Skin Diseases

Skin Diseases

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Herpes Simplex Virus: Genital Infections

Genital herpes (GH) is a chronic sexually transmitted viral infection, characterized by asymptomatic viral shedding. In most cases, both primary infection and recurrences are asymptomatic. When symptomatic, primary GH may present with grouped vesicles at the site of inoculation associated with significant pain and regional lymphadenopathy. When aware of GH, individuals may notice mild symptoms, uncommonly of recurring outbreaks of vesicles at the same site. Most symptoms from GH relate to the psychological stigma of having a chronic transmissible STD. Neonates are susceptible to HSV infection when exposed perinatally, with risk of significant morbidity and mortality.


HSV infection is transmitted through close contact with a person shedding virus at a peripheral site, mucosa surface, or secretion. HSV is inactivated promptly at room temperature; aerosol or fomitic spread unlikely. Infection occurs via inoculation onto susceptible mucosal surface or break in skin. Subsequent to primary infection at inoculation site, HSV ascends peripheral sensory nerves and enters sensory or autonomic nerve root ganglia, where latency is established. Latency can occur after both symptomatic and asymptomatic primary infection. Recrudescences may be clinically symptomatic or asymptomatic.


Most people who are infected with HSV never develop any symptoms. When symptoms do occur, they vary widely from person to person. Symptoms of a first episode of genital herpes usually appear within two to 10 days of exposure to the virus and last an average of two to three weeks. Early symptoms can include:

* Itching or burning sensation.
* Pain in the legs, buttocks, or genital area.
* Vaginal discharge.
* Feeling of pressure in the abdominal region.

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