Herpes simplex orofacial infection: Difference between revisions
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* [[mouth|Oro]][[face|facial]] [[infection]] | * [[mouth|Oro]][[face|facial]] [[infection]] | ||
* [[Herpes simplex anogenital infection|Anogenital | * [[Herpes simplex anogenital infection|Anogenital infection]] | ||
* [[Herpes simplex ocular infection|Ocular | * [[Herpes simplex ocular infection|Ocular infection]] | ||
* [[Herpes simplex encephalitis|Herpes | * [[Herpes simplex encephalitis|Herpes encephalitis]] | ||
* [[Herpes simplex neonatorum|Neonatal | * [[Herpes simplex neonatorum|Neonatal herpes]] | ||
* [[Herpetic whitlow|Herpetic | * [[Herpetic whitlow|Herpetic whitlow]] | ||
* [[Herpes gladiatorum|Herpes | * [[Herpes gladiatorum|Herpes gladiatorum]] | ||
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* The symptoms of primary [[HSV]] infection generally resolve within two weeks | * The [[symptom|symptoms]] of primary [[Herpes simplex virus|HSV]] [[infection]] generally resolve within two weeks | ||
|[[File:Herpesinfection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|thumb|Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|400x400px]] | |[[File:Herpesinfection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|thumb|Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|400x400px]] | ||
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|[[Aphthous ulcer|Aphthous ulcers]] | |[[Aphthous ulcer|Aphthous ulcers]] | ||
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* Painful, red spot or bump that develops into an open [[ulcer]] | * [[pain|Painful]], [[erythema|red]] spot or bump that develops into an open [[ulcer]] | ||
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* | * [[female|Female gender]] | ||
* Between the ages of 10-40 | * Between the ages of 10-40 | ||
* Family history of [[Aphthous ulcer|aphthous ulcers]] | * [[Family history]] of [[Aphthous ulcer|aphthous ulcers]] | ||
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* Physical examination | * [[Physical examination]] | ||
* Diagnosis of exclusion | * [[Diagnosis]] of exclusion | ||
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* Oral cavity | * [[mouth|Oral cavity]] | ||
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* | * It is elf-limiting and [[pain]] usually decreases in 7 to 10 days, with a complete healing in 1 to 3 weeks | ||
|[[File:Afta foto - By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358.jpg|thumb|Apthous ulcer on the under surface of the tongue|By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358|400x400px]] | |[[File:Afta foto - By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358.jpg|thumb|Apthous ulcer on the under surface of the tongue|By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358|400x400px]] | ||
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|[[Squamous cell carcinoma]] | |[[Squamous cell carcinoma]] | ||
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*Non healing [[ulcer]], [[nodule]], indurated plaque or mass | *Non healing [[ulcer]], [[nodule]], [[Induration|indurated]] [[plaque]] or [[mass]] | ||
*May involve [[skin]], [[lips]], inside the [[mouth]], [[throat]] or [[esophagus]] | *May involve [[skin]], [[lips]], inside the [[mouth]], [[throat]] or [[esophagus]] | ||
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* Chronic sun or [[Ultraviolet|UV exposure]] | * Chronic sun or [[Ultraviolet|UV exposure]] | ||
* Fair [[skin]] | * Fair [[skin]] | ||
* [[Elderly]] age (>45 yrs) | * [[old age|Elderly]] [[aging|age]] (>45 yrs) | ||
* [[Male sex]] | * [[Male sex]] | ||
* [[Smoking]] | * [[Smoking]] | ||
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*[[Biopsy]] | *[[Biopsy]] | ||
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*[[Oral Cavity]] | *[[mouth|Oral Cavity]] | ||
**Floor of [[mouth]] | **Floor of [[mouth]] | ||
**Lateral [[tongue]] | **Lateral [[tongue]] | ||
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*[[Malignant]] | *[[Malignant]] | ||
*Can spread to [[TMJ]] | *Can spread to [[Temporomandibular joint disorder|TMJ]] | ||
*Some times associated with [[leukoplakia]] | *Some times associated with [[leukoplakia]] | ||
|[[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]] | |[[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]] | ||
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*Lateral borders of [[tongue]] | *Lateral borders of [[tongue]] | ||
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* | *[[Tobacco]] use | ||
*Chronic [[irritation]] | *Chronic [[irritation]] | ||
*[[Immunodeficiency]] | *[[Immunodeficiency]] | ||
