Management of Herpes Labialis Triggered by Stress

Abstract

Introduction : Herpes Labialis is the most common form of orofacial herpes, beginning with a feeling of vesicle formation at the vermilion margin of the lips and the surrounding area within 24 hours and then rupture, superficial erosion occurs which is then covered with crusts. Herpes labialis occurs in 50-75% of individuals exposed to HSV-1 infection in the oral cavity and often has a recurrence followed by prodromal symptoms. Reactivation can occur due to triggers in the form of decreased immune conditions due to weather changes, fever, sun exposure, emotional stress, trauma, menstruation, systemic diseases, allergies, and immunosuppression. Case: 22 years old female with a complaint of a wound on the angular lip, initially the patient had a fever for 2 days then a fluid-filled blister appeared which then rupture. Case Treatment: The diagnosis is made using anamnesis, clinical and supporting examination. CBC and Antybody Titer HSV-1 show value under normal for eosinophil and reactive for IgG HSV-1 established. Patient take medicine topical antiinflammation 3 time a day and multivitamins 1 time a day. Discussion: HSV-1 infektion is latent and can reaktivation. Under Stress Condition can caused a reduced circulating population of immune cells such as IL-6, TNFα, Lymphocites B, NK cell, dan Monocytes which HSV-1 Reactivation. Conclucion: Management in case can be successful if the clinician understand HSV-1 Infection Manifestation and added Suporting Examination. In Addition, cooperation from the patien is needed to manage stress so that the disease no more recurrence.

Diagnosis and Treatment of Recurrent Herpes Labialis: A Case Report

“…Reactivation of the latent phase of HSV-1 in these patients is possibly due to increased levels of endogenous corticosteroids produced by the adrenal cortex during times of stress. Under conditions of stress, both physical and psychological, it causes a reduction in circulating immune cell populations such as cytokines (IL-6, TNFα) B lymphocyte cells, NK cells, (Ganesha et al, 2021).…”

“…It can increase the patient's immune system through adequate intake of the vitamins. Multivitamins needed and prevent the occurrence of functional metabolic disorders that cause reduced vitamin intake also accelerates the change of proline and lysine residues in procollagen to hydroxyproline and hydroxylysine in collagen synthesis (Ganesha et al, 2021;Haryana et al, 2022). This process is very important for speed up the healing process.…”

“…Stressful conditions in patients can occur both physically and emotionally, these stressful conditions can trigger the reactivation of the HSV-1 virus. During stressful conditions there will be a decrease in CD4 T cells and CD8 T cells so that they cannot protect the body from the latent HSV-1 virus and reactivation occurs (Ganesha et al, 2021). Handling in cases of HSV-1 virus infection includes causative therapy and supportive therapy.…”

Stress as Trigger Factor of HSV-1 Reactivation Causing Recurrent Intraoral Herpes Mimicking HAEM: A Case Report

“…19 Anti-HSV IgG antibody titers usually increase 1-2 weeks after primary infection, peak in 6-8 weeks after infection. 20 …”

“…19 Anti-HSV IgG antibody titers usually increase 1-2 weeks after primary infection, peak in 6-8 weeks after infection. 20 Antiviral treatment decreases HSV subclinical shedding, considerably lowering transmission. 21 This virus cannot be removed from the body after it has been ingested, but effective treatment can lower the virus load, one of them using analogs of viral nucleosides like acyclovir.…”