What is HSV?
HSV stands for herpes simplex virus. This pathogen causes common infections leading to herpes labialis, genital herpes, herpes whitlow, and keratitis. The virus belongs to the herpesviridae family, with the two main types being HSV-1 and HSV-2. Both types can cause genital and orofacial infections. However, HSV-1 usually leads to mouth infection, while HSV-2 mainly involves genital infections. [1, 2, 3].
HSV is a major sexually transmitted disease globally. In 2016, more than half of the global population between 15 and 50 years had HSV-1, and one in ten had HSV-2 [4, 5].
What causes HSV?
HSV infection is caused by the herpes simplex viruses 1 and 2 [6].
HSV-1 is commonly linked to oral infection and cold sores but can also infect the genitals [7, 8]. It can be contracted by direct contact with a herpes sore, saliva, and other secretions. The infection can be transmitted by sharing eating utensils, kissing, and lipstick sharing [9].
On the other hand, HSV-2 typically causes genital herpes. However, it can also lead to oral infection and cold sores [7, 8]. The genital infection by HSV is sexually transmitted, but the virus is also found in saliva, vaginal secretion, and semen [10].
Generally, the virus is transmitted by people who do not have any symptoms and are unaware that they are carriers [5].
How to diagnose and treat HSV?
Diagnosis of impetigo
A doctor often diagnoses an HSV infection based on symptoms and physical examination. A mixture of blisters and sometimes symptoms like tingling and burning with flu-like symptoms is indicative [5].
The definitive confirmation comes from an HSV culture. To perform this laboratory test, the physician takes a fluid swab and sents it for culture for the virus [5].
Another method to confirm HSV exposure is an antibody test. However, it is not accurate until 12 months after the exposure [5]. Therefore, other laboratory techniques, such as different biochemical assays, microscopy, and nucleic acid amplification, can be used to determine an HSV infection [11].
Treatment of impetigo
The treatment of HSV includes antiviral medication, home remedies, and lifestyle changes. However, the therapy depends on the virus type [12].
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What is impetigo?
Impetigo is a bacterial infection that affects the superficial epidermis of the skin. It occurs most frequently in children between 2 and 6 years of age, but it can affect anyone [13, 14].
Typically, impetigo is caused by Staphylococcus aureus or Streptococcus pyogenes bacteria. The infection often begins with minor cuts or insect bites that interrupt the continuity of the skin [15, 13].
Two main forms of impetigo are nonbullous and bullous. Nonbullous impetigo accounts for about 70% of cases. It is characterized by ulcers or erosions with crusts. Bullous impetigo makes up the remaining 30% of cases. This type of impetigo presents with bullae or blisters that are filled with fluid [15, 16].
Impetigo is highly contagious. It can spread by direct contact with the infected part of the skin. The early symptoms are red, pimple-like sores with red skin around them. Usually, the infection happens on the legs, arms, and face. With the advancement of the disease, the sores fill with pus, which eventually leaks out, forming a crust. Often, the sores are itchy. However, scratching them can contribute to the spread of the bacteria [13].
What causes impetigo?
Impetigo is caused mainly by two types of bacteria: Staphylococcus aureus and Streptococcus pyogenes [17].
Impetigo is highly contagious and spreads via direct contact with the infected region. However, it can also be transmitted by touching the towels, sheets, and clothes of the infected person [14].
Among the factors that increase the risk of impetigo are:
- living in a warm and high-humidity climate,
- having diabetes mellitus,
- being immunocompromised,
- having dermatological conditions like dermatitis, psoriasis, eczema, sunburns and other burns, scabies, HVS,
- practicing contact sports [14].
How to diagnose and treat impetigo?
Diagnosis of impetigo
The diagnosis of impetigo is usually based on appearance. The dermatologist looks for identification marks, like the honey-colored crusts on lesions. The bacterial culture is normally done only when the impetigo does not respond to treatment [14].
Treatment of impetigo
As impetigo is a bacterial infection, the therapy is based on antibiotics. They can be given orally or in topical form. In the case of localized and uncomplicated non-billous impetigo, topical treatment is sufficient. The medications recommended are retapamulin, mupirocin, and fusidic acid. However, before the antibiotics are applied, the pus and crusts have to be removed from the lesions with water and soap [18, 19].
Systemic antibiotics should be taken in cases of severe non-bullous and bullous impetigo. Treatment of choice includes cephalosporins (like cephalexin), amoxicillin-clavulanate dicloxacillin, and penicillin [18, 19].
When impetigo is caused by MRSA-confirmed bacteria, the treatment should consist of clindamycin or doxycycline [18, 19].
In all cases of impetigo, lesions can be covered with bandages to prevent the spread of the infection [20].