Herpesvirus
Wang L. Cheung, MD, PhD
Key Facts
Terminology
Infection by herpes virus (HSV1, HSV2, and VZV)
Clinical Issues
Clear fluid-filled vesicles that heal well, usually on mucosa sites (lip, eyes, genitals)
For zoster, fever and malaise, then grouped vesicles in a dermatome distribution (area of skin supplied by same sensory ganglia)
Microscopic Pathology
Multinucleated keratinocytes with chromatin margination and molding
Top Differential Diagnoses
Erythema multiforme
Hand-foot-mouth disease
Cytomegalovirus
Orf (ecthyma contagiosum)
 Herpes simplex presents as grouped, painful, vesicles  on a red base on the upper lip. |
 Histologically, herpesvirus infections show multinucleated cells with chromatin margination and molding  . |
TERMINOLOGY
Synonyms
Herpetic dermatitis
Herpetic whitlow (hands)
Eczema herpeticum (herpes + atopic dermatitis)
Definitions
Infection by herpesvirus (HSV1, HSV2, and varicella zoster virus [VZV])
ETIOLOGY/PATHOGENESIS
Infectious Agents
Patients infected by fluids from infected person containing HSV1 and HSV2
Enter mucosa or disrupted epidermis, then enter sensory ganglia and stay dormant or cause re-infection
CLINICAL ISSUES
Epidemiology
Incidence
58% of USA population with HSV1
Approximately 17% of USA population with HSV2
Higher for African Americans (39.2%) and higher for females (20.9%)
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