What are the clinical manifestations of herpes?

Herpes can be divided into shingles, genital herpes, and herpes simplex. Most of them are caused by viral infections. Small blisters will appear on the skin surface. At first, the skin will itch, and then the blisters will appear. Generally, they will heal themselves after one or two weeks.

1. Common symptoms

Small yellow-white or translucent blisters appear on the skin surface, often in patches and filled with fluid. Smallpox, chickenpox, etc. have this symptom; the pathogen is a virus, which often occurs on the upper lip or face. The symptoms are local itching first, and then the appearance of blister-like protrusions containing transparent fluid, which is slightly painful, and scabs will heal on their own after one or two weeks.

2. Causes of Herpes

1. Acantholysis (30%):

Due to the degeneration of intercellular bridges (desmosomes and tension filaments, etc.) in the epidermis, the cells lose their tight connection and become loose, thus forming cracks, blisters or blisters in the epidermis. Acantholysis can be caused by autoimmune factors, such as pemphigus. Acantholysis caused by genetic factors is seen in chronic familial benign eczema and keratosis follicularis.

2. Basal cell liquefaction (20%):

Basal cell liquefaction refers to the cavitation or fragmentation of epidermal basal cells. In severe cases, the basal cell layer disappears and the spinous cells are in direct contact with the dermis. Immune, genetic and drug allergies are often the causes of basal cell liquefaction, which is seen in hereditary epidermolysis macrocarcinoma, systemic lupus erythematosus, dermatomyositis, etc. The causes of basement membrane lesions are autoimmune and genetic. Watery dysentery diseases caused by basement membrane lesions include pemphigoid carcinoma, herpes gestationis, dermatitis herpetiformis, etc.

3. Balloon degeneration and reticular degeneration (15%):

Due to intracellular edema, the volume of epidermal cells increases, forming a balloon shape. The cells swell and rupture, and the adjacent remaining cell membranes connect into multiple reticular septa, finally forming multilocular ulcers, which are more common in viral infectious skin diseases.

4. Spongioedema (15%):

Boils are formed due to the widening of the intercellular spaces caused by the increase of intercellular fluid. They are seen in eczema, contact dermatitis, and sweat herpes.

5. Vasculitis (10%)

It is mostly caused by immune complex type allergic reaction, and ulcers are formed due to inflammation and necrosis of tissues, such as allergic vasculitis. Behcet's disease, acute febrile neutrophilic dermatosis, etc.