Definition And Description

The vesicles of Herpes labialis are small in size, not usually exceeding one line in diameter. They are situated on a reddened and slightly inflamed base, appear upon either the upper or lower lip or upon both, or clustered about the angle of the mouth. The vesicles usually rupture on the second or third day, leaving a denuded surface. If the serum which filled them is not wiped away it dries into a thin transparent scale or crust. This remains attached for a day or two longer and then drops off, leaving a slightly reddened mark, which gradually fades away, without leaving any trace behind. The eruption may be unilateral or bilateral, more frequently the former. The affecttion is rarely painful, a little heat or pruritus being usually the extreme limit of incon-venience.

Diagnosis

The only affections with which Herpes labialis are likely to be confounded are, first, a well-defined disease known as Zoster, and second, certain anomalous vesicular affections which are included under the provisional name of Hydroa. The differential diagnosis between Herpes labialis and Zoster is best appreciated by an analytical comparison of the two:

Herpes Is frequently bilateral.

May attack frequently.

Little pain, but alight sensation of heat or itching.

Vesicles small. Fluid usually transparent. Vesicles usually rupture in a day or two.

Duration four to ten days. Lesion superficial.

Never leaves cicatrices.

Zoster.

Is unilateral (with very rare exceptions).

Occurs but once in a patient's life (with rare exceptions).

Neuralgic pain. often severe in the course of one of the nerves underlying the eruption.

Vesicles large.

Fluid often opaque

Vesicles often persist until the fluid is absorbed.

Duration two to four weeks.

Lesion deeper, often extends to the corium.

Often leaves cicatrices.

Prognosis

The affection is a trivial one and the prognosis is always good.

Etiology

Herpes labialis often ocurs at the close of some mild fe-brile affection or during the course of an acute catarrhal one. and has re-ceived the common names of "fever-sore" and "cold-sore." Beyond this we know nothing as to its etiology.

Treatment

Herpes labialis usually requires little, if any treatment.

At most a drop or two of tincture of camphor, or a little simple da powder may be applied, if the surface is moist or weeping. Some persons are more subject to the affection than others, that is, they have an attack on the slightest provocation. If this tendency to frequent attacks could be controlled, it would be a great convenience to them. Unfortunately I do not know of any means of doing it.