Genital vesicles are caused by the herpes simplex virus (HSV), with 90% caused by HSV-2 and 10% by HSV-1. Genital herpes has become one of the most common sexually transmitted diseases in Europe and America. In China, it ranks fifth in the incidence of sexually transmitted diseases. HSV-2 is almost exclusively transmitted through sexual contact. The disease can follow a chronic recurrent course, and there is currently no cure. HSV has become the leading cause of genital ulcers in many countries and regions, while also being linked to the etiology of cervical carcinoma and serving as a source of neonatal vesicle disease outbreaks.

bubble_chart Clinical Manifestations

1. Primary infection: In initial infections, 80-90% are subclinical infections, with only a minority being symptomatic. After recovery from the initial infection, most cases transition to latent infection.
2. Primary infection, also known as first-episode infection, has an incubation period of 1 to 45 days, averaging 6 days. At this stage, no HSV antibodies are present in the serum, and systemic symptoms such as fever, headache, fatigue, myalgia, and inguinal lymphadenitis are common. Scattered bilateral lesions appear in the genital area, manifesting as painful erythema, papules, chickenpox-like vesicles, pustules, erosions, and ulcers. These symptoms last 1–2 weeks, with lesions typically crusting and healing within 3–4 weeks.
3. Non-primary infection refers to cases with a history of HSV infection and positive serum HSV antibodies. Symptoms are milder than in primary infections. Additionally, patients previously infected with HSV-1 exhibit fewer systemic symptoms and faster healing of genital vesicles compared to those experiencing their first genital HSV infection.
4. Latent infection and recurrence: The virus remains in a latent state within the host for long periods. About 90% of first-episode HSV-2 infections experience at least one recurrence within 12 months (averaging 4 recurrences). Recurrences may be triggered by factors such as fever, menstruation, sunlight exposure, cold, or certain viral infections.
5. Other HSV infections: These include rectal, anal, and digital infections (herpetic whitlow), as well as infections in pregnant women, fetuses, and newborns. Recent studies suggest a strong association between HSV-2 infection and the development of cervical cancer.

bubble_chart Diagnosis

1. History of unclean sexual intercourse;
2. Genital skin and mucosal erythema, papules, chickenpox-like lesions, erosions, ulcers;
3. May have systemic symptoms with spontaneous pain;
4. Laboratory tests show positive HSV antigen/antibody and isolation of vesicular virus.

bubble_chart Treatment Measures

Principles of Treatment

1. Currently, there is no particularly effective method. Treatment can alleviate symptoms and suppress recurrence, but it cannot eradicate latent viral infections;
2. Acyclovir is the first choice.

1. Acyclovir has proven efficacy. For those with frequent recurrences, continuous use for 6-12 months is recommended;
2. Topical application of general anti-inflammatory acyclovir cream or antiseptic cleaning solutions can prevent secondary infections;
3. The efficacy of interferon is not well-established and should be used as appropriate.

bubble_chart Cure Criteria

1. Cure: The damage subsides, scabs form, and heals in about 3 weeks. The skin lesions completely disappear with no clinical symptoms;
2. Improvement: Skin lesions subside by 30%, symptoms are alleviated;
3. No cure: Skin lesions subside by less than 30%, clinical symptoms persist.