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Annales de Dermatologie et de Vénéréologie
Vol 129, N° 4-C2  - avril 2002
pp. 597-602
Doi : DERM-04-2002-129-4-C2-0151-9638-101019-ART13
Herpès non génital de l'adulte. Clinique, valeur diagnostique de la clinique, évolution

[1]  Service des Maladies Infectieuses et Tropicales — Hôpital Pitié-Salpêtrière — Paris.


Le spectre de l'herpès non génital de l'adulte (oeil et immunodéprimé exclus) inclut toutes les formes d'herpès cutané, les autres localisations muqueuses (anale, nasale, buccale) et l'érythème polymorphe. La valeur de la clinique et de l'évolution pour le diagnostic de ces différentes localisations herpétiques est surtout influencée par la localisation de l'infection. Dans les sites classiques (oral, labial, anal) et les formes cliniques typiques (vésiculeuse, érosive puis croûteuse), le diagnostic des primo-infections et des récurrences repose sur des données cliniques et anamnestiques. Dans les localisations atypiques (herpès cutané localisé, herpes cutané diffus, surinfection herpétique), le diagnostic doit parfois s'appuyer sur les examens complémentaires. Un traitement antiviral se discute dans certaines formes pour des raisons épidémiologiques ou pronostiques.

Non-genital herpes simplex virus infections in adults. Clinical aspects, accuracy of clinical signs and evolution

The clinical spectrum of non-genital herpes simplex virus infections (excluding ocular localisations and immunosuppressed patients) includes all the clinical forms of cutaneous herpes, the other mucous membranes locations (anal, nasal, oral), and erythema multiform. The predictive value of the clinical signs and the course of the disease, for the diagnosis of herpes infection, vary greatly according to the localisation of the disease. The diagnosis of the forms associated with the most common locations (oral, labial, anal) and characteristics signs (vesicules, erosion, crusts), whatever it is a primary infection or a recurrence, relies on clinical and epidemiological grounds. In contrast the diagnosis of cutaneous locations (localised cutaneous herpes, herpes gladiatorium, eczema herpeticum and other dermatoses complicated by herpes infection) may rely on complementary exams given the lack of sensitivity of clinical signs. Nonetheless treatment might be started before the results of these exams due to the contagiosity and the severity of some of these forms of herpes infections.

© 2002 Elsevier Masson SAS. Tous droits réservés.
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