Epidemiologic, clinical findings and risk factors of recurrent herpes labialis in healthy adult patients: a case-control study

Year 2019, Volume: 5 Issue: 3, 545 - 549, 04.05.2019

Mohammad Nassaji , Raheb Ghorbani Ramin Taheri Maryam Azizzadeh Fatemeh Abbassyan

https://doi.org/10.18621/eurj.384806

Cited By: 1

Abstract

Objectives: Herpes labialis is a common viral infection and
characterized by recurrent vesicular lesion primarily on the lips and perioral
skin. The
aim of this study was to determine the epidemiological, clinical characteristics and trigger
factors associated with recurrence
herpes labialis
in adult patients.

Methods:
This case-control study was
conducted with the participation of one hundred adult patients and the same
number of control. Data collected about demographics, clinical, as well as
trigger factors from individuals
who met inclusion criteria.

Results:
Seventy-four percent of cases and 34% of controls were female that showed
significant difference (p <
0.001). Mean body mass index of patients was significantly higher than controls
(25.9 ± 2.9 kg/m² versus 22.0 ± 2.9 kg/m², p < 0.001). The most common location of the
lesions during the last episode of infection was upper lip (65%). The number of lesions was single
in 58% and multiple in 42% of patients. The frequency of
episodes per year was more than two attacks each year in most patients (83%). Positive family history of recurrence
herpes labialis
was found in 50% and 20% of cases and controls respectively (p < 0.001). Emotional stress (61%), sunlight exposure (54%) and flu
(37%)
were the main triggering factors reported by the patients.

Conclusions: This study revealed that recurrence herpes
labialis is more common in women and on the upper lip. Family history of recurrence herpes
labialis was positive significantly in patients. The most common trigger
factors were stress,
sunlight exposure, flu. Higher body mass index was a probable risk factors for recurrence herpes
labialis. 

Keywords

Recurrence herpes labialis, adult, epidemiology, trigger factors

References

• [1] Whitley RJ, Roizman B. Herpes simplex virus infections. Lancet 2001;12;357:1513-8.
• [2] Fatahzadeh M2, Schwartz RA. Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007;57:737-63; quiz 764-6.
• [3] Arduino PG, Porter SR. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. J Oral Pathol Med 2008;37:107-21.
• [4] Worrall G. Herpes labialis. BMJ Clin Evid 2009;2009. pii: 1704.
• [5] Higgins CR, Schofield JK, Tatnall FM, Leigh IM. Natural history, management and complications of herpes labialis. J MedVirol 1993 41(Suppl 1):22-6.
• [6] Siegel MA. Diagnosis and management of recurrent herpes simplex infections. J Am Dent Assoc 2002;133:1245-9.
• [7] Fatahzadeh M, Schwartz RA. Human herpes simplex labialis. Clin Exp Dermatol 2007;32:625-30.
• [8] Dreno B, Malkin JE, Saiag P. Understanding recurrent herpes labialis management and impact on patients’ quality of life: The HERPESCOPE study. Eur J Dermatol 2013;23:491-9.
• [9] Glick M. Clinical aspects of recurrent oral herpes simplex virus infection. Compend Contin Educ Dent 2002; 23:4-8.
• [10] Alfvén G, Nilsson S. Validity and reliability of a new short verbal rating scale for stress for use in clinical practice. Acta Paediatr 2014;103:e173-5.
• [11] Milner JJ, Beck MA. The impact of obesity on the immune response to infection. Proc Nutr Soc 2012;71:298-306.
• [12] Dobner J, Kaser S. Body mass index and the risk of infection - from underweight to obesity. Clin Microbiol Infect 2018;24:24-28.
• [13] Bernstein KT, Jacobson LP, Jenkins FJ, Vlahov D, Armenian HK. Factors associated with human herpesvirus type 8 infection in an injecting drug user cohort. Sex Transm Dis 2003;30:199-204.
• [14] Löwhagen GB, Bonde E, Eriksson B, Nordin P, Tunbäck P, Krantz I.Self-reported herpes labialis in a Swedish population. Scand J Infect Dis 2002;34:664-7.
• [15] Shulman JD, Carpenter WM, Lewis DL. The prevalence of recurrent herpes labialis during an Army hot weather exercise. J Public Health Dent 1992;52:198-203.
• [16] Katz J, Chaushu G, Peretz B. Recurrent oral ulcerations associated with recurrent herpes labialis – two distinct entities? Community Dent Oral Epidemiol 2001;29:260-3.
• [17] Embil JA, Stephens RG, Manuel FR. Prevalence of recurrent herpes labialis and aphthous ulcers among young adults on six continents. Can Med Assoc J 1975;113:627-30.
• [18] Celik M, Sucakli MH, Kirecci E, Ucmak H, Ekerbicer HC, Ozturk P. Recurrent herpes labialis among health school students in Kahramanmaras, Turkey: a cross-sectional survey. Dermatol Sin 2013;31:64-7.
• [19] Shulman JD.Recurrent herpes labialis in US children and youth. Community Dent Oral Epidemiol 2004;32:402-9.
• [20] Lorette G, Crochard A, Mimaud V, Wolkenstein P, Stalder JF, El Hasnaoui A. A survey on the prevalence of orofacial herpes in France: the INSTANT Study. J Am Acad Dermatol 2006;55:225-32.
• [21] Axéll T, Liedholm R.Occurrence of recurrent herpes labialis in an adult Swedish population. Acta Odontol Scand 1990;48:119-23.
• [22] Sawair FA, Jassim ZA, Malkawi ZA, Jamani KD. Epidemiologic aspects of recurrent herpes labialis among Jordanian university students. Saudi Med J 2010;31:808-13.
• [23] Azodo CC, Umoh AO. Herpes labialis among dental healthcare providers in Nigeria. Indian J Dent 2015;6:116-20.
• [24] Chi CC, Wang SH, Delamere FM, Wojnarowska F, Peters MC, Kanjirath PP. Interventions for prevention of herpes simplex labialis (cold sores on the lips). Cochrane Database Syst Rev 2015;(8):CD010095.
• [25] Stock C, Guillén-Grima F, de Mendoza JH, Marin-Fernandez B, Aguinaga-Ontoso I, Krämer A. Risk factors of herpes simplex type 1 (HSV-1) infection and lifestyle factors associated with HSV-1 manifestations. Eur J Epidemiol 2001;17:885-90.
• [26] Chida Y, Mao X. Does psychosocial stress predict symptomatic herpes simplex virus recurrence? A meta-analytic investigation on prospective studies. Brain Behav Immun 2009;23:917-25.
• [27] Sainz B, Loutsch JM, Marquart ME, Hill JM. Stress-associated immunomodulation and herpes simplex virus infections. Med Hypotheses 200;56:348-56.
• [28] Freeman ML, Sheridan BS, Bonneau RH, Hendricks RL. Psychological stress compromises CD8+ T cell control of latent herpes simplex virus type 1 infections. J Immunol 2007;179:322-328.