From the Guidelines
Diagnosis of herpes labialis is primarily clinical, based on the patient's history and clinical signs and symptoms, such as characteristic vesicular lesions on the lips or surrounding skin 1.
Clinical Diagnosis
A definitive diagnosis can be made by a healthcare professional through physical examination and medical history.
- The diagnosis is usually based on the patient's history of the condition and clinical presentation.
- Laboratory confirmation may be required in immunocompromised patients if the clinical presentation is atypical 1.
Laboratory Tests
In some cases, laboratory tests such as viral culture, PCR (polymerase chain reaction), or serology may be used to confirm the diagnosis, especially in atypical cases or when antiviral treatment is being considered.
- These tests can help confirm the presence of the herpes simplex virus and rule out other possible causes of symptoms.
- However, laboratory tests are not always necessary and may not be required for patients with typical symptoms and a clear history of the condition 1.
From the FDA Drug Label
Patients should be advised to initiate treatment at the earliest symptom of a cold sore (e.g., tingling, itching, or burning). The diagnosis of herpes labialis is based on the earliest symptoms, such as tingling, itching, or burning, before the appearance of a cold sore.
- The FDA drug label does not provide a clear diagnostic criteria for herpes labialis, but it mentions the early symptoms that can indicate the onset of a cold sore.
- The diagnosis is likely based on clinical presentation and patient history, rather than a specific test or diagnostic criterion. 2
From the Research
Diagnosis of Herpes Labialis
The diagnosis of herpes labialis is mainly clinical, based on the presence of classic grouped lesions (papules, vesicles, ulcers) on the lip 3. In cases where the diagnosis is uncertain, additional testing can be carried out, usually using polymerase chain reaction 4. The clinical history and presenting features are also important in making a diagnosis, and confirmatory laboratory diagnosis may be required in immunocompromised patients 5.
Key Features of Herpes Labialis
Some key features of herpes labialis include:
- Recurrent vesicular eruptions primarily on the lips and perioral skin 3, 6
- Pain and discomfort 3, 6
- Contagious nature of the condition 3
- Potential for significant impact on quality of life 3
- Latent virus that can recur 4
Diagnostic Considerations
In diagnosing herpes labialis, the following should be considered:
- Clinical presentation, including the appearance of lesions and symptoms such as pain and discomfort 3, 4
- Patient history, including any previous episodes of herpes labialis 3
- Laboratory testing, such as polymerase chain reaction, if necessary 4
- Differential diagnosis to rule out other conditions with similar symptoms 5