Access Dermatology

Summary

The global prevalence of genital herpes is estimated to be 10%, with an annual estimated incidence of 20 million. Genital herpes may present clinically in both typical and atypical fashion, although transmission occurs most commonly during periods of asymptomatic shedding. Stress has recently been correlated with acute outbreaks. Polymerase chain reaction technology may soon supplant viral culture as a means of diagnosis. Type-specific serology may be utilized to establish a diagnosis in the absence of lesions. Acyclovir and related agents remain drugs of choice for management of genital herpes, and various strategies exist to treat acyclovir-resistant strains. While still controversial, the administration of antiviral drugs during the third trimester of pregnancy is becoming the de facto standard of care in many countries. Condom use clearly reduces, but does not eliminate, the risk of herpes acquisition.