Herpes on the pubis: routes of infection and effective treatment.

Herpes on the pubis appears as a result of infection with the corresponding virus.

There are types 1 and 2 of herpes simplex.

Herpetic lesions on the pubis are usually caused by the second type.

The source of infection is a virus carrier or a person with herpes.

It is transmitted sexually.

There are also other methods of transmission.

Infection is possible through close household contact.

However, if the elements of the rash are located predominantly on the pubis, infection most likely occurred during sexual intercourse.

Genital herpes on the pubis

Initially, the herpes virus, penetrating the body, begins to multiply exactly where it penetrated the skin.

Bubbles form there.

These are vesicles - morphological elements that are small cavities with clear liquid.

The virus subsequently enters the circulatory system.

It invades nerve endings and ganglia.

The herpes virus will persist for life in autonomic nerve cells and can cause exacerbations.

It leads to a decrease in immunity, as it affects immunocompetent cells.

If herpes is localized on the pubis and genitals, then the main reservoir of the virus is the ganglia of the lumbosacral spine.

The infection can have a different clinical course.

Sometimes a person who has had genital herpes never suffers from it again.

But in 40% of cases recurrent herpes develops.

It can occur at any age.

Pubic herpes may appear again after a few months or years.

The causes are provoking factors:

insolation (tanning)
hypothermia
injury
serious disease
drinking alcohol
hormonal disorders

Most often, recurrent herpes develops as a local process.

That is, rashes appear on the pubis again and again.

But the rash does not spread to other parts of the body.

Sometimes genital herpes becomes generalized.

It can affect different areas of the skin, organs, including the brain.

Rash on the genitals

The causes of rashes on the genitals can be very different. Among them, a special group consists of sexually transmitted diseases. In addition to them, the rash can be a consequence of fungal infections, inflammatory, dermatological and oncological diseases.

There are many types of rashes. Let's name the main ones:

ulcers containing cloudy liquid;
bubbles also containing liquid;
erythema (purple spot raised above the skin);
chancre (has a rough bottom and hard edges);
plaques (small blistering rash);
papule (a node rooted deep in the skin, but rising above it at the exit);
vesicle (contains liquid, often blood);
pustule (has the shape of a vesicle containing pus).

What does pubic herpes look like?

Classic herpes consists of blisters with liquid on the skin.

They often appear not only on the pubis, but also on other areas of the skin and mucous membranes.

Vesicles are formed in groups.

They are located asymmetrically.

Appear on hyperemic skin.

The vesicles resolve spontaneously after an average of 3 days.

In their place, either erosions or ulcers form.

More often these are erosions, and they are more favorable.

Because ulcers leave behind scars, because they are associated with damage to the deeper layers of the skin.

Main patient complaints:

burning sensation on the pubis
pain
edema
enlarged lymph nodes

Local and general symptoms of herpes on the pubis

After the initial infection, as well as with each relapse, rashes appear on the pubic area.

Herpes also gives general symptoms.

They are as follows:

hyperthermia
weakness
enlarged lymph nodes
their soreness

This condition occurs with general viremia.

That is, it is caused by the herpes virus entering the circulatory and lymphatic system.

This occurs when the human immune system is unable to localize the process.

Herpes on the pubis can be primary or recurrent.

Primary is the one that arose for the first time.

It is caused by a fresh infection from another person (sexual partner).

Recurrent is a form of the disease that develops as a result of activation of herpes.

The virus remains latent for a long time.

Then it “wakes up” and causes an exacerbation with the re-formation of a rash on the pubis.

Recurrence of herpes occurs without previous sexual contact with the source of infection.

Since the virus is already in the patient’s body.

Based on the symptoms, genital herpes can be:

typical
atypical
asymptomatic

After infection, two scenarios are possible.

The first is that the person does not feel symptoms.

He becomes a carrier of the virus, but is unaware of it.

Second, a stormy clinical picture arises.

Herpes is much more severe than subsequent relapses, if any.

The shorter the incubation period, the stronger the symptoms.

Its duration is up to 10 days.

Sometimes the incubation period lasts only 2-3 days.

Then an acute herpetic infection can last up to 1 month or more.

