Herpes simplex - 单纯疱疹https://en.wikipedia.org/wiki/Herpes_simplex
单纯疱疹 (Herpes simplex) 是一种由疱疹病毒引起的感染。根据感染部位的不同,可分为口腔疱疹和生殖器疱疹。口腔疱疹常见于面部或口腔,表现为成群的小水疱,通常称为唇疱疹或发烧水疱。生殖器疱疹(常简称为疱疹)可能仅有轻微症状,也可能出现水疱,水疱破裂后形成小溃疡,通常在两至四周内自行痊愈。水疱出现前常伴有刺痛感。首次发作往往更为严重,可能伴随发热、肌肉疼痛、淋巴结肿大和头痛。由疱疹病毒引起的其他疾病包括:手指疱疹瘿疡、眼部疱疹以及新生儿疱疹。

单纯疱疹 (herpes simplex) 病毒有两种类型:1 型 (HSV-1) 和 2 型 (HSV-2)。HSV-1 更常导致口腔周围感染,HSV-2 则更常引起生殖器感染。病毒通过与感染者的直接接触传播,生殖器疱疹属于性传播感染,且可在分娩时传给婴儿。感染后,病毒沿感觉神经向神经细胞体迁移,并终生潜伏。复发常因免疫功能下降、压力或阳光照射等因素触发。

在大多数情况下,仅在症状明显时才使用抗病毒药物。对经常复发的患者,可考虑每日口服抗病毒药物。目前尚无可用于预防单纯疱疹的疫苗,带状疱疹疫苗也不能起到预防作用。使用阿昔洛韦或伐昔洛韦等抗病毒药物可减轻症状并缩短病程。

全球成人中 HSV-1 或 HSV-2 的感染率在 60% 至 95% 之间。HSV-1 多在儿童时期感染。截至 2003 年,估计全球约有 5.36 亿人(约占人口的 16%)感染 HSV-2,女性和发展中国家的感染率更高。大多数 HSV-2 感染者并未意识到自己已被感染。

