herpes simplex vs. aphthous ulcers Flashcards
what is seen mainly in children and is caused by HSV1 in most cases
primary herpes gingivostomatitis
herpes simplex.
sever primary infections have oral lesions accompanied by:
high fever
malaise
cervical lymphadenopathy
dehydration
herpes simplex.
less commonly, primary infection occurs in the young adult; in such cases infections may be from either:
HSV1 or HSV2
where do herpes gingivostomatitis/herpes simplex vesicles develop in oral cavity?
pharynx
palate
buccal mucosa
lips
tongue
herpes gingivostomatitis/herpes simplex vesicles rapidly break down into:
smaller ulcers and covered with exudate
how long do herpes gingivostomatitis/herpes simplex lesions generally resolve
without therapy, 2 weeks
HSV (does/doesnt) survive long in external environment
doesn’t
how does almost all primary HSV infections occur
from contact with infected person who is releasing the virus
HSV fever affects what % of population
50% (~80%)h
hsv fever starts what age
<10 from adults
is hsv contagious? caused by?
yes contagious and caused by adults
hsv
type 1=
type 2=
1=mouth lips face
2= genital outer lips and attached gingiva
what stage is contageous for hsv
vesicle stage
what signs of hsv arise 6-24 hours before lesions develop?
how long does it take to heal?
prodromal signs=tingling, itching, pain, burning
2 week
what does hsv look like
multiple fluid filled blisters
merge and collapse
yellowish crust
virus that is dormant in nerve cell and reoccurs with immune weakness
herpes simplex
what is considered immune weakness with herpes simplex
stress
fever
illness
injury
sunburn
infections of the thumbs or fingers
-grouped fluid filled or pus filled
usually itchy and painful
herpetic whitlow
in the past, how was primary herpetic gingivostomatitis treated?
what if diagnosed early?
treated symptomatically
but if diagnosed early, antiviral medications can have big influence
this medication is initiated during first 3 symptomatic days in a rinse-and-swallow tecnique 5x/day for 5 days.
-for primary herpetic gingivostomatitis
significant acceleration in clinical resolution is seen
acyclovir suspension
recurrent herpes labial is best treated in the
prodrome phase
what decrease the number of vesicles in herpes labialis?
clinically minimal reduction in healing time and pain
acyclovir ointment cream
systemic acyclovir
valacyclovir
famiciclovir
for patients with herpes labialis whose recurrences appear to be associataed with dental produces, a remigen of:
2 g of valacyclovir taken 2x on day of producer and 1 g taken 2x day following
what is 60% of the US population and starts around 1-20 years old?
frequency varies.
apthous ulcers
(canker sores)
lesions
prodromal tingling or burning sensation- usually 1-2 days before ulcers appears
apthous ulcers (canker sores)
____ days before apthous ulcers appear, ____ days pain, ____ days healed
1-2 days before
3 days pain
7 days healed
if mild disease, treatment for canker sores aka apthous ulcers is
topical corticosteroids
no single triggering agent is responsible, the mucosal destruction appears to represent T-cell mediated immunologic reaction for
aphthous lesions
what tends to occur along family lines?
when both parents have history, 90% children will develop
aphthous lesions
3 clinical varations of aphthous lesions
minor
major
herpetiform
minor major or herpetiform aphthous ulcerations.
pts. experience fewest recurences and shortest duration
minor
minor major or herpetiform aphthous ulcerations.
ulcers exclusively on nonkeratinized mucosa, preceded by erythematous macule
(associated with prodromal symptoms of burning itching or stinging)
minor
wont scare
minor
minor major or herpetiform aphthous ulcerations.
ulcer measures 3-10mm
oval
heal withing scatting 7-14 days
minor
minor major or herpetiform aphthous ulcerations.
1-5 lesions
pain often out of proportion for size
minor
what oral areas affected most by minor aphthous ulcers
buccal and labial mucosa followed by ventral surface of tongue
minor aphthous recurrence rate:
high variable, ranging from 1 ulcer every few years to 2 episodes a month
minor major or herpetiform aphthous ulcerations.
larger than minor 1-3 cm
major
minor major or herpetiform aphthous ulcerations.
have longest duration per episode
major
ulcers deep and can take 2-6 weeks toheal
major
lesions very from 1-10
major
onset is after puberty
major
minor major or herpetiform aphthous ulcerations.
greatest number of lesions and most frequent recurrence
herpetiform
lesions small 1-3 mm
herpetiform
many as 100 ulcers present in single occurrence
herpetiform
lesions bear superifical resemblance to primary HSV due to
herpetiform
due to small size and how many
common for individual lesions to coalesce into larger irregular ulcerations
herpetiform
heals within 7-10 days
herpetiform
many patients affect almost constantly for periods as long as 3 years
herpetiform
any oral mucosal involved
herpetiform
minor major or herpetiform aphthous ulcerations.
female predominance
herpetiform
onset is adulthood
herpetiform
minor major or herpetiform aphthous ulcerations.
<1cm and shallow
minor
minor major or herpetiform aphthous ulcerations.
> 1 cm and many scar when heal
major
minor major or herpetiform aphthous ulcerations.
more numerous and vesicular
herpetiform
aphthous ulcers treatment.
symptomatic:
- viscous benzocaine
- orajel, anbesol
aphthous ulcers treatment.
local anti-inflammatory:
kenalog in orabase paste 2-4x day
aphthous ulcers treatment for sealing agent
ameseal
canker sores (aphthous ulcers)
only fda approved tx
paste=barrier
apply 2-4x day
must start early in prodromal stage!!!
aphthasol
