Herpes Simplex and Zoster — Skin MCQ — NEET PG Practice Question | NEETPGAI
Herpes Simplex and Zoster — Skin
easy
hand Dermatology
A 28-year-old woman presents with recurrent painful vesicles on the lower lip and perioral region. She reports a prodrome of tingling and burning 12 hours before lesion appearance. Which is the most common site of recurrent herpes simplex virus (HSV) infection in immunocompetent individuals?
A. Genital region
B. Fingertips and dorsal hands
C. Buttocks and sacral region
D. Lips and perioral region
Explanation
Most Common Site of Recurrent HSV Infection
Key Point
The lips and perioral region (herpes labialis) represent the most common site of recurrent HSV-1 infection in immunocompetent individuals, accounting for approximately 60–70% of all recurrent HSV episodes.
Pathophysiology of Recurrence
Recurrent HSV infection occurs due to reactivation of latent virus in the trigeminal ganglion (for orofacial HSV) or sacral ganglia (for genital HSV). The virus travels along sensory nerve axons to the skin, causing characteristic vesicular eruptions at the same anatomical site repeatedly.
Clinical Features of Herpes Labialis
Table
Feature
Details
Prodrome
Tingling, burning, or pain 12–24 hours before lesion appearance
Lesion morphology
Grouped vesicles on erythematous base
Duration
7–10 days from vesicle to crusting to healing
Frequency
Highly variable; ranges from once yearly to monthly
Highest viral shedding site — Trigeminal ganglion (CN V) is the largest and most frequently reactivating sensory ganglion.
2.
Frequent minor trauma — Lips are exposed to environmental stress (sunlight, wind, friction).
3.
Epidemiological prevalence — HSV-1 is acquired early in life (often by age 5) via oral secretions; genital HSV-2 acquisition occurs later and less universally.
High-YieldNEET PG
In immunocompetent patients, herpes labialis is the clinical hallmark of HSV recurrence. Genital HSV recurs more frequently in HSV-2 seropositive individuals but remains less common overall than orofacial disease.
Clinical Pearl
The presence of a prodrome (tingling, burning) is pathognomonic for recurrent HSV and allows patients to initiate topical or systemic antivirals before vesicles appear, reducing lesion severity and duration.
Robbins 10e Ch 8
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