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Recurrent infection with herpes simplex type I manifests as a well-localized cluster of small vesicles along the vermilion border of the lip or adjacent skin. These vesicles subsequently rupture and a crust is formed. Spontaneous healing occurs in 7–10 days. Diagnosis is based on clinical findings and history. In immunocompetent individuals, herpes labialis is self-limiting. Topical application of penciclovir cream may reduce healing time. Use of systemic anti-virals is reserved for immunocompromised patients.


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Figure 1: Recurrent herpes labialis. Note the small ulcers surrounded by oedema on the vermilion border of the upper lip.
Figure 2: Recurrent herpes labialis. Note the vesicles on the upper lip surrounded by erythematous margin.
Figure 3: Recurrent herpes labialis. Note the 1 cm ulcer below the lower lip in this 40–year-old woman.
Figure 4: Recurrent herpes labialis. Note the small, shallow, oval shaped ulcer on the upper lip and another discrete ulcer under the nose.
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