The typical form of genital herpes is characterized by:

formation of erythema (red spots)
the appearance of vesicles
their resolution with the formation of erosions
epithelialization

With recurrent herpes, subjective sensations appear a day or two before the next relapse.

The patient suffers from itching of the pubic skin, pain, and the skin may turn red.

Sometimes general symptoms such as fever and malaise appear.

Lymph nodes may enlarge before the rash appears.

Molluscum contagiosum in men

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The size of the papules can reach from several millimeters to 1.5 cm in diameter. With slight pressure, a mushy substance emerges from the center of the papupules white contents. It is worth noting that the papules are painless, do not itch and do not cause any concern as such, except perhaps only aesthetically. However, you can evaluate this point for yourself in the
photo of molluscum contagiosum in men
.
The following routes of transmission of the virus are distinguished:
1. Contact and household More common in children. Children go to kindergarten, school, swimming pool, where there are a lot of them, where they are constantly in contact with each other.
Where they share toys. And children’s attitude to personal hygiene is not the most responsible. 2. Sexual. More common in adults. Molluscum contagiosum in men is a sexually transmitted infection. Papules are most often localized on the external genitalia, inner thighs, pubis, or lower abdomen. Molluscum contagiosum occurs and molluscum contagiosum in the groin in men .
Molluscum contagiosum in men is a sexually transmitted infection.

If the examination of the hips and pubis does not present any difficulties, then the examination of the external genitalia should be approached with increased care.
Do not forget to expose the head of the penis, examine the inner layer of the foreskin and the external opening of the urethra, because molluscum contagiosum on the glans in men is not so uncommon.
And also, due to the increase in same-sex sexual intercourse, it is necessary to examine the anus. In order to avoid relapses after treatment, it is necessary to examine and, if necessary, treat the man’s sexual partner. And it should be remembered that molluscum contagiosum is contagious as long as there is a rash. And at this time, you should avoid sexual contact, carefully observe hygiene, and thoroughly clean the apartment. 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In order to avoid relapses after treatment, it is necessary to examine and, if necessary, treat the man’s sexual partner.
The diagnosis of molluscum contagiosum is made after a thorough examination. 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Enlarged lymph nodes due to herpes pubis

With herpes, the inguinal lymph nodes increase in size.

This occurs after the initial infection.

And also whenever the infection recurs.

Enlarged lymph nodes are often unilateral.

They may be painful when palpated.

Swelling of the skin and redness over the lymph nodes and blood vessels are often noted.

Atypical forms of herpes on the pubis

It is much more difficult to diagnose herpes on the pubis if there is an atypical form of the disease.

Atypical is a form in which:

the cycle of formation of morphological elements changes
non-standard location of lesions
subjective sensations prevail over objective symptoms of herpetic infection

Abortive form - characterized by rapid regression of rashes immediately after their appearance.

It often occurs in patients who receive antiherpetic therapy in a timely manner.

The next exacerbation is usually preceded by a prodromal period.

Over time, patients learn to recognize it.

As soon as the condition worsens, the body temperature rises, the pubis itches, they take medications.

As a result, a classic exacerbation does not develop.

The rash may present as:

papules
red spot on swollen skin
microerosions

Quite quickly the skin clears up and the exacerbation passes without really starting.

Edema form - there are no rashes, but only hyperemia and swelling.

Itchy form - the leading symptom is itching.

In the hemorrhagic form, blisters containing blood rather than clear liquid appear.

In the subclinical form, there are no rashes, but only cracks in the skin.

Itching of the genitals

Itching in the genital area may have the following localization:

on the skin of the genital organ (both in individual places and over all surfaces);
inside the genital organ (usually accompanied by a burning sensation and other pain, as well as various kinds of pathological discharge);
on the head of the penis (may also be accompanied by burning and pain).

The causes of itching can be divided into 3 groups:

External influence (violation of hygiene standards, poor quality of underwear, allergic reactions, stressful situations, mechanical damage, etc.).
Sexually transmitted diseases (male thrush (candidiasis), balanitis (balanoposthitis), trichomoniasis, genital herpes, gonorrhea, ureaplasmosis, etc.).
Diseases of the genitourinary system (urethritis, cystitis, etc.).

