This is a viral infection of the oral mucous membrane caused by herpes simplex virus-I (HSV-I)

Usually HERPES SIMPLEX VIRUS type 1 (HSV-1) and rarely type 2 (HSV-2)

Usually occurs in young patients and is often asymptomatic but may be associated with systemic symptoms.

It is usually seen between the ages of 6 months and 6 years.

The onset of the disease is abrupt and is clinically characterized by

High fever

Head ache

Malaise

Anorexia

Irritability

Bilateral lymphadenopathy

Sore mouth

The affected mucosa is RED and EDEMATOUS, with numerous coalescing vesicles, which rapidly rupture, leaving painful small, round, shallow ulcers covered by yellow fibrin.

Vesicles will appear first and will progress to ulcers that crust.

New lesions continue to form during the first 3-5 days

The ulcers heal in 10-14 days

Both movable and non movable oral mucosa may be affected.

Gingival lesions are almost always present, resulting in enlargement and edematous and painful erosions.

1-3 days of fever, loss of appetite and myalgia

Cervical lymphadenopathy is present

After the primary infection the virus remains latent in the nerve tissues.

If reactivation occurs it causes herpes labialis (cold sores).

Established from patients history and clinical findings

HSV isolation by cell culture is the gold standard

Tzanck smear

Biopsy

Serological tests

Necrotizing ulcerative gingivitis

Erythema multiforme

Stevens-Johnson syndrome

Apthous stomatitis (canker sores)

Herpangina

Desquamative gingivitis

Apthous ulcers

Local Applications

Using topical lignocaine in mild cases

Topical steroids like triamcinolone and clobetasol application in severe cases.

Systemic therapy

Pentroxifylline daspsone short bursts of systemic steroids and thalidomide have been used to reduce the number of ulcers and recurrence.