What Is Herpetic Stomatitis?

Herpes simplex virus infection is mainly transmitted through direct contact with droplets, saliva, and herpes fluids. It can also be transmitted indirectly through utensils and clothing. The infection is mainly through the respiratory tract, mouth, nose, conjunctiva, genital mucosa or damaged skin. human body.

Guan Xiaobing	(Chief physician)	Department of Oral Mucosa, Beijing Stomatological Hospital
Park King Ping	(Attending physician)	Department of Oral Mucosa, Beijing Stomatological Hospital

Herpes stomatitis is an infectious disease of the oral mucosa caused by the herpes simplex virus. It is clinically characterized by the appearance of clustered small blisters, which is self-limiting and easy to relapse.

Western Medicine Name

Herpes stomatitis

Affiliated Department

Department of Physiology-Stomatology

Disease site

Oral cavity

Main cause

Herpes simplex virus infection

Causes of herpes stomatitis

Herpes simplex virus infection is mainly transmitted through direct contact with droplets, saliva, and herpes fluids. It can also be transmitted indirectly through utensils and clothing. The infection is mainly through the respiratory tract, mouth, nose, conjunctiva, genital mucosa or damaged skin. human body.

Clinical manifestations of herpes stomatitis

Primary herpes stomatitis

(1) More common in children under 6 years old, most from 6 months to 2 years old.

(2) Prodromal symptoms are severe, and symptoms such as fever, headache, fatigue and discomfort, muscle pain, and lymphadenopathy may occur.

(3) Any part of the oral mucosa can be affected. It is most obvious near the palate and gingival margin of the primary molars (adult premolars). It is mainly manifested as clusters of small blisters that are easy to break and form large areas of erosion.

(4) The course of the disease is about 7 to 10 days, which is self-limiting.

Recurrent herpetic stomatitis

(1) Common in adults, the course of disease is about 1 to 2 weeks.

(2) Causes include infection, fatigue, sun exposure, local irritation, emotional stress, gastrointestinal disorders, and environmental changes.

(3) The lesion is usually on or near the lips, and it is mainly manifested in the process of burning-blistering-erosion-scab.

(4) No scar remains after the lesion heals, but there may be pigmentation.

Diagnosis of herpes stomatitis

In most cases, a diagnosis can be made based on clinical manifestations. Laboratory tests are only used for final diagnosis. Common methods include non-specific herpes virus tests and specific herpes virus tests.

Differential diagnosis of herpes stomatitis

1. Stomatitis aphthous ulcer: It is a scattered small ulcer with repetitive course and no blistering period. The ulcer is mainly distributed in the mucosa with poor keratosis in the oral cavity, which does not cause gingivitis, is rare in children, and has no skin damage.

2. Trigeminal shingles: Caused by varicella-zoster virus. The blister is distributed along the trigeminal nerve in a band-like arrangement, which does not exceed the midline. The pain is severe, and it usually does not recur after healing.

3. Hand, Foot and Mouth Disease: Caused by Coxsackie A16 virus, there are scattered blisters and pimples in the oral mucosa, palms, and soles of the feet, varying in number. The blisters in the mouth are easy to break and form ulcers.

4. Polymorphous erythema: A group of acute inflammatory skin mucosal diseases involving the skin and mucous membranes, with target-shaped or iris-shaped erythema as typical lesions, oral mucosa congestion and edema, sometimes visible erythema and blisters, herpes easy to break, and residual erosion Surface, the surface has a large amount of exudate to form a thick false film.

Herpes stomatitis treatment principles

1. Systemic antiviral therapy: nucleoside antivirals and ribavirin. For primary herpes stomatitis, acyclovir 200mg / time, 5 times / day, or ribavirin 200mg / time. , 3 to 4 times / day.

2. Local treatment: oral medication for oral mucosa. Frequently used preparations include solutions, pastes, powders and lozenges, such as compound boric acid solution, 0.1% 0.2% chlorhexidine solution, gargle, phthalbutamine ointment, acyclovir Wei ointment is applied topically, tin powder and Yangyinshengji powder are used topically, and chlorate gluconate has been included. For recurrent cold sores, local irradiation with helium-neon laser can also be used.

3. Symptomatic and Supportive Therapy: Patients with a severe condition should rest in bed, and those who have difficulty eating can receive intravenous fluids and supplement vitamins B and C.

4. Traditional Chinese medicine treatment. ^[1-2]