Oral lesions

Overview
In many cases, mouth sores are attributed to herpes simplex virus and idiopathic aphthous stomatitis. Oral lesions can be indicative of a more serious underlying condition. A full review of the systems and a full skin exam are necessary to obtain an accurate diagnosis.

Differential Diagnosis
In alphabetical order.


 * Agranulocytosis
 * Aphthous stomatitis
 * Allergic contact dermatitis
 * Behcet's disease
 * Bollus disease
 * Chemotherapy drugs
 * Erythema multiforme
 * Herpes stomatitis
 * Histoplasmosis
 * Primary syphilis
 * Self limited viral disease
 * Squamous cell carcinoma

History and Symptoms

 * Past medical/medicinal history
 * If the lesions occur in the same locations every time, culpit is HSV
 * Consider the patients sexual history
 * evaluate open and mucosal lesions
 * lichen planus - lacy white plaques

Laboratory Findings

 * culture for HSV-1
 * RPR
 * CBC
 * punch biopsy

Acute Pharmacotherapies

 * Orabase and topical steroids can increase speed of healing
 * Aphthous stomatitis - intralesional triamcinalone injections
 * HSV (recurrent) - acyclovir
 * Bollous disease - corticosteroids