复旦大学：《皮肤病学 Dermatology》课程教学资源（PPT课件）性传播疾病 Sexually transmitted diseases（2/2）

Sexually transmitted diseases(2) Lianjun Chen Huashan Hospital

Sexually transmitted diseases（2） Lianjun Chen Huashan Hospital

Genital Herpes

Genital Herpes

Definition &e etiology Genital herpes, or Herpes progenitalis, is a sexually transmitted disease(STD) which is mainly caused by the herpes simplex viruses type 2(HSV-2). HSV can cause blister erosion and sores, which appear in and around the skin or mucous membranes of the genital area The pathogen is herpes simplex viruses (HSV) HSV-type 2,90% HSV-type1,10%

Definition & Etiology Genital herpes , or Herpes progenitalis, is a sexually transmitted disease (STD) which is mainly caused by the herpes simplex viruses type 2 (HSV-2). HSV can cause blister、erosion and sores, which appear in and around the skin or mucous membranes of the genital area. The pathogen is herpes simplex viruses （HSV） – HSV－ type 2， 90％。 – HSV－ type 1，10％

Transmission Epidemiology way of infection: the sex contact infection is the main path of the Gh source of infection: the patients and nonsymptomatic virus carrier of gh mode of infection: HSV-1 is often transmitted by droplet and saliva Hsv-2 is chiefly transmitted by sex contact Genital herpes is one of the most common sexually transmitted viral diseases in Euro-American The incidence of GH is higher in the Hiv patients

Transmission & Epidemiology way of infection: the sex contact infection is the main path of the GH source of infection：the patients and nonsymptomatic virus carrier of GH mode of infection: HSV-1 is often transmitted by droplet and saliva,HSV-2 is chiefly transmitted by sex contact Genital herpes is one of the most common sexually￾transmitted viral diseases in Euro-American The incidence of GH is higher in the HIV patients

Clinical menifestation Primary genital herpes The latency is averagely 3-5 days The eruption starts with erythema and papules that develop rapidly into crops of vesicles, produce erosion or ulcer after vesicles rupture The lesions are often extensive and bilateral inguinal lymph nodes can be enlarged with tenderness Flu-like symptoms, such as fever, headache and systemic malaise may be also be present. Patients often complain about incandescence and pain in the involved area, together with dysuria Sometimes neurologic involvement The disorder lasts between 2-3 weeks

Clinical menifestation Primary genital herpes – The latency is averagely 3~5 days. – The eruption starts with erythema and papules that develop rapidly into crops of vesicles,produce erosion or ulcer after vesicles rupture. – The lesions are often extensive and bilateral inguinal lymph nodes can be enlarged with tenderness. – Flu-like symptoms, such as fever, headache and systemic malaise may be also be present. Patients often complain about incandescence and pain in the involved area, together with dysuria. – Sometimes neurologic involvement. – The disorder lasts between 2－3 weeks

Clinical manifestation Recurrent genital herpes It recurs for 5-8 times in the first year and less frequently in the years that follow Patients infected by hsv-1 less frequently suffer from recurrence than those by hsv-2 The duration may be 7 days The signs and symptoms of recurrent lesions are mild The recurrences of GH are triggered by trauma, fatigue, infection, menstrual or cold onset, and so on

Clinical manifestation Recurrent genital herpes – It recurs for 5~8 times in the first year and less frequently in the years that follow. – Patients infected by HSV-1 less frequently suffer from recurrence than those by HSV-2. – The duration may be 7 days. – The signs and symptoms of recurrent lesions are mild. – The recurrences of GH are triggered by trauma, fatigue, infection, menstrual or cold onset, and so on

hsv carcinomas cervicis Researches of recent years report that HSV-II is associated with the development of carcinoma cervicis, here are the evidences Women with GH correlate with a higher incidence of cervical cancer women with GH have higher sero-positive for HSV-II antibody HSV-I antigen found in the carcinoma cervicis cells The dna of HSv-l cultured in histiocyte can transform the hamster cells into cancer cells

HSV & Carcinomas cervicis Researches of recent years report that HSV-Ⅱ is associated with the development of carcinoma cervicis, here are the evidences: – Women with GH correlate with a higher incidence of cervical cancer . – women with GH have higher sero-positive for HSV-Ⅱ antibody – HSV-Ⅱ antigen found in the carcinoma cervicis cells. – The DNA of HSV-Ⅱ cultured in histiocyte can transform the hamster cells into cancer cells

Diagnosis and accessory examinations Diagnosis can be based on history of unprotected sexual contact with high-risk sexual partner(s)or history of HsV infection of partner(s) typical clinical manifestations. Differential diagnosis include chancre chancroid Behcet's syndrome Both virologic(cell culture/PCR assay)and type- specific serologic tests are of value in confirmation of the infection

Diagnosis and accessory examinations Diagnosis can be based on – history of unprotected sexual contact with high-risk sexual partner(s) or history of HSV infection of partner(s) – typical clinical manifestations. Differential diagnosis include – chancre – chancroid – Behcet’s syndrome Both virologic (cell culture / PCR assay) and type￾specific serologic tests are of value in confirmation of the infection

Treatment Systemic antiviral drugs can partially control the signs oy and symptoms of herpes episodes when used to treat first clinical and recurrent episodes or when used as daily suppressive therapy Systemic antiviral drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued

Treatment Systemic antiviral drugs can partially control the signs and symptoms of herpes episodes when used to treat first clinical and recurrent episodes, or when used as daily suppressive therapy. Systemic antiviral drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued