1/23. herpes simplex-associated erythema multiforme (HAEM): a clinical therapeutic dilemma.erythema multiforme of the mouth is an acute vesiculo-ulcerative lesion, which presents a diagnostic and therapeutic challenge to the clinician. herpes simplex is described as the most frequent cause of this disease. Controversy exists in the literature as to the definition of oral erythema multiforme and the role of systemic corticosteroids in its treatment. Recent treatment protocols advocate the use of systemic acyclovir, especially in cases triggered by the herpes simplex virus. Two cases of successful treatment of oral erythema multiforme with systemic corticosteroids after acyclovir treatment had failed are presented.- - - - - - - - - - ranking = 1keywords = ulcer, mouth (Clic here for more details about this article) |
2/23. Atypical herpes simplex can mimic a flare of disease activity in patients with pemphigus vulgaris.We present a 69-year-old white woman with pemphigus vulgaris limited to the oral mucosa who presented with oral pain and difficulty swallowing of 2 days duration, followed by multiple irregular ulcers arising from normal mucosa with no grouping of individual lesions--herpes simplex should be considered in the differential diagnosis of lesions that appear suddenly in patients with PV, particularly if the lesions fail to respond to an increased dose of corticosteroids.- - - - - - - - - - ranking = 0.89308311554869keywords = ulcer (Clic here for more details about this article) |
3/23. erythema multiforme secondary to herpes simplex infection: a case report.BACKGROUND: erythema multiforme (EM) is a complex disease that may have cutaneous and/or mucosal involvement. The severity may range from mild to severe and potentially life threatening. The literature cites many factors including viruses, infections, and medications as causes. This report documents a patient who developed EM secondary to a herpes simplex viral (HSV) infection. methods: Two weeks following an eruption of herpes labialis, a 20-year-old white female patient developed acutely painful oral and labial ulcers accompanied by target skin lesions. A diagnosis of erythema multiforme (EM) was made. The patient was treated with antivirals, analgesics, and symptomatic therapy. RESULTS: Nine days after the onset of symptoms, the oral and cutaneous lesions had started to heal and the patient no longer required pain medication. CONCLUSIONS: Although the etiology of EM is still often unknown, infections with herpes simplex virus have been implicated as a possible precipitating factor. This case illustrates the association of the occurrence of EM with an HSV infection.- - - - - - - - - - ranking = 0.89308311554869keywords = ulcer (Clic here for more details about this article) |
4/23. Case study: inoculation herpes barbae.A 21-year-old white man in otherwise excellent general health was referred for a painful, progressive, facial eruption with associated fever, malaise, and cervicofacial lymphadenopathy. The patient reported that a vesicular eruption progressed from the left side of his face to also involve the right side of his face over the 48 hours preceding his clinic visit. He also reported some lesions in his throat and the back of his mouth causing pain and difficulty swallowing. Four to 7 days before presentation to us, the patient noted exposure to his girlfriend's cold sore. Additionally, he complained of a personal history of cold sores, but had no recent outbreaks. physical examination revealed a somewhat ill man with numerous vesicles and donut-shaped, 2-4 mm, crusted erosions predominantly on the left side of the bearded facial skin. There were fewer, but similar-appearing lesions, on the right-bearded skin. The lesions appeared folliculocentric (Figure). Cervical and submandibular lymphadenopathy was present. Oral exam showed shallow erosions on the tonsillar pillars and soft palate. Genital examination was normal. The remainder of the physical exam was unremarkable. A Tzanck smear of vesicular lesions was positive for balloon cells and many multinucleated giant cells with nuclear molding. A viral culture was performed which, in several days, came back positive for herpes simplex virus. The complete blood cell count documented a white blood cell count of 8000/mm3 with 82.6% neutrophils and 9.0% lymphocytes. Based on the clinical presentation and the positive Tzanck smear, the patient was diagnosed with herpes simplex barbae, most likely spread by shaving. The patient was started on acyclovir 200 mg p.o. five times daily for 10 days. oxycodone 5 mg in addition to acetaminophen 325 mg (Percocet; Endo Pharmaceuticals, Chadds Ford, PA) was prescribed for pain relief. A 1:1:1 suspension of viscous lidocaine (Xylocaine; AstraZeneca Pharmaceuticals LP, Wilmington, DE), diphenhydramine (Benadryl; Pfizer Inc., New York, NY), and attapulgite (Kaopectate; Pfizer Inc., new york, NY) was given as a swish and spit to relieve the oral discomfort. Good hygiene, no skin-to-skin contact with others, and no further shaving to prevent autoinoculation were stressed. He was advised to discard his old razor.- - - - - - - - - - ranking = 0.10691688445131keywords = mouth (Clic here for more details about this article) |
