herpes simplex labialis

口唇単純ヘルペス

WordNet

1. unornamented; "a simple country schoolhouse"; "her black dress--simple to austerity"
2. any herbaceous plant having medicinal properties
3. (botany) of leaf shapes; of leaves having no divisions or subdivisions (同)unsubdivided
4. having few parts; not complex or complicated or involved; "a simple problem"; "simple mechanisms"; "a simple design"; "a simple substance"
5. having only one part or element; "a simplex word has no affixes and is not part of a compound--like `boy compared with `boyish or `house compared with `houseboat"
6. allowing communication in only one direction at a time, or in telegraphy allowing only one message over a line at a time; "simplex system"
7. relating to or near the female labium
8. of or relating to the lips of the mouth; "labial stops"
9. viral diseases causing eruptions of the skin or mucous membrane
10. any of the animal viruses that cause painful blisters on the skin (同)herpes_virus

PrepTutorEJDIC

1. 『簡単な』容易な,分かりやすい / (複合に対して)単一の / 『単純な』,込み入っていない / 『純然たる』,全くの / 『飾り気のない』,簡素な,地味な,質素な / 『もったいぶらない』;誠実な,実直な / お人よしの,だまされやすい / 《文》地位のない,普通の,平(ひら)の
2. 薬草,薬用植物
3. くちびる(lip)の / 唇音(しんおん)の / 唇音([m][p][b]など)
4. 疱疹(ほうしん)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/11/10 10:52:25」(JST)

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Herpes labialis
Classification and external resources
Herpes labialis of the lower lip. Note the blisters in a group marked by an arrow.
ICD-10	B00.1
ICD-9	054.9
MeSH	D006560

Herpes labialis, (also called cold sores, fever blisters, herpes simplex labialis, recurrent herpes labialis, or orolabial herpes), is a type of herpes simplex occurring on the lip, i.e. an infection caused by herpes simplex virus (HSV). An outbreak typically causes small blisters or sores on or around the mouth. The sores typically heal within 2–3 weeks, but the herpes virus remains dormant in the facial nerves, following orofacial infection, periodically reactivating (in symptomatic people) to create sores in the same area of the mouth or face at the site of the original infection.

Cold sore has a rate of frequency that varies from rare episodes to 12 or more recurrences per year. People with the condition typically experience one to three attacks annually. The frequency and severity of outbreaks generally decreases over time.

Definitions

In medical contexts, "labia" is a general term for "lip"; "herpes labialis" does not refer to the labia of the genitals, though the etymology is the same. When the viral infection affects both face and mouth, the broader term "orofacial herpes" is used to describe the condition, whereas the term "herpetic stomatitis" is used to specifically describe infection of the mouth; "stomatitis" is derived from the Greek word stoma that means "mouth".

Signs and symptoms

Herpes infections usually show no symptoms; when symptoms do appear they typically resolve within two weeks. The main symptom of oral infection is inflammation of the mucosa of the cheek and gums—known as acute herpetic gingivostomatitis—which occurs within 5–10 days of infection. Other symptoms may also develop, including headache, nausea, dizziness and painful ulcers—sometimes confused with canker sores—fever, and sore throat.

Primary HSV infection in adolescents frequently manifests as severe pharyngitis with lesions developing on the cheek and gums. Some individuals develop difficulty in swallowing (dysphagia) and swollen lymph nodes (lymphadenopathy). Primary HSV infections in adults often results in pharyngitis similar to that observed in glandular fever (infectious mononucleosis), but gingivostomatitis is less likely.

Recurrent oral infection is more common with HSV-1 infections than with HSV-2. Symptoms typically progress in a series of eight stages (see viral life cycle):

1. Latent (weeks to months incident-free): The remission period; After initial infection, the viruses move to sensory nerve ganglia (Trigeminal ganglion), where they reside as lifelong, latent viruses. Asymptomatic shedding of contagious virus particles can occur during this stage.
2. Prodromal (day 0–1): Symptoms often precede a recurrence. Symptoms typically begin with tingling (itching) and reddening of the skin around the infected site. This stage can last from a few days to a few hours preceding the physical manifestation of an infection and is the best time to start treatment.
3. Inflammation (day 1): Virus begins reproducing and infecting cells at the end of the nerve. The healthy cells react to the invasion with swelling and redness displayed as symptoms of infection.
4. Pre-sore (day 2–3): This stage is defined by the appearance of tiny, hard, inflamed papules and vesicles that may itch and are painfully sensitive to touch. In time, these fluid-filled blisters form a cluster on the lip (labial) tissue, the area between the lip and skin (vermilion border), and can occur on the nose, chin, and cheeks.
5. Open lesion (day 4): This is the most painful and contagious of the stages. All the tiny vesicles break open and merge to create one big, open, weeping ulcer. Fluids are slowly discharged from blood vessels and inflamed tissue. This watery discharge is teeming with active viral particles and is highly contagious. Depending on the severity, one may develop a fever and swollen lymph glands under the jaw.
6. Crusting (day 5–8): A honey/golden crust starts to form from the syrupy exudate. This yellowish or brown crust or scab is not made of active virus but from blood serum containing useful proteins such as immunoglobulins. This appears as the healing process begins. The sore is still painful at this stage, but, more painful, however, is the constant cracking of the scab as one moves or stretches their lips, as in smiling or eating. Virus-filled fluid will still ooze out of the sore through any cracks.
7. Healing (day 9–14): New skin begins to form underneath the scab as the virus retreats into latency. A series of scabs will form over the sore (called Meier Complex), each one smaller than the last. During this phase irritation, itching, and some pain are common.
8. Post-scab (12–14 days): A reddish area may linger at the site of viral infection as the destroyed cells are regenerated. Virus shedding can still occur during this stage.

