Cold Sore

WhatIs ?

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WhatCauses ?

Clinical Presentations Of

Complication Of

Treatment Options For

Prevention Of

What Is Cold Sore?

Herpes Simplex Virus (HSV) type 1 causes cold sore. It is a common viral infection which tends to be transmitted mostly through direct exposure/contact.

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Cold Sore
Cold Sore Samples
Cold Sore
Cold sore Virus HSV
Cold Sore
What Causes Cold Sore?

HSV1 gets transmitted by direct contact with infected saliva or secretion. After initial infection, the virus tends to become dormant in dorsal root ganglion. HSV is reactivated either spontaneously or by a trigger such as emotional stress, ultraviolet light, fever, local tissue damage, or immunosuppression

Clinical Presentations Of Cold Sore
    • Prodrome: fever with painful lymphadenopathy, burning & tingling sensation
    • HSV presents as grouped vesicles (small fluid filled blister) over erythematous (red) base, umbilicated with scalloped border.
    • It usually resolves in 2-6 weeks, recurrent with less severity and shorter duration
    • Gingivostomatitis (inflammation of gingiva), pharyngitis & mono-like syndrome can develop
    • Ulcerated lesions over buccal mucosa and gingivae
    • Edema & painful oropharyngeal ulcerations can cause dysphagia & drooling
    • Immunocompromised hosts would have recurrent herpes infection involving intraoral “soft” mucosa
Complication Of Cold Sore
    • Eczema herpeticum
      • Herpes infection over eczema lesions, burns, pemphigus, Darier disease, Hailey-Hailey disease, Mycosis Fungoides & Sezary syndrome
      • Rapid widespread infection of HSV which may be associated with fever, myalgia which can get complicated by superimposed bacterial infection
    • Ocular HSV infection
      • Usually in newborns
      • If it is not treated, it can cause corneal ulceration and scaring, globe rupture and blindness
    • Neonatal HSV infection
      • It can involve skin, eye, CNS and multiple internal organs
      • Encephalitis and seizure are indication of CNS infection
Treatment Options for Cold Sore

Prescription

  • Topical medications
    • Acyclovir 5% ointment for limited mucocutaneous lesions in immunocompromised patients
  • Systemic therapy
    • Acyclovir & Valacyclovir as oral regimens
    • Acyclovir treatment within 24-72 hrs would reduce duration & severity of infection
    • Chronic suppressive therapy for patients with at least 6 outbreaks per year
    • Foscarnet is the only antiviral drug approved by FDA for treatment of acyclovir-resistant HSV
    • IV acyclovir for neonatal HSV, severe infections in immunocompromised hosts, severe eczema herpeticum & patients with systemic complications
    • In immunocompromised patients, treat until the lesions are completely healed
Prevention Of Cold Sore
  • Prophylactic oral acyclovir for patients who have at least 6 outbreaks per year
  • Reduce stress as well as sun exposure to face (especially sun burn)
  • Avoid direct contact with a patient with active cold sore

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Herpes Simplex Virus (HSV) type 1 causes cold sore. It is a common viral infection which tends to be transmitted mostly through direct exposure/contact.