From time to time, virus particles travel distally to the submucosa and skin, sometimes resulting in new vesicles and erosions. In this way, one or more recurrences may occur. Diagnosis Characteristic group of vesicles or ulcerations is highly suggestive. The cytologic changes include ballooned and multinucleated giant epithelial cells, and Cowdry type A intranuclear inclusions. A negative Tzanck or Pap smear is not conclusive for the diagnosis of HSV in critical situations such as infections in pregnant women at term, or in new-borns.
Antiseptic solutions have a drying effect.
Intravenous acyclovir 500 mg eight-hourly is occasionally needed. Recurrences can be suppressed by one acyclovir tablet three times daily. Follow-up Patients with primary herpes should be reviewed at one to three day intervals. All patients should be tested for syphilis and other STDs. Patients on suppressive treatment for recurrences should be seen at one to three month intervals.