Pubic herpes and pregnancy

Herpes is dangerous during pregnancy.

Although external manifestations may be localized only on the pubis, in fact, pathological processes also affect the internal reproductive organs.

According to some studies, herpes provokes up to 30% of all cases of spontaneous abortions in the early stages of gestation.

This is the cause of half of late miscarriages.

In terms of the degree of negative impact on the fetus, herpes ranks second after rubella.

In addition, a mother can infect her child with this virus.

Infection occurs both in utero and during childbirth.

Any relapse of herpetic infection in pregnant women is subject to treatment.

If herpes occurs on the pubis before 34 weeks, drug prevention is indicated.

It is necessary to prevent the child from becoming infected.

Acyclovir is prescribed in the last 4 weeks before birth.

If infection or exacerbation occurs after 34 weeks, this is an indication for cesarean section.

Diagnosis and treatment

At an appointment with a doctor, the patient is interviewed and examined. To identify the cause of pain in the pubic area in men, blood is drawn in the treatment room. Then you have to donate urine for testing. The analysis allows you to determine the level of leukocytes, hemoglobin, ESR and other indicators indicating the development of pathology.

Additionally, they attend an ultrasound of the pelvic organs and x-ray examination. Antibacterial and anti-inflammatory treatment is used, analgesics and vitamins are prescribed.

Contacting the specialists of our clinic is a real opportunity to receive well-designed therapy. Doctors have sufficient experience in identifying and eliminating all pathologies that cause pain in the pubis. Our own laboratory and fully equipped technical equipment accompany the recovery of each patient.

Complications of herpes on the pubis

Herpes in most cases has a mild or moderate clinical course.

But sometimes seemingly harmless pubic rashes ultimately lead to serious complications.

At risk are elderly and weakened patients, people with immunodeficiencies.

Herpes can cause:

inflammation of the ENT organs and bronchitis
meningoencephalitis
myocarditis and coronary heart disease
inflammation of the digestive tract

Treatment of herpes on the pubis

The principles of herpes therapy are as follows:

Destroying the virus with antiviral drugs
Normalization of the immune system

Treatment goals may vary.

Usually they are as follows:

stopping another exacerbation of infection
relapse prevention
preventing infection of sexual partners or a child (from a pregnant woman)
prevention of complications

Treatment is carried out on an outpatient basis.

Rarely, hospitalization is required.

Indications for it:

complications of the brain or spinal cord
generalized herpetic infection
individual intolerance to antiviral drugs against the background of severe herpes

Drugs that are used for herpes pubis:

acyclovir
famciclovir
valacyclovir

Studies do not show benefits for any drugs.

They all have the same mechanism of action.

The efficiency is comparable.

The differences relate mainly to cost and ease of use.

The most convenient to use is valacyclovir.

It can be taken less frequently than other drugs of this pharmacological group.

The doctor chooses the treatment regimen.

It depends mainly on the clinical course, form and severity of herpes pubis.

Treatment takes the longest for primary infection.

The course of therapy for relapse may be somewhat shorter, since it usually proceeds more easily.

How to treat

Therapy depends on the disease and the type of pathogen. Initially, you need to seek help from a doctor - a dermatologist, gynecologist or venereologist. The doctor conducts a visual examination, collects anamnesis, and prescribes the necessary laboratory tests. Once the results are received, a diagnosis will be made.

Treatment of genital herpes lasts from two weeks to two months. Patients are prescribed antiviral drugs - Acyclovir, Valacyclovir. Additionally, you need to take a vitamin complex and immunomodulators. In parallel with the use of tablets, you need to use local ointments - Zovirax, Panavir. Complex treatment helps to cope with ulcers, and the disease goes into remission for a long time.
Sebaceous cysts and boils are usually removed surgically. The doctor gives an injection, opens the cavity of the abscess under local anesthesia and cleans it. Then stitches are applied if the pimple is large. The patient is recommended to take a five or seven-day course of antibiotics, this will avoid complications. Surgery allows you to get rid of the blister permanently.
When diagnosing scabies, it is necessary to use local remedies. Usually these are ointments that cause the death of parasites. They are produced on the basis of benzyl benzoate. Sulfur ointment and products with pyrethroids also help in therapy. Additionally, it is necessary to maintain personal hygiene and change underwear regularly. Before starting treatment, it is necessary to disinfect bedding and clothing to destroy all larvae.
For head lice, topical preparations based on permethrin or phenothrin are used. Additionally, household items are treated with special sprays to kill lice.
If blisters in women or men are caused by allergies, then it is necessary to limit contact with irritants and take antihistamines: Zodak, Zyrtec, Suprastin. The duration of the course and dosage are prescribed by the attending physician.
Psoriasis requires regular comprehensive treatment. Tablets for oral administration and ointments for topical use (they are used to lubricate plaques) are prescribed as medications.

