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Q: This morning I awoke with a blister in my lip, less the 12 hours after our encounter. It appears to look like a fever blister. My concern is that it is herpes, but I though it odd to show so soon. Could it be something else?
A: Since you mentioned a fever blister, it would be worthwhile to first say a few words about it in order to answer your question. Herpes simplex infections in the lips are also referred to as cold or fever sores. They are characterized by recurrent, small group of vesicles which may follow trauma, stress, minor infections, or exposure to the sun. In order to definitely establish the diagnosis, a smear of the affected area (Tzanck smear) may be carried out. In the presence of this infection, the smear shows characteristic giant cells with many nuclei. Furthermore, viral cultures of lesions may show the presence of the virus and analysis of the serum in blood shows the presence of antibodies against the virus. However, more than 85% of the adult population shows evidence of infection, probably acquired without any symptoms during childhood. Herpes infections in the lips are caused by the herpes simplex virus of type 1, in contrast to the herpes infections of the genitals, usually caused by the type 2 virus. The incubation period for the disease is usually 2 to 12 days, averaging 6 or 7 days. Of course, a diagnosis in your case cannot be definitely established without personally observing the lesion and performing the necessary tests. However, notice the characteristic pattern described above for herpes infections of the lips and that these lesions are recurrent. Clearly, the presence of a blister does not imply the presence of a herpes infection. Quite generally, blisters may occur as consequences of chemical, thermal, radiant, or mechanical trauma. Furthermore, they may also be caused by other infectious agents in addition to the herpes virus.
Updated: 06/29/99
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