Herpes simplex orofacial infection: Difference between revisions
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==Differential diagnosis== | ==Differential diagnosis== | ||
Herpes simplex orofacial infection must be differentiated from other diseases causing | Herpes simplex orofacial infection must be differentiated from other diseases causing oral lesions such as leukoplakia and herpes simplex virus infection. | ||
<div style="width: 70%;"> | <div style="width: 70%;"> | ||
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*Can spread to [[TMJ]] | *Can spread to [[TMJ]] | ||
*Some times associated with [[leukoplakia]] | *Some times associated with [[leukoplakia]] | ||
|[[File: | |[[File:PLoS oral cancer.png|thumb|400x400px| |Squamous cell carcinoma - By Luca Pastore, Maria Luisa Fiorella, Raffaele Fiorella, Lorenzo Lo Muzio - http://www.plosmedicine.org/article/showImageLarge.action?uri=info%3Adoi%2F10.1371%2Fjournal.pmed.0050212.g001, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=15252632]] | ||
|- | |- | ||
|[[Leukoplakia]] | |[[Leukoplakia]] | ||
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| pmid = 24113312 | | pmid = 24113312 | ||
}}</ref> | }}</ref> | ||
|[[File:Oral hairy leukoplakia (EBV, in HIV)a.jpg| | |[[File:Oral hairy leukoplakia (EBV, in HIV)a.jpg|thumb|400x300px|Leukoplakia - By Aitor III - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=9873087]] | ||
|- | |- | ||
|[[Melanoma]] | |[[Melanoma]] | ||
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*Progression involves [[MAPK/ERK pathway]] | *Progression involves [[MAPK/ERK pathway]] | ||
*[[RAS|N-RAS]] or [[BRAF]] [[oncogene]] also involved | *[[RAS|N-RAS]] or [[BRAF]] [[oncogene]] also involved | ||
|[[File: | |[[File:Palate malign melanoma 01.jpg|thumb|400x400px|Oral melanoma - By Emmanouil K Symvoulakis, Dionysios E Kyrmizakis, Emmanouil I Drivas, Anastassios V Koutsopoulos, Stylianos G Malandrakis, Charalambos E Skoulakis and John G Bizakis - Symvoulakis et al. Head & Face Medicine 2006 2:7 doi:10.1186/1746-160X-2-7 (Open Access), [1], CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=9839811]] | ||
|- | |- | ||
|[[Fordyce spots]] | |[[Fordyce spots]] | ||
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*No surrounding [[mucosal]] change | *No surrounding [[mucosal]] change | ||
*Several adjacent [[glands]] may coalesce into a larger cauliflower-like cluster | *Several adjacent [[glands]] may coalesce into a larger cauliflower-like cluster | ||
|[[File: | |[[File:Fospot.jpg|thumb|400x400px|Fordyce spots - Por Perene - Obra do próprio, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19772899]] | ||
|- | |- | ||
|[[Burning mouth syndrome]] | |[[Burning mouth syndrome]] | ||
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*Repeated [[trauma]] can cause [[bleeding]] | *Repeated [[trauma]] can cause [[bleeding]] | ||
*[[Surgery]] may be required in symptomatic | *[[Surgery]] may be required in symptomatic | ||
|[[File:06-06-06palataltoria.jpg|Torus palatinus|400x400px]] | |[[File:06-06-06palataltoria.jpg|thumb|Torus palatinus|400x400px|Torus palatinus - By Photo taken by dozenist, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=846591]] | ||
|- | |- | ||
| colspan="4" |'''Diseases involving oral cavity and other organ systems''' | | colspan="4" |'''Diseases involving oral cavity and other organ systems''' | ||
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*[[Outbreaks]] of exaggerated [[inflammation]] | *[[Outbreaks]] of exaggerated [[inflammation]] | ||
*Affects smaller [[blood vessels]] | *Affects smaller [[blood vessels]] | ||
|[[File: | |[[File:Behcets disease.jpg|thumb|400x400px|Behcet's disease - By Ahmet Altiner MD, Rajni Mandal MD - http://dermatology.cdlib.org/1611/articles/18_2009-10-20/2.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17863021]] | ||
|- | |- | ||
|[[Crohn's disease]] | |[[Crohn's disease]] | ||
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**[[Gumma|Gummas]] | **[[Gumma|Gummas]] | ||
**[[Neurosyphilis]] | **[[Neurosyphilis]] | ||
|[[File: | |[[File:Hutchinson teeth congenital syphilis PHIL 2385.rsh.jpg|thumb|400x400px|oral syphilis - By CDC/Susan Lindsley - http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349]] | ||
|- | |- | ||
|[[Coxsackie virus]] | |[[Coxsackie virus]] | ||
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*[[Pregnancy]] | *[[Pregnancy]] | ||
*[[Premature infants]] born to susceptible mothers | *[[Premature infants]] born to susceptible mothers | ||
*All [[infants]] born at less than 28 weeks [[gestation]] or who weigh | *All [[infants]] born at less than 28 weeks [[gestation]] or who weigh =1000 grams | ||
*[[Immunocompromised]] | *[[Immunocompromised]] | ||
| | | | ||
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*[[Paracetamol]] ([[acetaminophen]]) for [[fever]] | *[[Paracetamol]] ([[acetaminophen]]) for [[fever]] | ||
*[[Prednisolone]] is [[contraindicated]] | *[[Prednisolone]] is [[contraindicated]] | ||
|[[File: | |[[File:Herpangina2016.jpg|thumb|400x400px|Chickenpox - By James Heilman, MD - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=52872565]] | ||
|- | |- | ||
|[[Measles]] | |[[Measles]] | ||
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*Primary site of infection is the [[respiratory epithelium]] of the [[nasopharynx]] | *Primary site of infection is the [[respiratory epithelium]] of the [[nasopharynx]] | ||
*Transmitted in [[respiratory secretions]], via [[aerosol droplets]] containing [[Virus|virus particles]] | *Transmitted in [[respiratory secretions]], via [[aerosol droplets]] containing [[Virus|virus particles]] | ||
|[[File: | |[[File:Koplik spots, measles 6111 lores.jpg|thumb|400x400px|Koplick spots (Measles) - By CDC - http://phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=824483]] | ||
