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Genital Herpes — SCE Dermatology MCQ

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ModerateGenital DermatologyGenital HerpesSCE Dermatology

A 32-year-old man presents with grouped vesicles on an erythematous base on his penile shaft. This is his first episode. He has bilateral tender inguinal lymphadenopathy. What is the most appropriate first-line treatment?

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Correct answer: E — Oral Valaciclovir 500 mg twice daily for 10 days

For first-episode genital herpes, BASHH and BAD guidelines recommend a longer treatment course than recurrent episodes. Oral Valaciclovir 500 mg twice daily for 10 days (or Aciclovir 200 mg five times daily for 5 days or 400 mg three times daily for 5 days) is recommended. First episodes are treated for longer because viral shedding duration is greater. Topical antivirals alone are insufficient for genital herpes. For recurrent episodes, shorter 5-day courses are appropriate.

Reference: BASHH 2014 UK National Guidelines on Management of Genital Herpes