Small pimple in the coronal groove

When the coronal sulcus pimples first occur, you will just feel some small pimples growing around your glans and foreskin. These pimples will not cause any signs of itching, but as the condition worsens, itching symptoms will gradually occur, and the itching may even become unbearable. A small number of patients with more severe symptoms may also experience nausea and vomiting. These are typical clinical manifestations.

1. Primary infection patients are the first onset of the disease, which can be divided into primary infection and non-primary infection.

(I) Patients with primary infection have no history of herpes simplex and no HSV antibodies in their serum. After infection with HSV, the clinical manifestations are the most severe. Patients develop the disease after sexual contact with active herpes simplex victims. The incubation period is 3 to 14 days, with an average of about 6 days. In men, it is more common on the glans penis, coronal sulcus, foreskin, and penis; in women, it is more common on the vulva, cervix, perianal area, and buttocks, with most millet-sized papules and blisters appearing, which can fuse into pieces.

After 2 to 4 days, it breaks down into erosion or ulcer, and the patient will feel burning and pain. When the damage invades the urethral epithelium, the patient will experience urinary pain, difficulty urinating, and mucous secretions at the urethral opening. When it invades the cervical epithelium, the cervical erosion, ulcer, and leucorrhea increase. The patient's inguinal lymph nodes are enlarged and tender, but they will not purulent or rupture. New rashes appear from time to time within 1 week of onset. The skin lesions reach their peak at 7 to 10 days, and then gradually subside and scab over. It usually takes 18 to 21 days for the skin lesions to completely subside and normal epithelium to grow out. Some cases may experience fever, headache, nausea, photophobia, and even neck stiffness in the first week of the disease, which are symptoms of viral blood syndrome or even meningeal irritation.

(II) Non-primary infection is the first clinical manifestation of genital herpes in patients, but they have a history of simple herpes on the lips. There are HSV-1 antibodies in the serum. Due to the protective effect of HSV-1 antibodies on the body, the clinical manifestations of non-primary genital herpes are milder than those of primary genital herpes, with limited skin lesions and a mild course. Generally, the skin lesions will completely scab and fall off in about 2 weeks. Patients generally have no systemic symptoms and their inguinal lymph nodes are not enlarged.

2. Recurrent infection The first recurrence usually occurs half a year to one year after the primary infection subsides. The average number of recurrences is 3 to 4 times per year, and those who have more than 6 times per year are considered frequent recurrences. Recurrence causes include decreased immune function and non-immune factors, fatigue, mental stress, trauma, menstruation, and other infections. Generally, men are more likely to relapse than women, but the symptoms of women after relapse are more severe than those of men. Clinical manifestations and the number of recurrences vary from person to person.

1. There are often prodromal symptoms a few hours to 1-2 days before recurrence, such as local burning, abnormal sensation or tingling, etc., and some people have radiating pain to the buttocks and thighs.

2. The patient's vulva has papules and blisters, which are more localized and less in number than primary cases. After rupture, they become punctate erosions or shallow ulcers.

Generally, scabs will form after 4 to 5 days, and the skin lesions will heal in about 10 days.