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irritation on corner of mouth
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irritation on corner of mouth

I posted before but still am concerned.  At the end of April I noticed a red irritation beginning on the corner of my mouth.(I was 36 weeks pregnant). I applied vaseline to it.  I told my OB and she said that if it is a cold sore then it should be gone in 7-10 days.  The next week I didn't apply any vaseline to it and it got really dry and the skin was flaky.  When I wiped away the skin it a small pustle weeped a little yellow-brown fluid(blood?).  When the irritation was still there (just redness) the next week, I went to a derm and he said it was probably a pimple.  Two weeks later, the redness was still there so I went to another derm who gave me an antifungal.  Three days after using the antifungal, it looked worse, much more red and irritated.  Went to another derm and he prescribed me desonide.  The desonide helped and now, 2 months later I'm not using the desonide anymore and the redness is pretty much gone.  My concern is that it was herpes (cold sore) and that by the time I went to the derm, just the irritation was there so that's why they didn't think it was a cold sore.  My concern is that, even though it is pretty much gone, I'm worried about passing it to my 5-week old baby through viral shedding(without symptoms).  I may be overly paranoid but I wash my hands thoroughly before touching her and will not kiss her.  I know that I can't go on forever like this but I'm terrified of hurting her.  I know that neonatal herpes is extremely dangerous, even if passed by cold sores, not genital herpes , and that a lot of research now shows that you can pass the virus on without having any symptoms.  What are the chances that it was a cold sore and if so, what are the chances of passing it to the baby through kissing or saliva?  I've read that a large percentage of people have the virus, so wouldn't neonatal herpes be fairly common since most people have the virus?  Is there anything that can be done to calm my nerves?
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Well, I hope to try, anyway.

Herpes cold sores rarely affect the corners of the mouth--they're usually at the margin of the lip somewhere in the middle.  Irritation at the corners of the mouth is called angular stomatitis.  It can be just irritation from saliva or sometimes yeasts hanging around the GI tract are involved--which is why one dermatologist gave you an antifungal cream.  But a low-potency steroid like desonide often works, as it seems to be doing for you.

You've seen three dermatologists, all of whom did not diagnose herpes.  If that doesn't reassure you, in addition to my comments, I'm not sure what will.

Neonatal herpes is indeed quite uncommon.  It occurs in newborns, not 5-week-olds.  Considering how many people (including parents) have cold sores, you should infer that even if you have one, there's no reason for paranoia.  But you almost certainly don't have one.

Best.

Dr. Rockoff
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