Management of mucocutaneous herpes simplex virus infections

Herpes simplex virus type 1 and 2 are causes of common inflammatory conditions of the mucous membranes and skin. The proper management of these infections begins with an accurate diagnosis. Viral cultures should be performed whenever possible. Patients should be counselled regarding the proper care of lesions, the risk of complications, the likelihood of experiencing recurrent infection, and should be urged to avoid intimate contact while lesions are active. Antiviral therapy is now available to ameliorate the symptoms and shorten the duration of infection in selected patients, but does not prevent recurrences. Topical, oral and intravenous preparations of acyclovir are effective in treatment of primary herpes simplex infections. Immunosuppressed patients with herpes simplex infections also benefit from acyclovir therapy. Oral activity has some activity in ameliorating recurrent genital herpes and should be considered for patients who are particularly troubled by their infections.