The recurrent infection is thus often called herpes simplex labialis. Rare reinfections occur inside the mouth (intraoral HSV stomatitis) affecting the gums, alveolar ridge, hard palate, and the back of the tongue, possibly accompanied by herpes labialis.

A lesion caused by herpes simplex can occur in the corner of the mouth and be mistaken for angular cheilitis of another cause. Sometimes termed "angular herpes simplex". A cold sore at the corner of the mouth behaves similarly to elsewhere on the lips. Rather than utilizing antifungal creams, angular herpes simplex is treated in the same way as a cold sore, with topical antiviral drugs.

Causes

Herpes labialis infection occurs when the herpes simplex virus comes into contact with oral mucosal tissue or abraded skin of the mouth. Infection by the type 1 strain of herpes simplex virus (HSV-1) is most common; however, cases of oral infection by the type 2 strain are increasing. Specifically, type 2 has been implicated as causing 10–15% of oral infections.

Cold sores are the result of the virus's reactivating in the body. Once HSV-1 has entered the body, it never leaves. The virus moves from the mouth to remain latent in the central nervous system. In approximately one-third of people, the virus can "wake up" or reactivate to cause disease. When reactivation occurs, the virus travels down the nerves to the skin where it may cause blisters (cold sores) around the lips, in the mouth or, in about 10% of cases, on the nose, chin, or cheeks.

Cold sore outbreaks may be influenced by stress, menstruation, sunlight, sunburn, fever, dehydration, or local skin trauma. Surgical procedures such as dental or neural surgery, lip tattooing, or dermabrasion are also common triggers. HSV-1 can in rare cases be transmitted to newborn babies by family members or hospital staff who have cold sores; this can cause a severe disease called Neonatal herpes simplex.

The colloquial term for this condition, "cold sore" comes from the fact that herpes labialis is often triggered by fever, for example, as may occur during an upper respiratory tract infections (i.e. a cold).

People can transfer the virus from their cold sores to other areas of the body, such as the eye, skin, or fingers; this is called autoinoculation. Eye infection, in the form of conjunctivitis or keratitis, can happen when the eyes are rubbed after touching the lesion. Finger infection (herpetic whitlow) can occur when a child with cold sores or primary HSV-1 infection sucks his fingers.

Blood tests for herpes may differentiate between type 1 and type 2. When a person is not experiencing any symptoms, a blood test alone does not reveal the site of infection. Genital herpes infections occurred with almost equal frequency as type 1 or 2 in younger adults when samples were taken from genital lesions. Herpes in the mouth is more likely to be caused by type 1, but (see above) also can be type 2. The only way to know for certain if a positive blood test for herpes is due to infection of the mouth, genitals, or elsewhere, is to sample from lesions. This is not possible if the afflicted individual is asymptomatic.

Treatment

Docosanol, a saturated fatty alcohol, is a safe and effective topical application that has been approved by the United States Food and Drug Administration for herpes labialis in adults with properly functioning immune systems. It is comparable in effectiveness to prescription topical antiviral agents. Due to its mechanism of action, there is little risk of drug resistance. The duration of symptoms can be reduced by a small amount if an antiviral, anaesthetic or non-treatment cream (such as zinc oxide or zinc sulfate) is applied promptly.

Effective antiviral medications include acyclovir and penciclovir, which can speed healing by as much as 10%. Famciclovir or valaciclovir, taken in pill form, can be effective using a single day, high-dose application and is more cost effective and convenient than the traditional treatment of lower doses for 5–7 days.

Lysine has been suggested as a treatment for herpes labialis based on in vitro studies, but the evidence is inconclusive in humans.

Prevention

Avoiding touching an active outbreak site, washing hands frequently while the outbreak is occurring, not sharing items that come in contact with the mouth, and not coming into contact with others (by avoiding kissing, oral sex, or contact sports) can reduce the likelihood of the infection being spread to others.

Because the onset of an infection is difficult to predict, lasts a short period of time and heals rapidly, it is difficult to conduct research on cold sores. Though famciclovir improves lesion healing time, it is not effective in preventing lesions; valaciclovir and a mixture of acyclovir and hydrocortisone are similarly useful in treating outbreaks but may also help prevent them.

Oral acyclovir (800-1,600 mg daily) and valacyclovir (500 mg daily for 4 months) are effective in preventing recurrent herpes labialis if taken prior to the onset of any symptoms or exposure to any triggers.