It is not recommended to treat acne with traditional methods, since they will not be able to influence the causative agent of the disease. If necessary, it is allowed to use folk advice as an additional treatment, but after consulting a doctor.

Conclusion

Pubic ulcers in men and women cause unpleasant symptoms, they depend on the specific disease. The ulcers hurt, itch, and cause discomfort when walking. Treatment is prescribed depending on the disease and the microorganisms that caused the blisters.

For bacterial infections, antibiotics are used, for viral infections, antiviral agents are used. If we are talking about fungal diseases, then antimycotic ointments are prescribed.

Drug prevention of herpes

Drug prophylaxis can be emergency or planned.

Emergency is performed after unprotected sexual intercourse.

Planned - in advance.

Emergency drug prevention for herpes is ineffective.

Even if a person receives medications immediately after coitus, this will not reduce the risk of infection.

The symptoms of herpes will be much less pronounced.

Perhaps they won't appear at all.

But the pathogen will still penetrate the body.

It will persist in the nerve ganglia and may cause exacerbation in the future.

Planned prevention is effective.

The source of the infection should receive the drugs, not the person who may become infected.

Prevention of herpes infection in the family

It happens that one spouse suffers from herpes on the pubis, and the second is healthy.

Naturally, he does not want to get infected.

In such cases, planned drug prophylaxis can be used.

Valaciclovir can be used for this.

It is prescribed 0.5 g, once a day.

Two schemes are possible.

The first is used for constant, the second - for occasional sexual intercourse.

The patient chooses the regimen.

The decision depends on how often sex is practiced in the family.

If it is regular, then the drugs must be taken constantly and continuously.

If sex is episodic, then valacyclovir should be used 3 days before planned contact.

This use of the drug allows you to protect your healthy partner from infection.

Herpes pubis: why do you need a vaccine?

We are all accustomed to the fact that vaccines against viral infections are administered for preventive purposes.

The body develops immunity, and a person does not become infected with a particular disease.

But the herpes vaccine is curative.

It has been used for decades.

Although the drugs are constantly being improved.

The vaccine is a killed virus.

The use of vaccinations is indicated for recurrent genital herpes.

Vaccination helps to form specific immunity due to antigenic stimulation of the body.

Antibodies are produced that prevent relapses.

Indications for use of the vaccine:

elderly age
concomitant HIV infection
severe exacerbations of herpes
frequency of exacerbations more than 3 times a year
established immunodeficiency conditions

Complications

If left untreated, the disease can lead to complications. Genital herpes and psoriasis will constantly recur. Dermatological or fungal skin lesions gradually affect large areas of the skin. With lice or scabies, parasites can spread throughout the body.

In addition, the skin becomes more vulnerable, and secondary infections are possible. In this case, the integument swells and hurts greatly. In case of an abscess, surgical intervention, opening of the abscess and taking antibiotics are urgently required.

Maintenance therapy for herpes

Suppressive or maintenance therapy is continuous antiviral treatment.

It is used in severe cases when relapses occur too often.

The essence of this treatment is the continuous use of antiviral drugs.

Can be used:

acyclovir – twice a day, 0.2 g
famciclovir – 0.25 g once daily
valacyclovir – once a day 0.5 g

The duration of suppressive therapy is determined individually.

The number and severity of relapses are taken into account.

Patients may receive this treatment for years.

If the doctor cancels it, the further clinical course of herpes is assessed by two relapses.

