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Herpes Labialis (Cold Sore) — MRCGP AKT MCQ

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EasyDermatologyHerpes Labialis (Cold Sore)MRCGP AKTUKMLAPARAPSA

A 20-year-old woman presents with painful blistering on her lips which started yesterday. She felt a tingling sensation beforehand. Examination shows several vesicles and early ulcers on an erythematous base on the vermillion border of her lower lip. She has had similar episodes before. What is the most appropriate management?

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Correct answer: A — Topical aciclovir cream

This is a typical presentation of recurrent herpes labialis (cold sore) caused by Herpes Simplex Virus (HSV). NICE CKS recommends topical antiviral preparations (e.g., aciclovir 5% cream) applied early (ideally at the prodromal tingling stage) and frequently (5 times daily) for 5 days to reduce symptom duration and viral shedding. Oral aciclovir is usually reserved for severe, frequent, or complicated episodes, or immunocompromised patients. Flucloxacillin is for bacterial infection. Hydrocortisone may worsen viral infections. While self-limiting, treatment can shorten the episode.

Reference: CKS: Herpes simplex - oral