Herpes Stomatitis

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 valacyclovir (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