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Key Features

  • Common, mild, and short-lived and requires no intervention in most adults

  • In immunocompromised persons, however, reactivation of herpes simplex virus infection is frequent and may be severe

Clinical Findings

  • Initial symptom is burning, followed by typical small vesicles that rupture and form scabs

  • Differential diagnosis

    • Aphthous stomatitis

    • Erythema multiforme

    • Syphilitic chancre

    • Carcinoma

Diagnosis

  • Lesions

    • Most commonly found on the attached gingiva and mucocutaneous junction of the lip

    • Can also form on the tongue, buccal mucosa, and soft palate

Treatment

  • Acyclovir (200–800 mg orally five times daily for 7–10 days) or valcyclovir (1000 mg orally twice daily for 7–10 days)

    • May shorten the course

    • May reduce postherpetic pain

    • May only be effective when started within 24–48 hours of the onset of initial symptoms (pain, itching, burning)

    • Not effective once vesicles have erupted

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