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Unusual herpes simplex cases

With the recent burst of sunshine you may be seeing more cases of herpes simplex ­ these GP photographs show a few examples

This patient complained of irritation in his gluteal area, writes Dr Koshy Johnson. He was found to have vesicles which were pustular. The lesions have a surrounding area of erythema and this occurs commonly.

This 14-year-old girl developed these herpes simplex lesions recurrently over the preceding five years, writes Dr Andy Jordan. The lesions tended to occur after a sunny spell and lasted about one week. They resolved leaving an area of redness. Before the lesions developed, she had noted a peculiar tight sensation in the area.

These are herpes simplex lesions frequently induced by ultraviolet radiation.

There is frequently a stinging/abnormal sensation in the prodrome. A differential diagnosis might include discoid lupus, lesions of which are also sun-induced, but the rapid resolution weighs against this diagnosis.

This man was anxious to find out why he suffered this recurrent rash. Some people suggested he recurrently fell over and suffered abrasions. But the rash was always in the same place and was induced by sunlight.

He was reassured when told this was herpes simplex and that wearing a hat and using sunscreen would reduce the likelihood of the eruption recurring. He had been on the golf course two days before this picture was taken.

Recurrent type 1 herpes simplex infections usually occur in the same place each time with this 11-year-old girl, writes Dr John Davies. Untreated they last about

12 days but topical aciclovir cream can shorten an attack.

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