Epidemiology

Herpes labialis is endemic throughout the world. A large survey of young adults on six continents reported that 33.2% of males and 28% of females had herpes labialis on two or more occasions during the year before study. The lifetime prevalence in the United States of America is estimated at 20-45% of the adult population. Lifetime prevalence in France was reported by one study as 32.4% in males and 42.1% in females. In Germany, the prevalence was reported at 31.7% in people aged between 35 and 44 years, and 20% in those aged 65–74. In Jordan, another study reported a lifetime prevalence of 26.4%.

References

UpToDate Contents

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• 1. 免疫正常患者における単純ヘルペスウイルス1型感染の治療 treatment of herpes simplex virus type 1 infection in immunocompetent patients
• 2. 単純ヘルペスウイルス1型感染の臨床症状および診断 clinical manifestations and diagnosis of herpes simplex virus type 1 infection
• 3. 免疫正常患者における単純ヘルペスウイルス1型感染の防止 prevention of herpes simplex virus type 1 infection in immunocompetent patients
• 4. 新生児単純ヘルペスウイルス感染：臨床的特徴および診断 neonatal herpes simplex virus infection clinical features and diagnosis
• 5. 性器単純ヘルペスウイルス感染と妊娠 genital herpes simplex virus infection and pregnancy

English Journal

• HSV-1 clinical isolates with unique in vivo and in vitro phenotypes and insight into genomic differences.

• Danaher RJ1, Fouts DE2, Chan AP2, Choi Y2, DePew J2, McCorrison JM2, Nelson KE2, Wang C3, Miller CS3.
• Journal of neurovirology.J Neurovirol.2016 Oct 13. [Epub ahead of print]
• Strain-specific factors contribute in significant but undefined ways to the variable incidence of herpes simplex virus (HSV) recrudescence. Studies that investigate these strain-specific factors are needed. Here, we used qPCR, in vitro assays, and genomic sequencing to identify important relationshi
• PMID 27739035

• Multiorgan Dysfunction Syndrome from Strongyloides stercoralis Hyperinfection in a Patient with Human T-Cell Lymphotropic Virus-1 Coinfection After Initiation of Ivermectin Treatment.

• Choksi TT1, Madison G2, Dar T3, Asif M4, Fleming K3, Clarke L4, Danilewitz M5, Hennawy R6.
• The American journal of tropical medicine and hygiene.Am J Trop Med Hyg.2016 Oct 5;95(4):864-867. Epub 2016 Aug 15.
• Strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. Herein, we describe the c
• PMID 27527631

• Long-term safety of etanercept in psoriasis: Retrospective study focused on infections.

• Orsini D1, Narcisi A1, Arcese A1, Costanzo A2.
• The Journal of international medical research.J Int Med Res.2016 Sep;44(1 suppl):58-60.
• OBJECTIVE: Retrospective study to evaluate the incidence of infectious adverse events in patients with psoriasis treated with etanercept.METHODS: Patients with psoriasis or psoriatic arthritis who were treated with etanercept (50 mg, administered weekly via subcutaneous injection) for ≥48 weeks
• PMID 27683141

Japanese Journal

• 単純ヘルペスウイルス感染による咽喉頭病変

• 日本気管食道科学会会報 59(3), 347-353, 2008
• NAID 130004469959

• Detection of Herpes Simplex Virus DNA in Serum and Oral Secretions during Acute Recurrent Herpes Labialis

• Journal of dermatology 29(7), 404-410, 2002-07-01
• NAID 10016262036

• Latent Multiple Infections by Herpes Simplex Virus Type 1.

• The Kurume Medical Journal 47(2), 159-164, 2000
• NAID 130000882295

Related Links

• Herpes labialis (Cold sore, Fever blister, Herpes simplex - oral ...

Herpes labialis Cold sore, Fever blister, Herpes simplex - oral, Oral herpes simplex information center covers Definition, Disorders, Overview, Causes, & Risk Factors, Symptoms & Signs, Diagnosis & Tests, Treatment, Support ...

• Herpes labialis (oral Herpes simplex)

Herpes labialis is infection of the lips, mouth, or gums with the herpes simplex virus. It leads to the development of small, painful blisters commonly called cold sores or fever blisters. Herpes labialis is a common disease caused by infection of the mouth area with herpes simplex virus type 1.

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★リンクテーブル★

リンク元	「口唇単純ヘルペス」
関連記事	「simple」「simplex」「labial」

「口唇単純ヘルペス」

　　[★]

英

herpes simplex labialis

「simple」

　　[★]

• adj.

• (比較級simpler-最上級simplest)単純な、簡便な、シンプルな、簡素な、単一の、単一性の、単純性の

関

convenient、mono、parsimonious、plain、simplex、simplicity、simply、single、unity

　 　 　 　 　 　

「simplex」

　　[★]

• adj.

• 単一性の、単式

関

simple

　 　

「labial」

　　[★]

• adj.

• (解剖)唇の、唇状の