If the disease worsens, suppressive therapy can be resumed.

Immune drugs for herpes

As we have already found out, there are drugs that destroy the herpes virus.

Despite this, immunomodulatory therapy is used for this disease.

Why is it needed?

Firstly, in order to reduce the number of relapses.

Few people want to receive antiviral drugs constantly and continuously.

It is much easier to normalize the immune system so that it can resist viruses on its own.

Secondly, herpes itself causes secondary immunodeficiency.

Therefore, patients who present with pubic rashes often complain of frequent respiratory infections.

They may develop ulcers.

The following changes are found in the blood:

decrease in the number of T-lymphocytes
decrease in CD4 count - both during exacerbation and during remission
increased CD8
in severe cases, the level of IgA (immunoglobulins of the mucous membranes) decreases

The number of circulating immune complexes increases significantly during an exacerbation.

Subsequently, the body’s defense response is exhausted.

If you have recurrent herpes, patients should:

take an immunogram
consult an immunologist
receive immunomodulatory therapy

In this case, the relapse rate will be lower.

Exacerbations of herpes on the pubis with normal immunity are much easier.

Treatment

Pre-hospital assistance

A woman with a suspected pelvic fracture should be placed on a backboard with her legs bent and a pillow placed under them. The pelvic bones should be secured by wrapping a scarf or sheet. To prevent traumatic shock, it is recommended to warm up with a blanket, drink plenty of warm drinks, and take an anesthetic. Fractures and suspicion of an interrupted tubal pregnancy are indications for immediately calling an ambulance.

Conservative therapy

Therapeutic tactics are determined by the cause of the development of pain in the pubis:

Injuries.
Upon admission, intrapelvic anesthesia is administered; in the case of isolated pubic bone fractures, local anesthetic administration is possible. The fixation option is chosen taking into account the type of injury; a shield or a hammock is used, or in severe cases, skeletal traction. Painkillers are used, and antibiotics are prescribed for open injuries. During the rehabilitation period, patients are referred to exercise therapy, massage and physiotherapy.
Osteomyelitis.
The basis of therapy is antibiotics, which are selected taking into account the sensitivity of the pathogen and administered intramuscularly or intravenously. Analgesics are used. In case of severe intoxication, infusion therapy is carried out. Dressings are carried out, the wound is washed and drained.
Symphysitis.
To eliminate hypocalcemia, calcium supplements are prescribed, and vitamin D and magnesium supplements are used to improve the absorption of the microelement. To eliminate aseptic inflammation, NSAIDs are recommended. Non-drug methods include magnetic therapy, wearing a bandage, and special exercise therapy complexes. An adequate choice of obstetric care tactics is required, taking into account the severity of the pathology.
Endometritis.
The first priority is to fight the infection with antibacterial agents. In case of severe intoxication, protein and saline solutions are administered intravenously. Immunomodulators, antihistamines, and multivitamin complexes are prescribed. To eliminate bleeding and reduce pain in the acute period, cold and hormonal drugs are used. After the condition improves, medicinal electrophoresis, UHF, magnetic therapy, and ultrasound therapy are useful.
Endometriosis.
Conservative treatment is carried out in case of asymptomatic or mild symptoms during premenopause, if it is necessary to restore or preserve reproductive function. Hormone therapy is carried out with combined estrogen-progestogen agents, gestagens, antigonadotropic drugs, gonadotropic releasing hormone agonists.
Cystitis.
The treatment regimen includes antibiotics from the groups of fluoroquinolones, nitrofurans, macrolides, cephalosporins and non-fluorinated quinolones. Uroseptics, NSAIDs, and combined herbal remedies are used. Intravesical instillations are performed. Inductothermy, UHF, and iontophoresis are performed.
Detrusor tuberculosis.
Treatment is carried out with anti-tuberculosis drugs and fluoroquinolones. Additionally, NSAIDs and angioprotectors are prescribed to reduce the severity of inflammation and prevent cicatricial changes in the urinary tract.

For adnexitis and salpingitis, antibiotics, anti-inflammatory drugs, and physiotherapy are used. For oncological lesions alone or as part of combination therapy, including radiation therapy and chemotherapy in the pre- and postoperative period.