Herpes is painless and itchy? What are the symptoms of herpes?

Herpes is mainly caused by the herpes simplex virus, which often invades the junction of the skin and mucous membranes. The rash is localized clustered small blisters. The virus is latent for a long time and recurs repeatedly. So what are the symptoms of various types of herpes?

1. Oral herpes: Herpes and ulcers appear on the oral mucosa, tongue, gums, and pharynx, and may affect the esophagus. The patient has local pain, refuses to eat, and drools. It may be accompanied by fever and enlargement of submandibular and/or cervical lymph nodes. It is more common in children and young people.

2. Skin herpes: It is common at the junction of skin and mucous membrane, such as the edges of the lips, corners of the mouth, and around the nostrils. Initially, the local skin will feel itchy, burning or stinging, followed by congestion and redness, and later clusters of blisters the size of needle tips or rice grains will appear with a slightly red base. The blisters do not merge with each other, but multiple clusters of blisters may appear at the same time. The blister wall is thin and the blister fluid is clear. It will spontaneously rupture, erode, and exude fluid in a short period of time, and then dry and form a scab after 2-10 days. No scars will be left after the scab falls off.

3. Genital herpes: mainly caused by HSV-Ⅱ infection. The skin of the genitals, perineum, around the vulva, thighs and buttocks may occur, with herpes, ulcers and pitting erosions. In men, it often occurs in the glans penis, foreskin, coronal sulcus, and penis, and may also affect the scrotum; in women, it is more common in the labia majora and minora, clitoris, vagina, and cervix, and may also affect the urethra. Homosexuals with a history of anal intercourse may develop herpetic proctitis, followed by purulent infection of the anus and rectum or inguinal lymphadenitis.

4. Ocular herpes: manifested as simple herpes keratitis and conjunctivitis, mostly unilateral, often accompanied by herpes or edema on the affected eyelid and enlarged preauricular lymph nodes. Recurrent attacks may cause corneal ulcers, opacities, and even perforations leading to blindness. Chorioretinitis may occur in neonates and patients with AIDS.

5. Herpetic scrofula: HSV on the fingers is a complication of primary oral or genital herpes. The virus can enter through damaged epithelial cells of the fingers or directly enter the epidermis of the fingers due to occupational or other reasons. Herpes lesions often occur on the distal knuckles and penetrate into the nail bed to form honeycomb necrosis. Therefore, the local pain is severe and throbbing, often accompanied by fever, cubital and axillary lymphadenitis. Dentists and nurses who frequently come into contact with herpes patients with their bare hands are at risk of contracting the disease.

6. Herpetic eczema: It is caused by HSV infection in patients with chronic eczema, dermatitis and other lesions, and is easily misdiagnosed as an aggravation of the original eczema. The virus may suddenly infect the skin in the affected area and its surrounding areas, or spread through the bloodstream, affecting other important organs and causing the condition to worsen.

7. Disseminated herpes simplex: Disseminated HSV infection is more common in children aged 6 months to 3 years, and can also be seen in people with primary or secondary immunodeficiency (suppression). The initial symptoms are severe herpetic gingivitis, esophagitis, or vulvovaginitis, high fever, and even convulsions, followed by widespread blisters on the body with umbilical depressions on the blister tops. Viremia may also occur, causing herpetic hepatitis, encephalitis, pneumonia, gastroenteritis, adrenal dysfunction and other visceral damage.

8. Neonatal herpes: 70% of neonatal HSV infections are caused by HSV-II, which is caused by contact with genital secretions at birth; congenital infection is often caused by primary HSV infection in mothers during pregnancy, leading to intrauterine infection of the fetus. Fetuses infected in utero may be born prematurely, or have congenital malformations or intellectual disabilities, which is the so-called "TQRCH" syndrome. Neonatal HSV infection may present asymptomatic latent infection, or may cause clinical manifestations of different forms or degrees. Mild cases only present with oral, skin, and eye herpes, while severe cases present with central nervous system infection or even systemic disseminated infection.