Snapshot A 20-year-old college student presents to the student health clinic complaining of a painful, blistering rash on her upper lip. She says the rash has relapsed and remitted multiple times and she usually feels a mild tingling sensation in the area before a break-out of the lesions. On exam, her upper lip demonstrates clustered vesicles with an erythematous base and crusting. Introduction Overview login to view 7 more bullets Associated conditions login to view 5 more bullets Epidemiology Prevalence login to view 4 more bullets Demographics login to view 5 more bullets Location login to view 3 more bullets Risk factors login to view 7 more bullets ETIOLOGY Pathogenesis login to view 5 more bullets Transmission occurs from direct contact with active lesions Virus resides in the dorsal root ganglia of local nerves until reactivation login to view 2 more bullets Intrahost viral spread occurs via epidermal cells login to view 1 more bullet Presentation Symptoms login to view 35 more bullets Physical exam login to view 14 more bullets Studies Tzanck smear login to view 3 more bullets Culture or direct fluorecent anti-body staining login to view 1 more bullet Differential Herpes zoster virus login to view 2 more bullets Varicella zoster virus (VZV) login to view 3 more bullets Treatment Lifestyle login to view 2 more bullets Medical login to view 13 more bullets Complications Complications login to view 9 more bullets Prognosis No cure Relapsing and remitting course login to view 1 more bullet Treatment can improve symptoms