The most common clinical presentation of herpes simplex viruses (HSVs) are the recurring skin lesions of the facial and genital skin that follow a primary infection. Certain individuals have regular recurrences, while others who are infected never have overt clinical lesions. These secondary lesions occur because the herpesviruses have the ability to establish latent infection in sensory nerve ganglia despite measurable host immune response. Various triggers reactivate the latent virus, which then replicates and travels to the skin via the sensory nerve. The factors that determine individual susceptibility to recurrent herpetic lesions are, at this time, unknown. This chapter will focus on recognizable recidivans lesions; however, comments about the primary phase and asymptomatic shedding in the absence of overt lesions will be included.
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