治疗 - 非处方药
出现水泡时,应避免任何身体接触,例如亲吻儿童,以防将病毒传播给他人。患者应多休息,避免饮酒。
#Acyclovir cream
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  • 嘴唇上的单纯疱疹。
  • 单纯疱疹 (Herpes simplex) —— 手指单纯疱疹感染在幼儿中比成人更常见。
  • 如果症状严重,服用抗病毒药物最能帮助缓解症状。
  • 如果病变出现在嘴周围,需要与angular cheilitis(口角炎)区分。但在这张照片中,更可能是疱疹,因为嘴周围出现了几个小水泡。
  • Herpes gingiva —— 疱疹感染不仅可发生在口腔周围,还可出现在口腔内部、鼻周及眼周区域。
  • 女性生殖器疱疹
  • 臀部疱疹的特点是疲劳时会复发。
  • 如果感染范围较广,可能需要加强治疗,例如带状疱疹。
References Herpes Simplex Type 1 29489260 
NIH
HSV-1感染通过上皮细胞的初次侵入、随后在神经元中的潜伏期以及再次激活而完成。HSV-1通常导致初发和复发性水疱疹,主要出现在口腔和生殖器黏膜上。其临床表现范围广泛,既可表现为口唇疱疹,也可出现疱疹性毛囊炎、皮肤感染、眼部受累,甚至严重的疱疹性脑炎。抗病毒治疗有助于控制HSV-1感染。
Herpes simplex virus type 1 (HSV-1) is a member of the Alphaherpesviridae subfamily. Its structure is composed of linear dsDNA, an icosahedral capsid that is 100 to 110 nm in diameter, with a spikey envelope. In general, the pathogenesis of HSV-1 infection follows a cycle of primary infection of epithelial cells, latency primarily in neurons, and reactivation. HSV-1 is responsible for establishing primary and recurrent vesicular eruptions, primarily in the orolabial and genital mucosa. HSV-1 infection has a wide variety of presentations, including orolabial herpes, herpetic sycosis (HSV folliculitis), herpes gladiatorum, herpetic whitlow, ocular HSV infection, herpes encephalitis, Kaposi varicelliform eruption (eczema herpeticum), and severe or chronic HSV infection. Antiviral therapy limits the course of HSV infection.
 Herpes Simplex Type 2 32119314 
NIH
Herpes simplex virus type 2 (HSV-2) 是一种常见感染,约 22% 的 12 岁及以上成年人受到影响,美国约有 4500 万成年人感染。虽然 HSV-1 通常导致口腔溃疡,但也可能引起生殖器病变。然而,当出现生殖器病变时,HSV-2 通常是主要致病因素。HSV-2 发作的症状常不典型,如生殖器瘙痒、刺激感,容易导致误诊或延迟治疗。诊断延迟可能增加向未感染者传播的风险。
Herpes simplex virus type 2 (HSV-2) continues to be a common infection, affecting approximately 22% of adults ages 12 and older, representing 45 million adults in the United States alone. While HSV-1 often affects the perioral region and can be known to cause genital lesions, HSV-2 is more commonly the consideration when patients present with genital lesions. Despite this, most outbreaks of the infection will present with nonspecific symptoms such as genital itching, irritation, and excoriations, which may cause diagnosis and treatment to be delayed. As a result, further exposure to uninfected individuals may occur.
 Prevention and Treatment of Neonatal Herpes Simplex Virus Infection 32044154 
NIH
Herpes simplex virus (HSV) 通常会导致青少年和成人出现生殖器疱疹和唇疱疹等感染。当在出生后 4-6 周内感染 HSV 的婴儿,可能会出现严重疾病并导致严重后果。快速诊断新生儿 HSV 感染对于阻止疾病恶化、预防神经系统并发症(甚至死亡)至关重要。
Herpes simplex virus (HSV), a member of the Herpesviridae family, is a well-known cause of infections including genital herpes and herpes labialis in the adolescent and adult population. Transmission of HSV infection to an infant during the first 4-6 weeks of life can lead to devastating disease with the potential for poor outcomes. Early diagnosis is imperative when evaluating neonatal HSV infection in order to prevent further disease progression, neurological complications, and even death.
 Herpes simplex virus infection in pregnancy 22566740 
NIH
Herpes simplex 感染很常见,可由孕妇传染给婴儿。该病毒可导致新生儿出现严重健康问题,甚至死亡。虽然在孕期罕见,但在分娩时常见。若母亲在妊娠后期感染,风险最高。不过,在某些情况下,可通过使用抗病毒药物或选择剖腹产来降低风险。
Infection with herpes simplex is one of the most common sexually transmitted infections. Because the infection is common in women of reproductive age it can be contracted and transmitted to the fetus during pregnancy and the newborn. Herpes simplex virus is an important cause of neonatal infection, which can lead to death or long-term disabilities. Rarely in the uterus, it occurs frequently during the transmission delivery. The greatest risk of transmission to the fetus and the newborn occurs in case of an initial maternal infection contracted in the second half of pregnancy. The risk of transmission of maternal-fetal-neonatal herpes simplex can be decreased by performing a treatment with antiviral drugs or resorting to a caesarean section in some specific cases.
 Clinical management of herpes simplex virus infections: past, present, and future 30443341 
NIH
Herpes simplex virus (HSV) 1 型和 2 型感染影响全世界许多人。通常,病毒感染皮肤后会潜伏于神经细胞中,但稍后可能重新激活,导致唇疱疹。有时,它会引起严重问题,如眼部感染、脑炎,或在新生儿及免疫功能低下者中出现危及生命的情况。虽然目前的药物有助于控制感染,但耐药性和副作用的风险仍令人担忧。我们需要研发新药,以更有效地针对该病毒。
Infection with herpes simplex virus (HSV) types 1 and 2 is ubiquitous in the human population. Most commonly, virus replication is limited to the epithelia and establishes latency in enervating sensory neurons, reactivating periodically to produce localized recurrent lesions. However, these viruses can also cause severe disease such as recurrent keratitis leading potentially to blindness, as well as encephalitis, and systemic disease in neonates and immunocompromised patients. Although antiviral therapy has allowed continual and substantial improvement in the management of both primary and recurrent infections, resistance to currently available drugs and long-term toxicity pose a current and future threat that should be addressed through the development of new antiviral compounds directed against new targets.