 It is a viral infection of the oral mucous

membrane caused by herpes simplex virus-

I(HSV-I).
 Usually HERPES SIMPLEX VIRUS TYPE I
(HSV-1), and rarely TYPE II (HSV-2).
 It is usually seen between the ages of 6 months
and 6 years
 The onset of the disease is abrupt and is clinically
characterized by HIGH FEVER, HEADACHE,
MALAISE, ANOREXIA, IRRITABILITY,
BILATERAL SENSATIVE REGIONAL
LYMPHADENOPATHY, and SORE MOUTH
LESIONS.
 The affected mucosa is RED and EDEMATOUS,
with numerous coalescing VESICLES, which
rapidly rupture, leaving painful small, round,
shallow ULCERS, covered by yellow fibrin
 New LESIONS continue to develop during the first
3-5 days
 The ulcers heal in 10-14 days.
 Both movable and non movable oral mucosa may
be affected.
 GINGIVAL LESIONS are almost always present,
resulting in enlargement and edematous and
painful erosions.
 1-3 days of fever , loss of appetite and myalgia
 Cervical lymphadenopathy is present.
 After the Primary infection the virus remains latent
in the nerve tissues.
 If reactivation occurs it causes herpes labialis
(cold sore).
 The virus targets the epithelial cells which show
“ballooning degeneration”
 These cells are called Tzanck cells.
 Infected cells fuse , forming multinucleated cells
and infected cells edema leads to formation of an
intraepithelial vesicles that rupture and develops a
secondary inflammatory response with a fibro
purulent exudate
 Discrete ulceration have a central portion of acute
inflammation with exudate surrounded by
engorged blood vessels.
 Established from patients history & clinical
findings.
 HSV isolation by cell culture is the gold
standard.
 Tzanck smear
 BIOPSY
 SEROLOGICAL TESTS.
 Necrotizing Ulcerative Gingivitis
 Erythema multiforme
 Stevens-Johnson Syndrome
 Apthous Stomatitis (canker sores)
 Herpangina
 Desquamative gingivitis
 Early pemphigus
 Aphthous ulcers
 1. Local Applications:
 *Using topical lignocaine and benzocaine
in mild cases.
 *topical steroids like triamcinolone and
clobetasol application in severe cases.
 2. Systemic therapy :
 *pentroxifylline daspsone short bursts of
systemic steroids & thalidomide have been
used to reduce the no. of ulcers and
recurrence.