Headache is a constant problem that lasts during most of the episode. The discomfort is often in the front portion of the head but seems diﬂicult to deﬁne. It is persistent. Sleep makes little difference; a patient will complain of the headache on going to bed and on arising. It is not severe and can usually be controlled by aspirin every 4 to 6 hours.
HERPES LESIONS IN WOMEN
The ﬁrst symptoms to appear in the genital type of Herpes in women are the usual ones of headache, enlarged lymph nodes, and a mild fever. Sores in the mouth may or may not be present. Burning on urination is common. These symptoms all may appear before the sensitivity begins in the genital area.
The ulcers of the disease may be multiple or there may be just a few. A ﬁnding of only one sore is not unusual. The lesions may be distributed widely over the perineum and the vulva, from the monsveneris (in front, where the hair is), over the clitoris, the labia, and the forchet (the area between the posterior portion of the vagina and the anus). Sores may be noted to each side toward the thighs. Lesions in the area of the anus are not uncommon.
The typical lesions of Herpes in women are about one centimeter or one fourth “of an inch in diameter and are extremely painful to the touch. The pain is particularly severe in sores which are located on the labia (the lips of the vagina) or the clitoris (the structure that is in front of the vagina and is highly supplied with nerves).
When the labia are involved with the disease process, they may swell to twice the normal size blood cells. The layer is hard and, at ﬁrst, ﬁrmly adherhent to the underlying ulcer.
In six or seven days the crusts begin to fall oﬁ. This process is nearly completed in forty-eight hours. There may be a small amount of bleeding when the crusts separate. Left behind is a patch of inﬂammation roughly identical in size and shape to the area of vesiculation. In an indeﬁnite number of days the redness fades and the lesions disappear.
Lymph node enlargement follows the same course in men and women and usually is completed with the fad- ing of the inﬂammation. ‘
Herpes in men reminds me of a ﬁrst or second degree burn caused by a hot stove. In a few hours after touching the stove a large blister forms. When the blister breaks (and it may be tough and slower to break than a blister of Herpes), there is an area of ulceration revealed. This area is very tender. If the burn has destroyed the deep layer of the skin, primary healing cannot occur. The growing, regenerating cells of the skin are missing and healing is slower. Scarring results.
A similar situation occurs when the Herpes lesions penetrate deeper tissues; a scar is the result. Scarring is not usual but is sometimes seen won the shaft of the penis where the skin is thin and very tender. Subsequent episodes may recur in the same site causing the skin to become parchment-like and shiny.
Occasionally, the blisters are merely pencil-point-size ulcers. This type of lesion seems to be less painful and to heal more rapidly.