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*[[Physical exam]] | *[[Physical exam]] | ||
*Diagnosis of exclusion | *[[Diagnosis]] of exclusion | ||
*[[Biopsy]] | *[[Biopsy]] | ||
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*[[Vulva|Vulvar]] lesions occur independent of oral lesions | *[[Vulva|Vulvar]] lesions occur independent of [[mouth|oral lesions]] | ||
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*Associated with [[HIV]] | *Associated with [[HIV]] | ||
*Persistant white spots | *Persistant white spots | ||
*[[Benign]] but can progress to [[carcinoma]] after almost 10 years | *[[Benign]] but can progress to [[carcinoma]] after almost 10 years | ||
*Oral proliferative [[Leukoplakia|verrucous leukoplakia]] is an aggressive | *[[mouth|Oral]] proliferative [[Leukoplakia|verrucous leukoplakia]] is an aggressive subtype with multiple lesions and higher conversion to [[warts]] or [[carcinoma]]<ref>{{Cite journal | ||
| author = [[Ann M. Gillenwater]], [[Nadarajah Vigneswaran]], [[Hanadi Fatani]], [[Pierre Saintigny]] & [[Adel K. El-Naggar]] | | author = [[Ann M. Gillenwater]], [[Nadarajah Vigneswaran]], [[Hanadi Fatani]], [[Pierre Saintigny]] & [[Adel K. El-Naggar]] | ||
| title = Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity! | | title = Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity! | ||
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|[[Melanoma]] | |[[Melanoma]] | ||
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*A lesion with | *A lesion with ABCD: | ||
**[[Asymmetry]] | **[[Asymmetry]] | ||
**Border irregularity | **Border irregularity | ||
**Color variation | **Color variation | ||
**[[ | **[[Diameter]] changes (or [[diameter]] more than 6 mm) | ||
*[[Bleeding]] from the lesion | *[[Bleeding]] from the lesion | ||
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*[[Genetic predisposition]] | *[[Genetic predisposition]] | ||
*[[Old age]] | *[[Old age]] | ||
*[[Male gender]] | *[[male|Male gender]] | ||
*Family or personal history of [[melanoma]] | *[[family history|Family]] or personal history of [[melanoma]] | ||
*Multiple benign or atypical [[Nevus|nevi]] | *Multiple [[benign]] or atypical [[Nevus|nevi]] | ||
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* | *Presence of ABCD characteristics | ||
*[[Bleeding]] or [[ulceration]] may | *[[Bleeding]] or [[ulceration]] may be related to [[malignancy]] | ||
*Serum [[LDH]] may be elevated in case of [[malignancy]] | *Serum [[LDH]] may be elevated in case of [[malignancy]] | ||
*[[Biopsy]] | *[[Biopsy]] | ||
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*1-2 to hundreds of [[granules]] | *1-2 to hundreds of [[granules]] | ||
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*[[Neural crest cell]] derivative | *[[Neural crest cell]] [[Derivative (chemistry)|derivative]] | ||
*Development begins with disruption of [[nevus]] growth control | *Development begins with disruption of [[nevus]] growth control | ||
*Progression involves [[MAPK/ERK pathway]] | *Progression involves [[MAPK/ERK pathway]] | ||
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*Rice-like [[granules]] or [[spots]] | *Rice-like [[granules]] or [[spots]] | ||
*Small, [[painless]], [[ | *Small, [[pain|painless]], raised, [[pale]], [[erythema|red]] or white | ||
*1 to 3 mm in [[diameter]] | *1 to 3 mm in [[diameter]] | ||
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*Greasy skin types | *Greasy [[skin]] types | ||
*Some [[Rheumatic|rheumatic disorders]] | *Some [[Rheumatic|rheumatic disorders]] | ||
*[[Hereditary nonpolyposis colorectal cancer]] | *[[Hereditary nonpolyposis colorectal cancer]] | ||
**Lower [[gingiva]] (gums) | **Lower [[gingiva]] ([[gingiva|gums]]) | ||
**[[Vestibular system|Vestibular mucosa]] | **[[Vestibular system|Vestibular mucosa]] | ||
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*Small [[keratin]]-filled [[pseudocysts]] | *Small [[keratin]]-filled [[pseudocysts]] | ||
*May be seen on [[incidental]] [[mucosal]] [[biopsy]] | *May be seen on [[incidental]] [[mucosal]] [[biopsy]] | ||
**[[Biopsy]] not done for | **[[Biopsy]] not done for [[patients]] primarily | ||
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*[[Oral cavity]] | *[[mouth|Oral cavity]] | ||
**[[Vermillion border|Vermilion border]] of the lips | **[[Vermillion border|Vermilion border]] of the [[lip|lips]] | ||
**[[Oral mucosa]] of the upper lip | **[[Oral mucosa]] of the [[lip|upper lip]] | ||
*[[Buccal mucosa]] in the commissural region often bilaterally | *[[Buccal mucosa]] in the commissural region often bilaterally | ||
*[[Genitals]] | *[[Genitals]] | ||