5/23. Complex oral manifestations of an hiv-seropositive patient.A complex manifestation of characteristic oral lesions occurring simultaneously in an hiv-seropositive patient is presented. Necrotizing ulcerative gingivitis (NUG), necrotizing ulcerative periodontitis (NUP), oral-facial herpes infection, pseudomembranous candidiasis and atypical oral ulceration are discussed. In spite of extremely low CD4 T-cell counts of 3 x 10(6)/L and lack of anti-retroviral therapy, an AIDS patient responded favourably to standard periodontal therapy. In the follow-up period of 3 months, no recurrence of any of the oral lesions initially present occurred and no special prophylactic regimes were needed to maintain oral health. This case illustrates that appropriate management of the oral manifestations contributes significantly to improvement of the quality of life of patients in the terminal stage of hiv-AIDS.- - - - - - - - - - ranking = 313.85927717239keywords = oral ulcer, ulcer (Clic here for more details about this article) |
6/23. Oral herpetic lesions in an edentulous patient.This article reports a case of oral herpetic lesions that recurred several times over 1 1/2 years in an edentulous 65-year-old woman. The patient was under treatment for complete dentures at the new jersey Dental School. A differential diagnosis of mucosal ulcerative lesions is described, along with the laboratory methodology for confirmation of herpes simplex virus type 1 (HSV-1) infection.- - - - - - - - - - ranking = 0.89308311554869keywords = ulcer (Clic here for more details about this article) |
7/23. Characterization of a dna polymerase mutant of herpes simplex virus from a severely immunocompromised patient receiving acyclovir.A series of herpes simplex virus isolates were recovered from a bone marrow transplant patient who received prolonged acyclovir therapy for indolent herpes simplex mouth and throat ulceration. Of 14 isolates received 10 were resistant to acyclovir and partially resistant to phosphonoacetic acid. Biochemical characterization revealed that resistance was due to an alteration in the virus dna polymerase. dna sequence analysis of the polymerase gene of a plaque-purified resistant virus isolate revealed a single nucleotide change when compared with the sequence of the gene of a plaque-purified sensitive isolate. This single base change resulted in a predicted amino acid substitution of Gly to Ser at residue number 841, a putative functional region of the polymerase.- - - - - - - - - - ranking = 1keywords = ulcer, mouth (Clic here for more details about this article) |
8/23. EBV and HSV infections in a patient who had undergone bone marrow transplantation: oral manifestations and diagnosis by in situ nucleic acid hybridization.The course of infections with herpes simplex virus and Epstein-Barr virus in an immunosuppressed patient who had undergone bone marrow transplantation and had tested seronegative for human immunodeficiency virus is described. The clinical oral manifestations were unusual, as they included hairy leukoplakia-like lesions and extensive mucosal ulceration. Histologic examination disclosed unique features consisting of both lichenoid and viral cytopathic changes. The association of the lesions with both Epstein-Barr virus and herpes simplex virus was confirmed by in situ hybridization histochemistry. The importance of recognition of the symptoms, specific diagnosis by dna hybridization, and implications for antiviral prophylaxis and therapy are emphasized.- - - - - - - - - - ranking = 0.89308311554869keywords = ulcer (Clic here for more details about this article) |
9/23. Therapeutic effect of human fibroblast interferon on premalignant lesions arising in oral mucosa. A pilot study.Human fibroblast interferon (HuIFN-beta) was topically administered to 20 premalignant lesions histopathologically showing epithelial dysplasia such as leukoplakia and lichen planus which arose in the oral mucosa. HuIFN-beta was prepared in the water-soluble gel form containing 2% carboxymethylcellulose, 45% glycelin, 0.1 M citrate buffer (pH 4.5) and 0.2% SDS as stabilizing agents. This preparation was found to be effective for herpetic gingivostomatitis and zostal lesions arising along the intercostal nerve. Thus, the HuIFN-beta preparation (10(4) to 5 X 10(3) IU) was applied to the oral mucosal lesion for 1 h twice a week. The lesion with topical administration of HuIFN-beta was covered tightly with the mucosal bandage which was coated with carboxymethylcellulose, glycelin and CaCl2 on vinyl acetate matrix. The 14 oral lesions with erosion or ulcer formation accompanied by severe pain by touch, had complete remission after approximately 10 successive applications of this preparation. Although subjective symptoms such as irritation pain in the other 6 patients with severe hyperkeratotic lesion subsided, white coatings and streaks could not be completely removed by this therapy. No other side-effects excluding slight pain and reddish swelling which occurred intermittently during HuIFN-beta administration were observed.- - - - - - - - - - ranking = 0.89308311554869keywords = ulcer (Clic here for more details about this article) |
10/23. herpes simplex infection associated with pemphigus vulgaris. Case report and literature review.A 55-year-old man had an 8-week history of oral ulcers. Studies revealed concurrent pemphigus vulgaris and active herpes simplex infection. There have been seven previous case reports of this association, and these are reviewed.- - - - - - - - - - ranking = 312.07311094129keywords = oral ulcer, ulcer (Clic here for more details about this article) |
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