-iodine solution (e.g. Betaisodona Lsg., R203 ) or potassium permanganate solution (light pink).

Soft zinc pastes or gels with zinc sulphate have an antiphlogistic effect.

In the development phase glucocorticoids can also be used in the short term, e.g. as foam or cream, if necessary with antiseptic additives. They shorten the duration of the disease (e.g. magistral hydrocortisone cream 0.5-2.0%).

Furthermore, drying dye brushes are suitable, e.g. with aqueous eosin solution(eosin disodium solution, aqueous 0.5/1/2% ) or methylrosanilinium chloride solution or disinfecting vaginal suppositories (e.g. Betaisodona vaginal gel, Betaisodona vaginal suppositories).

Note: Topical antivirals (Aciclovir, Tromantadin, Penciclovir, Vidarabin etc.) have been shown to be ineffective in genital herpes. They are not indicated for vulvangitis herpetica as primary infection.

Cave! Bacterial or mycotic superinfections.

Internal therapyThis section has been translated automatically.

Primary infection:

  • In severe cases, systemic therapy with aciclovir (Zovirax 200) 5 times/day 1 tbl. every for 5-10 days. Oral therapy is usually sufficient.
  • Alternative: Aciclovir 400mg p.o. 3x daily for 7-10 days.
  • Alternative: If necessary, intravenous therapy with aciclovir can be considered (aciclovir 5 mg/kg bw 3 times/day every 8 hours for 5 days).
  • Alternative: Valciclovir: 500-1000mg p.o./2x/day for 5-10 days.
  • Famciclovir: 250mg p.o. 3x/day for 5-10 days.
  • Patients with immunosuppression: Aciclovir 400mg 4x/day or Zovirax 800mg 5 times/day.

Recurrence:

  • Systemic therapy with aciclovir (Zovirax 200) 2 times/day 1 tbl. for 5-10 days. Oral therapy is usually sufficient.
  • Alternative: Aciclovir 800mg p.o. 3 times/day for 2 days.
  • Alternative: Valciclovir: 500mg p.o./2x/day for 3-5 days.
  • Famciclovir: 125mg p.o. 2x/day once.

Relapse prophylaxis:

  • Systemic therapy with aciclovir (Zovirax 400) 2x/day.
  • Alternative: Valciclovir: 500mg p.o./1x/day
  • Famciclovir: 250mg p.o. 2x/day

Usually, relapse prophylaxis is given for months to years. It is successful in 80% of patients, the recurrences are significantly reduced. Periodic breaks in therapy are necessary to control the recurrence.

Progression/forecastThis section has been translated automatically.

Scarless healing after 2-3 weeks.

LiteratureThis section has been translated automatically.

  1. Corey L et al (2004) Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 350: 11-20
  2. Kaplowitz LG et al (1991) Prolonged continous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infections. JAMA 265: 747-751
  3. Lautenschlager S et al (2000) Herpes genitalis. dermatologist 51: 964-980
  4. Maccato ML (1992) Herpes genitalis. Dermatol Clin 10: 15-22
  5. Villa A et al (2003) Genital herpes infection: beyond a clinical diagnosis. Skinmed 2: 108-112

Authors

Last updated on: 24.05.2022

Author: Prof. Dr. med. Peter Altmeyer