ABSTRACT
Clinical aspect: Primary herpes simplex (HS) is characterized by significant morbidity, long duration, general symptoms (fever, malaise, and myalgia), and significant local pain. After an incubation period ranging from 1 to 3 weeks, multiple and often clustered vesicles of approximately 0.5–0.8 mm in diameter, surrounded by erythema and edema, appear on the labia, vaginal introitus, and perineal area (Figures 4.1.1 and 4.1.2); subsequently, blisters may erode, leaving polycyclic abrasions (Figures 4.1.3 through 4.1.5) or shallow and tender ulcers (Figures 4.1.6 and 4.1.7). Frequent cervical and urethral involvement causes vaginal and urethral discharge, dysuria, and, sometimes, urinary retention. Inguinal lymph nodes are enlarged and tender. Multiple clustered blisters: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_1.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Shallow ulcers resulting from vesicle abrasion: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_2.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Polyciclic abrasion due to rupture of clustered herpetic blisters with surrounding erythema. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_3.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Policyclic abrasions with prominent erythema: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_4.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Policyclic abrasion with surrounding erythema: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_5.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Multiple ulcerations in a dark-skinned patient: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_6.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/> Extensive ulcerations in a dark-skinned patient: herpes simplex. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429160967/163b7f5e-cc4b-49c3-bdf2-114d4fa08aec/content/fig4_1_7.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/>