|}</small></small> | |}</small></small> | ||
</div> | </div> |
Revision as of 21:30, 13 September 2017
Herpesviral vesicular dermatitis | |
Herpes lesion on upper lip and face |
Herpes simplex Microchapters |
Patient Information |
Classification |
Herpes simplex orofacial infection On the Web |
Risk calculators and risk factors for Herpes simplex orofacial infection |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Orofacial Infection
Infection by HSV-1 is the most common cause of herpes that affects the face and mouth (orofacial herpes), although recent years have seen an increase in oral HSV-2 infections.[1] A majority of primary HSV-1 infections occur during childhood and, if the virus has come into contact with the mucosa or abraded skin, can cause acute herpetic gingivostomatitis (inflammation of the mucosa of the cheek and gums) within 5–10 days. Some other symptoms may also develop, including fever and sore throat, and painful ulcers may appear.[1] Primary HSV infection in adolescents frequently manifests as severe pharyngitis with lesions developing on the cheek and gums. Some individuals develop difficulty in swallowing (dysphagia) and swollen lymph nodes (lymphadenopathy).[1] Primary HSV infections in adults often presents as pharyngitis similar to that observed in glandular fever (infectious mononucleosis), but gingivostomatitis is less likely. The symptoms of primary HSV infection generally resolve within two weeks.[1]
Once a primary oral HSV-1 infection has resolved, the HSV enters the nerves surrounding the primary lesion, migrates to the cell body of the neuron, and becomes latent in the trigeminal ganglion. In some people, the virus reactivates to cause recurrent infection; this is more common with HSV-1 than HSV-2 oral infection. Prodromal symptoms often precede a recurrence, which typically begins with reddening of the skin around the infected site, with eventual ulceration to form fluid-filled blisters that affect the lip (labial) tissue and the area between the lip and skin (vermilion border). The recurrent infection is thus often called herpes simplex labialis. Rare occasions of reinfections occur inside the mouth (intraoral HSV stomatitis), affecting the gums, alveolar ridge, hard palate, and the back of the tongue. This may be accompanied by herpes labialis.[1] [2]
Oral herpes is spread by direct contact with an active sore in an infected person, for instance, during kissing. However, the virus can be transmitted through the skin in the absence of a lesion. Oral herpes and cold sores can sometimes be confused with canker sores.
Differential diagnosis
Herpes simplex orofacial infection must be differentiated from other diseases causing oral lesions such as leukoplakia and herpes simplex virus infection.
Disease | Presentation | Risk Factors | Diagnosis | Affected Organ Systems | Important features | Picture |
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Diseases predominantly affecting the oral cavity | ||||||
Oral Candidiasis |
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Localized candidiasis
Invasive candidasis |
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Herpes simplex oral lesions |
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Aphthous ulcers |
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Squamous cell carcinoma |
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Leukoplakia |
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Melanoma |
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Fordyce spots |
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Burning mouth syndrome |
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Torus palatinus |
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Diseases involving oral cavity and other organ systems | ||||||
Behcet's disease |
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Crohn's disease |
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Agranulocytosis |
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Syphilis[5] |
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Coxsackie virus |
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Chicken pox |
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Measles |
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References
- ↑ 1.0 1.1 1.2 1.3 1.4 Bruce AJ, Rogers RS (2004) Oral manifestations of sexually transmitted diseases. Clin Dermatol 22 (6):520-7. DOI:10.1016/j.clindermatol.2004.07.005 PMID: 15596324
- ↑ Herpes Online: Exploring the "H" Community, pages 1-4 American Social Health Association 1996 Access date: 2007-03-29
- ↑ Ann M. Gillenwater, Nadarajah Vigneswaran, Hanadi Fatani, Pierre Saintigny & Adel K. El-Naggar (2013). "Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity!". Advances in anatomic pathology. 20 (6): 416–423. doi:10.1097/PAP.0b013e3182a92df1. PMID 24113312. Unknown parameter
|month=
ignored (help) - ↑ Andrès E, Zimmer J, Affenberger S, Federici L, Alt M, Maloisel F. (2006). "Idiosyncratic drug-induced agranulocytosis: Update of an old disorder". Eur J Intern Med. 17 (8): 529–35. Text "pmid 17142169" ignored (help)
- ↑ title="By Internet Archive Book Images [No restrictions], via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File:A_manual_of_syphilis_and_the_venereal_diseases%2C_(1900)_(14595882378).jpg"
- ↑ Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE (2000). "Individual and community risks of measles and pertussis associated with personal exemptions to immunization". JAMA. 284 (24): 3145–50. PMID 11135778.
- ↑ Ratnam S, West R, Gadag V, Williams B, Oates E (1996). "Immunity against measles in school-aged children: implications for measles revaccination strategies". Can J Public Health. 87 (6): 407–10. PMID 9009400.