A patient after a trip to Bangkok has developed fever and perioral vesicles, diagnosis is:
Ans. (a) Herpes simplex.* Notice the grouped vesicles with lesions showing umbilication which is a presentation of primary herpes gingivo- stomatitis.* Primary episode is quite distressing for the patient with fever constitutional symptoms and small eroded painful lesions on lips oral mucosa and perioral area.* Impetigo presents with honey colored crusts on the skin and is ruled out.* Molluscum contagiosum is caused by pox virus infection and produces crops of dome shaped papules with umbilicated center on body which are asymptomatic.* In the question patient has fever and location of vesicles is peri-oral and trip to a place known for sex tourism which favors diagnosis of herpes simplex.
Herpes simplex
Impetigo
Molluscum contagiosum
Bullous pemphigoid
S.T.D.