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HSV shedding is intermittent. Therefore, testing swabs from asymptomatic patients is not recommended for routine diagnosis since it is unlikely to yield confirmation of carrier status. However, laboratory confirmation in all patients with suspected herpes is recommended. HSV DNA detection by real-time polymerase chain reaction is considered the gold standard for diagnosis. Swabs for testing are taken from the base of the lesion (vesicles should be unroofed with a needle or scalpel blade). HSV typing into HSV-1 and HSV-2 is recommended in all patients with first-episode genital herpes to guide counseling and management.