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*[[Menopause]] | *[[Menopause]] | ||
*[[Oral thrush]] or [[dry mouth]], or damaged [[nerves]] transmitting taste | *[[Oral thrush]] or [[dry mouth]], or damaged [[nerves]] transmitting taste | ||
*[[Female gender ]] | *[[female|Female gender]] | ||
*[[Menopause]] | *[[Menopause]] | ||
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*[[Physical exam]] | *[[Physical exam]] | ||
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*[[Oral cavity]] | *[[mouth|Oral cavity]] | ||
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*Pain typically is | *[[Pain]] typically is mild in the morning and builds up over the day | ||
*Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective | *Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective | ||
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|[[Torus palatinus]] | |[[Torus palatinus]] | ||
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*Bony growth on midline of the [[hard palate]] | *[[bone|Bony]] growth on midline of the [[hard palate]] | ||
*[[Nodular]] mass covered with normal [[mucosa]] | *[[Nodular]] [[mass]] covered with normal [[mucosa]] | ||
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*[[Genetic predisposition]] | *[[Genetic predisposition]] | ||
**[[Autosomal dominant]] | **[[Autosomal dominant]] | ||
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*[[Physical | *[[Physical examination]] | ||
*Types | *Types: | ||
**[[Torus palatinus|Flat tori]] | **[[Torus palatinus|Flat tori]] | ||
**[[Torus palatinus|Spindle tori]] | **[[Torus palatinus|Spindle tori]] | ||
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*Twice more common in [[females]] | *Twice more common in [[females]] | ||
*Repeated [[trauma]] can cause [[bleeding]] | *Repeated [[trauma]] can cause [[bleeding]] | ||
*[[Surgery]] may be required in symptomatic | *[[Surgery]] may be required in [[symptom|symptomatic]] [[patients]] | ||
|[[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]] | |[[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]] | ||
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|[[Behçet's disease|Behcet's disease]] | |[[Behçet's disease|Behcet's disease]] | ||
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*Painful [[mouth sores]] | *[[pain|Painful]] [[mouth sores]] | ||
*[[Acne]] like skin lesions | *[[Acne]] like [[skin]] lesions | ||
*Headache, [[fever]], | *[[Headache]], [[fever]], [[Balance disorder|poor balance]] and [[disorientation]] | ||
*[[Abdominal pain]], [[diarrhea]] or [[bleeding]] | *[[Abdominal pain]], [[diarrhea]] or [[bleeding]] | ||
*[[Uveitis]] | *[[Uveitis]] | ||
*Joint [[swelling]] and joint [[pain]] | *[[Joint]] [[swelling]] and [[joint]] [[pain]] | ||
*Genital [[sores]] wit [[pain]] and [[scaring]] | *[[Sex organ|Genital]] [[sores]] wit [[pain]] and [[scaring]] | ||
*[[Aneurysms]] | *[[Aneurysms]] | ||
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* | *Overactive [[immune system]] | ||
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*[[Physical examination]] | *[[Physical examination]] | ||
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*[[Mouth]] | *[[Mouth]] | ||
*[[Genitals]] | *[[Sex organ|Genitals]] | ||
*[[GIT]] | *[[Gastrointestinal tract|GIT]] | ||
*[[Eye]] | *[[Eye]] | ||
*[[Joints]] | *[[Joints]] | ||
*[[Skin]] | *[[Skin]] | ||
*[[Vascular system]] | *[[Circulatory system|Vascular system]] | ||
*[[Brain]] | *[[Brain]] | ||
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Revision as of 06:54, 15 May 2021
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 within the recent years an increase in oral HSV-2 infections has been reported.[1]
- A majority of primary HSV-1 infections occur during childhood and if the virus comes into contact with the mucosa or abraded skin, it can cause acute herpetic gingivostomatitis (inflammation of the cheek's mucosa 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 patients, the virus reactivates to cause recurrent infection; which is more common with HSV-1 than HSV-2 oral infection.[1] [2]
- 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 (vermillion 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] [3]
- Oral herpes is spread by direct contact with an active sore in an infected person, for instance, by 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 | ||||||
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[6] |
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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 1.5 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
- ↑ 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.